Dementia Companion: Guide for Additional Caregivers in Nursing Care

Description:

The successful book for additional caregivers now in an updated 4th edition. Caregivers take on an important task in the care and accompaniment of people with dementia and contribute to the improvement of the individual living situation. This handbook supports not only everyday caregivers, but also volunteers and professional caregivers in their meaningful and demanding task. All the important basics are explained in an understandable way to help people with dementia or mental illness to cope with their everyday lives. Learn more about: Disease theory, everyday life design and employment offers, care quality, first aid in difficult situations, housekeeping. The book is coordinated with all contents of the advanced training for additional caregivers according to § 87b SGB XI. In addition, there are tips and checklists for the internship, for reflection and self-care. For caregivers in training and practice, and for all people who accompany people with dementia or limited everyday competence.

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Preface

» “Time for care”

This was the title of the article in the German Medical Journal in June 2012 about dementia companions in the care and support of seniors. Although the various professional groups, the public and the media expressed themselves predominantly negatively and rejectingly when the care staff directive was published, it has proven in practice that additional care has become a success story. A scientific evaluation commissioned by the GKV-Spitzenverband confirmed the high satisfaction of the participants.

From our point of view, the critical attitude was not justified even then, because the accompaniment of a person with dementia is learnable. In the directive on the qualifications and tasks of additional care staff published in August 2008, the requirements for dementia companions were fundamentally defined.

Requirements for care staff

• A positive attitude towards sick, disabled and elderly people
• Social competence and communication skills
• Observation and perception skills
• Empathy and relationship skills
• The willingness and ability to communicate non-verbally
• Imagination, creativity and flexibility
• Composure in dealing with behavioral peculiarities resulting from dementia and mental illnesses or intellectual disabilities
• Psychological stability, ability to reflect on one’s own actions, ability to set boundaries
• Ability to accompany and guide individuals or groups of people with dementia, mental illnesses or intellectual disabilities with dignity
• Teamwork skills
• Reliability

Our concern remains to equip the future dementia companions with these necessary knowledge and skills through this book, so that they can fulfill their important and beautiful task with joy and creativity. We wish all those affected and their relatives such a companion who walks a part of the way with them.

» “What you tell me, I forget.

What you show me, I remember. What you let me do, I understand.” Confucius

We thank Ms. Sarah Busch, our “companion” at Springer Verlag, who always supports us competently. We thank Ms. Ulrike Niesel for the prudent project management, who has accompanied us for many years.

Ms. Barbara Lengricht, who accompanied us with heart and commitment in the first edition, made this book possible. We would also like to thank her warmly.

We owe great thanks to our friends and colleagues, but especially to our families, for their understanding, support and tolerance.

