A 2011 article in The New York Times described a nursing home in Phoenix, Arizona, with a different take on Alzheimer’s patients: They are people—individuals—with food preferences, interests, and things that make them happy. Rather than trying to fit all the square, triangular, and oval-shaped people into the same round hole, Beatitudes nursing home creates the niche to fit the patient.
Is This Behavior Management?
Alzheimer’s patients sometimes become agitated and can be quite a handful for nursing home staff. Instead of subduing these folk with antipsychotic drugs, Beatitudes has found the following effective treatments:
- allowing residents to sleep, bathe, and eat when they prefer;
- finding out their favorite foods, and supplying them;
- making food available all the time because residents tend to become distracted and eat less during group meals;
- dabbing one patient’s favorite cologne on her;
- giving another patient a baby doll to care for;
- providing as much chocolate or other treats as residents want;
- allowing them to have a nightcap in the evening, if that’s what they like; and
- providing one-on-one activities, rather than the usual group programs.
The Proof Is In the Pudding—Or the Chocolate
Tena Alonzo, Director of Research at Beatitudes, supports giving residents with Alzheimer’s virtually anything that brings them comfort and joy. “The state tried to cite us for having chocolate on the nursing chart,” she said. “They were like, ‘It’s not a medication.’ Yes, it is. It’s better than Xanax.”
Alonzo has witnessed the magic of simple pleasures on Alzheimer’s residents at Beatitudes. The results include
- very little sundowning, or agitation and difficult behavior that occurs particularly in the afternoon and evening;
- elimination of restraints, such as bedrails and deep-seat wheelchairs;
- a drastic reduction in antipsychotics and other behavior management drugs; and
- less use of diapers.
Research Supports This Approach
The latest research findings on care of Alzheimer’s patients show that caregivers can reduce distress and difficult behaviors by providing positive emotional experiences for them. Some techniques to accomplish this goal include the following:
- creating positive feelings with music, art, exercise, favorite foods, and individualized scheduling;
- getting patients involved with activities that use their skills; and
- encouraging caregivers to be more accepting.
A study done at the University of Iowa indicated that emotion persists even after cognition is diminished. People with brain damage that causes amnesia similar to that in Alzheimer’s patients watched film clips that were either sad and depressing or funny and happy. Six minutes later, although the participants could not recall what they had seen, the emotions evoked by the film clips remained.
Justin Feinstein, lead author in the study, points out the implications of this research. He says that the findings suggest that depression, agitation, and other behavioral problems that Alzheimer’s patients display may be brought on by events or feelings that the patients cannot explain because they don’t remember them.
Because a truly effective treatment for Alzheimer’s disease has yet to be found, high-quality caregiving is of paramount importance. Lisa P. Gwyther, education director for the Bryan Alzheimer’s Disease Research Center at Duke University, says, “There’s actually better evidence and more significant results in caregiver interventions than there is in anything to treat this disease so far.”
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