NURSING MANAGEMENT FOR DEMENTIA

Promoting the Client’s Safety

-Safety considerations involve protecting against injury, meeting physiological needs, and managing risks
posed by the environment,including internal stimuli such as delusions and hallucinations.

Promoting Adequate Sleep and Proper Nutrition,Hygiene, and Activity

- Clients require assistance to meet basic physiological needs.Clients may eat poorly because of limited
appetite or distraction at mealtimes.

-Balance between rest and activity is an essential component of the daily routine. Mild physical activity
such as walking promotes physical health but is not a cognitive challenge.

Structuring the Environment and Routine

-A structured environment and established routines can reassure clients with dementia. Familiar
surroundings and routines help eliminate some confusion and frustration from memory loss.

-The nurse needs to monitor and manage the client’s tolerance of stimulation. Generally, clients can
tolerate less stimulation when they are fatigued, hungry, or stressed. Also, with the progression of
dementia,tolerance for environmental stimuli decreases.

Providing Emotional Support

The therapeutic relationship between client and nurse involves “empathic caring,” which includes being
kind, respectful, calm, and reassuring and paying attention to the client. Nurses use these same qualities
with many different clients in various settings.

*For example, if the client is confused about getting dressed, the nurse might say,

"I’ll be glad to help you with that shirt. I’ll hold it for you while you put your arms in the sleeves. "
(offering self/suggesting collaboration)

*Supportive touch is effective with many clients. Touch can provide reassurance and convey caring
when words may not be understood.

Promoting Interaction and Involvement

-In a psychosocial model of dementia care, the nurse or caregiver plans activities that reinforce the
client’s identity and keep him or her engaged and involved in the business of living.