Martina Döbele Simone Schmidt

Table of contents :
Foreword
Preface
Contents
List of Abbreviations
1 Dementia
1.1  Disease
1.1.1  Forms of Dementia
1.1.1.1  Classification of Dementia According to ICD-10
1.1.1.2  Severity Levels
1.1.2  Symptoms
1.1.2.1  Consequences of the Symptoms
1.1.3  Diagnosis and Differential Diagnosis
1.1.4  Prognosis
1.1.5  Treatment
1.1.5.1  Medicinal Treatment
1.1.5.2  Non-pharmacological Treatment
1.1.5.3  Prevention
1.1.5.4  Complications
2 Mental Disorders
2.1  Psychosis
2.1.1  Classification of Psychoses
2.1.2  Symptoms of Psychosis
2.1.2.1  Paranoid Symptoms
2.1.2.2  Hallucinations
2.1.3  Treatment and Care
2.2  Depression
2.2.1  Symptoms of Depression
2.2.2  Treatment and Dealing with Depressive people
2.3  Mental Disability
2.3.1  Symptoms of Mental Retardation
2.3.2  Treatment Options
3 Dealing with People with Dementia
3.1  Communication
3.2  Communication with People with Dementia
3.2.1  Communication Problems
3.3  Interaction
3.4  Dealing with People with Dementia
3.4.1  Attitude
3.4.2  Getting to Know
3.4.3  Nonverbal Communication
3.4.3.1  Facial Expressions
3.4.3.2  Gestures
3.4.3.3  Touches
3.4.4  Verbal Communication
3.4.4.1  Word Finding Difficulties
3.4.4.2  Interpretation of Communication
3.4.4.3  Form of Address “Sie” or “Du”
3.4.4.4  “We Don’t Talk About That”
3.4.4.5  Conflicts
3.4.4.6  Truth or Lie?
3.4.4.7  Coercion and Violence
3.4.4.8  Signal- or Key Words
3.5  Biography
3.5.1  External Biography
3.5.2  Internal Biography
3.6  Communication Games
4 Age-Related Diseases
4.1  Diabetes Mellitus
4.1.1  Clinical Picture
4.1.1.1  Type 1-Diabetes
4.1.1.2  Type 2-Diabetes
z Complications
4.1.2  Diagnosis and Treatment
4.1.3  Hyperglycemia (Hyperglycemia)
4.1.4  Hypoglycemia (Hypoglycemia)
4.2  Degenerative Diseases of the Musculoskeletal System
4.2.1  Joint Wear (Osteoarthritis)
4.2.1.1  Causes
4.2.1.2  Symptoms
4.2.1.3  Diagnosis and Treatment
4.2.2  Osteoporosis (Bone Loss)
4.2.2.1  Causes and Symptoms
4.2.2.2  Diagnosis and Treatment
4.3  Cardiovascular Diseases
4.3.1  Heart Diseases
4.3.2  The Blood Pressure
4.3.2.1  Low Blood Pressure (Hypotension)
4.3.2.2  High Blood Pressure (Hypertension)
4.3.3  Stroke (Apoplexy)
4.3.3.1  Consequences of Stroke
4.3.3.2  Treatment and Care After Stroke
5 Care and Documentation
5.1  Care Process
5.1.1  Phase 1: The Information Collection
5.1.2  Phase 2: Recognizing Resources and Care Problems
5.1.2.1  Resources – Promoting and Maintaining Independence
5.1.2.2  Care Problems
5.1.3  Phase 3: Determination of the Care Goals
5.1.3.1  Maintenance Goals
5.1.3.2  Rehabilitation Goals
5.1.3.3  Coping Goals
5.1.4  Phase 4: Planning of Care Measures
5.1.4.1  Care Standard
5.1.5  Implementation of Care
5.1.5.1  The Nursing Report
5.1.6  Evaluation (Evaluation)
5.2  Nursing Documentation
5.2.1  Structure of the Nursing Documentation
5.2.2  Content-Related Criteria
5.2.3  Formal Criteria
5.3  Basic Knowledge of Nursing
5.3.1  Activating Care
5.3.2  Degrees of Independence
5.3.2.1  Independence
5.3.2.2  Predominant Independence
5.3.2.3  Predominant Dependence
5.3.2.4  Dependence
5.3.3  The Need for Assistance
5.4  AEDL Structuring Model
5.4.1  Communicating
5.4.2  Moving Around
5.4.2.1  Support when Walking
5.4.2.2  Support when Getting up and Sitting Down
5.4.2.3  Positioning in Bed
5.4.2.4  Fall Prevention
5.4.3  Maintaining Vital Functions of Life
5.4.4  Care for Oneself
5.4.5  Eating and Drinking
5.4.5.1  Swallowing Disorders (Dysphagia)
5.4.6  Excretion
5.4.6.1  Urinary Incontinence
5.4.7  Dressing Oneself
5.4.8  Resting and Sleeping
5.4.9  Keeping Busy
5.4.10  Feeling as a Man or Woman
5.4.10.1  Intimate Sphere
5.4.11  Ensuring a Safe Environment
5.4.12  Securing Social Areas of Life
5.4.13  Dealing with Existential Experiences of Life Cope
5.4.13.1  Faith
5.5  Care Documentation
5.5.1  Structure of the Documentation
5.5.2  Contents of the Care Documentation
5.5.3  Documentation in the Outpatient Sector
