Some common problems that are associated with clients, and offers some suggestions for providing effective care.

Agitation Restlessness Anxiety.

• Speak in a calm voice, remove noise and distractions.  Avoid abrupt movements.
•  Establish a routine and stick with it.
• Offer repetitive, familiar tasks, like folding towels, sorting things, looking at pictures.
• Play soft music.

Lack of understanding of language.

• Repeat yourself.
• Use simple phrases and messages.
• Break down complex tasks into small, simple ones.
• Use pictures and gestures

Lack of judgment regarding safety.

• Be aware of safety concerns in the home, report them to the supervisor.
• Use gates, close doors and windows, remove clutter.
• Keep areas well lit. Post signs or pictures (STOP signs on outside doors, picture of the toilet on bathroom door).
• Put stickers or colored tape on clear glass doors and windows to avoid walking into the glass.
• Use locks on doors or alarms that will sound when the door is opened.
• Be sure the client wears some form of identification: a bracelet, ID label, etc.
• Keep chemicals and medications out of sight and out of reach.
• Remove knobs on the stove, unplug small appliances.
• Check the refrigerator for spoiled food.
• Use non-skid mats in the bathroom.
• Do not leave client unattended.

Lack of awareness for self-care needs

• Encourage client to care for self asmuch as possible, offering reminders and simple directions.
• Don’t give too many choices about when to bathe, what to wear.
• Be directive.

Memory loss Disorientation to person, place, or time.

• Use calendars.
• Write notes.
• Keep pictures & familiar objects in view.
• Do not move furniture around.

Hallucinations

• Ignore them, if harmless.
• Reassure the client who is worried.
• Do not argue about the reality of what he sees or hears.
• Try to re-direct activity. Remain calm.

Catastrophic Reaction/Event

• Try to determine what caused the unreasonable reaction: fatigue, change in routine, noise, too much stimulation, pain, hunger, and need to toilet.
• Try to remove triggers.
• Remain calm and reassuring.
• Call for help as necessary.
• Provide for your own safety.

Resistance to bathing

• Try to preserve familiar routines. If the person always showered in the morning, continue to offer that rather than a tub bath in the evening.
• Give simple directions, not choices: “Take off your shirt. Now take off your pants. Now step into the shower.”
• Never leave the client alone.

Refusal to eat

• Check for dental pain or other illness.
• Offer one food at a time.
• Cut into small pieces.
• Serve food attractively, in good lighting.
• Play soft music.
• Offer food again in a few minutes.

Frustration, Depression

• Report signs of depression to supervisor: aches and pains, low energy, sleeplessness or excessive sleeping, lack of interest.
•     Encourage self-care and independence.
• Encourage social interaction
• Listen.

Violent behavior

• Block his blows.
• Do not hit back. Step out of reach.
• Do not leave client alone.
• Call for help as necessary.
• Offer reassurance, using calm voice.

Repetitive phrases, like, “I want to go home.”

• Be patient.
• Allow client to repeat himself.
• Respond each time with same phrase.
• Attempt to distract with new activity.
• Do not argue with him or try to silence him.

Incontinence

• Assist to toilet every hour or two.
• Maintain regular schedule for toileting.
• Record bowel movements.
• Check skin for redness or breakdown.
• Assist with peri care as necessary.
• Keep skin clean and dry.

Wandering Pacing

• Try to determine whether he is uncomfortable due to hunger, need for toileting, need for exercise.
• Remove the cause if possible.
• Provide safe path.

Inappropriate sexual behavior.

• Ignore remarks.
• Offer distractions, other activities change the subject.
• Offer privacy.
• Realize that this is part of the disease.
• Exposing oneself could signify:

            1.  need to toilet;

            2.  forgot to get dressed;

            3.  is too warm.

Hiding and hoarding things.

• Don’t leave things lying around.
• Look through wastebaskets before emptying them.
• Look frequently in his usual hiding places.
• Keep the home uncluttered.

Lack of recognition for own health needs

• Observe and report changes & areas of concern to supervisor.
• Offer familiar foods and frequent liquids.
• Monitor weight.