Some common problems that are associated with clients…


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.