5.5.4  De-bureaucratized nursing documentation
6 Care of People with Dementia
6.1  Occupation
6.2  Occupational Opportunities
6.2.1  Communication
6.2.2  Movement
6.2.3  Eating and Drinking
6.2.3.1  Preparation
6.2.3.2  Implementation
6.2.3.3  Follow-up
6.2.3.4  Food Intake in Dementia
6.2.4   Engaging
6.2.4.1  Special Features of Dementia
6.2.4.2  Individual Care
6.2.5  Securing Social Areas of Life
6.2.6  Resting and Sleeping
6.2.7  Feeling as a Man or Woman
6.2.8  Care for Oneself
6.2.9  Existential Experiences
6.2.9.1  Pastoral Care
6.2.9.2  Religious Needs
6.2.9.3  Memory Work
6.3  Daily Structure
6.3.1  Week Structure
6.4  Environmental Design
6.4.1  Orientation Aids
6.4.2  Animals
6.5  Person-Centered Interventions
6.5.1  Validation
6.5.2  DCM
6.5.2.1  Malignant Social Psychology According to Kitwood
6.5.2.2  Benign Social Psychology According to Kitwood
6.6  Expert Standard for Relationship Building in the Care of People with Dementia
6.6.1  Understanding Hypothesis
6.7  Organization
6.7.1  Preparation
6.7.2  Implementation
6.7.3  Follow-up
7 Nutrition
7.1  Components of Nutrition
7.1.1  Macronutrients (Carbohydrates, Fat and Protein)
7.1.1.1  Carbohydrates
7.1.1.2  Fats (Oils)
7.1.1.3  Proteins
7.1.1.4  Fiber
7.1.2  Micronutrients (Vitamins, Minerals, Trace Elements, Secondary Plant Substances)
7.1.2.1  Vitamins
7.1.2.2  Minerals
7.1.2.3  Trace Elements
7.1.2.4  Secondary Plant Substances
7.2  Healthy, Balanced Diet
7.2.1  Body Weight
7.2.2  Energy Requirement
7.2.3  Calculation of the Energy Requirement
7.3  Over-, Mal- and undernutrition
7.3.1  Physical Changes in Old Age—Loss of Muscle Mass
7.3.2  Overweight (Obesity)
7.3.2.1  Overweight Reduce
7.3.3  Underweight -Malnutrition (Malnutrition)
7.3.3.1  Causes of Malnutrition
7.3.3.2  Nutritional Measures for Malnutrition
7.4  Diet or Hospital Diet
7.4.1  Diet
7.4.1.1  Diabetes Diet
7.4.2  Light Diet
7.4.3  Liquid Nutrition
7.4.4  Artificial Nutrition (Tube Feeding)
7.5  Balanced Fluid Balance
7.5.1  Lack of Thirst in Old Age
7.5.2  Dehydration (Dehydration)
7.5.2.1  Measures for Dehydration
8 Housekeeping
8.1  People with Dementia at Home
8.2  People with Dementia in Residential Groups
8.3  Household Care within the Framework of the Long-term Care Insurance
8.3.1  Shopping/Errands
8.3.1.1  Special Features When Shopping for Food
8.3.1.2  Helping with Shopping for Food
8.3.2  Preparing Meals/Cooking
8.3.2.1  Assistance in the Preparation of Meals
8.3.3  Dishes
8.3.3.1  Helping with Dishwashing
8.3.4  Cleaning the Apartment
8.3.4.1  Helping with Cleaning
8.3.5  Laundry Care
8.3.5.1  Helping with Laundry Care
8.3.6  Heating
9 First Aid
9.1  The Emergency
9.1.1  The Rescue Chain
9.1.2  The Emergency Call
9.2  Life-saving Immediate Measures
9.2.1  Recovery Position
9.2.2  Shock Treatment
9.3  First Aid for Cardiac Arrest
9.3.1  Chest Compression
9.3.2  Breathing Donation
9.4  First Aid for Injuries
9.4.1  Injury from Falls
9.4.1.1  Minor Fall
9.4.1.2  Severe Fall
9.4.2  First Aid for Bleeding
9.4.2.1  First Aid for Injury of an Artery
9.4.3  First Aid for Burns/Scalds
9.4.3.1  First Aid for Minor Burns/Scalds
9.4.3.2  First Aid for Major Burns/Scalds
9.4.4  First Aid for Poisoning
10 Legal Knowledge
10.1  Charter of Rights of People in Need of Help and Care
10.1.1  Significance of the Charter
10.2  Confidentiality
10.2.1  What is Covered by Confidentiality?
10.2.2  To Whom does Confidentiality Apply?
10.3  Important Legal Regulations
10.3.1  Long-term Care Insurance
10.3.2  Care Strengthening Acts 1 and 2
10.4  Crimes Against Life
10.5  Legal Guardianship
10.5.1  Power of Attorney
10.5.2  Advance Directive
10.6  Deprivation of Liberty
10.6.1  Restriction of Freedom by Mechanical Devices
10.6.2  Closed Accommodation
10.7  Protection Against Infection Act
11 Cooperation
11.1  Cooperation in the Facility
11.1.1  Organizational Structure
11.1.2  Responsibility
11.1.3  Job Description
11.1.4  Concept
11.2  Cooperation with Relatives
12 Outlook
Appendix
Glossary
References