Introduction

My name is Jolanta Wlodarczyk I live in Ballylahan in County Mayo. I am currently working as a Health Care Assistant in Blackrock’s Nursing Home in County Mayo. My role involves taking care of older people helping them to get up and showered in the morning. I help feed some of the residents who are unable to feed themselves. I also help them go to the bathroom and in some cases when they are inconteninent I change their pads to make them feel more comfortable. I also do some activities with them and I like to spend time chatting to them when I have the time.

Understanding of challenging behaviour

Facts about challenging behaviour

There are four types of challenging behaviour:

1. Self – injurious behaviour (hitting, scratching and biting)

2. Aggressive behaviour (hitting others, screaming, spitting and kicking)

3. Sexualised behaviour (public masturbation, groping)

4. Property ( throwing objects and stealing)

Introduction to Dementia

Dementia is the decline of the memory and other cognitive functions in comparison with the client’s previous level of function as determined by a history of decline in performance and by abnormalities noted from clinical examination and neuropsychological tests. When a resident has dementia one or more areas of the brain are damaged and they cannot help their behaviour resulting from this damage.

Causes of challenging behaviour in relation to dementia

1. Biological – (pain, medication, the need for sensory stimulation)

2. Social – (boredom, looking for company someone to talk to , the need for some control in their lives)

3. Environmental – (this can be too much noise too much or too little light or being able to go for a walk when they want or to have their belongings with them.)

   1. Psychological – (feelings of loneliness, disempowerment, people having negative expectations of them)

Observable and measurable behaviour of challenging behaviour

Often people with dementia with challenging behaviour can bite scream, hit people. In some incidents they can use very abuse language towards staff and other residents. This makes life very difficult for both the residents and staff involved. In some cases they may go to the toilet in inappropriate places such as the bed or rooms that are vacant and unlocked. In a lot of cases they may try their best to get out the building they are in they may only want to go for a walk but we may believe they want to get out, and we try to stop them for their own safety.

Describe the concept of unmet need

An unmet need is a need that is not met. A resident with dementia may have some UN met needs that they cannot communicate to us. This can be very frustrating for both the HCA and the resident because the resident cannot tell the HCA what they need. An

example of this is a resident may want to go for a walk and the HCA may think they are just wandering; they may have gone for regular walks at home.

Analysis and assessment of resident using NDB model

Introduction of resident

Mary is a lady in her eighties living in a nursing home. She has dementia and can be aggressive screaming and shouting at staff. She was a teacher and was used to being in charge all her life. She was used to great respect in the community and was used to doing things her own way. She finds it very difficult to do what other people tell her and likes to do things in her own time.

Describe information from the first exercise

In the first exercise we discussed Mary who was a teacher, she can be aggressive and hate having a shower, and she takes a long time and likes to spend time folding tissues and doing things her way. She was a teacher and was used to being in charge.

Describe information from the analysis of the background factors:

Mary was a teacher, she is a native Irish speaker and is used to being in charge and having great respect from her family and the community.

Current Factors

Mary has pain in her legs and using a walking aid. She is in the early stages of dementia. She likes to have everything where she wants it and sometimes can get agitated with other residents.

Description of the needs driven behaviour

Mary does not wander she does get agitatated and repeat herself in a demanding way. She believes she should be in charge at all times and gives out to staff and screams if she does not get her own way.

Develop a plan for how you will deal with this resident in the future

In the future I will leave Mary until last to have her shower. I will let her fold her her tissues listen to what she has to say and let her choose what clothes she would like to wear. I will call her by her full title as this will show her more respect which I believe she will like.

Conclusions

Key learning’s from the course

I learned about the unmet needs of people with dementia and about the ABC and NDC models and the ways they can help us look after the resident who has dementia better.

How you will deal with the resident differently in the future

I will be more patient with Mary I will call her by her full title, give her more time to do what she wants and give her more choice. I will listen more to what she has to say and try to make her as comfortable as possible. I will let her fold her tissues and put everything in the places she wants to put them.

Any other conclusions

I believe what I have learned on this course will help me deal better with residents in the future. By looking at what triggers and causes challenging behaviour we can deal with it better and listen to the resident try to make more time to take them for walks spend more time with them and do more activities with them.