9.1 Dementia and Care of Cognitively Impaired Residents
Key Takeaways
- Dementia care prioritizes safety, routine, reassurance, dignity, and simple communication.
- Approach from the front, use the resident's name, and give one instruction at a time.
- Do not argue with delusions; redirect and validate feelings when appropriate.
- Sudden confusion is not normal dementia progression and should be reported.
- Behavior often signals an unmet need such as pain, hunger, toileting, fear, or overstimulation.
Dementia Care Principles
Dementia affects memory, thinking, judgment, communication, and behavior. The CNA's goal is not to win arguments. The goal is safety and calm care.
Communication
Use these habits:
- Approach from the front.
- Make eye contact if culturally appropriate.
- Say the resident's name.
- Introduce yourself each time if needed.
- Use short sentences.
- Give one step at a time.
- Allow extra time.
- Avoid arguing.
Redirection
If a resident says, "I need to go home," do not respond, "This is your home now, remember?" That can increase distress.
A better response is: "You are safe here. Tell me about your home while we walk to lunch."
Behavior As Communication
Agitation may mean pain, fear, toileting need, hunger, noise, loneliness, infection, or fatigue. Look for triggers.
Report sudden behavior changes. New confusion can be delirium from infection, dehydration, low oxygen, medication effects, or other urgent problems.
Wandering And Safety
Residents who wander need supervision, safe walking paths, ID safeguards, and prompt reporting if missing. Do not lock a resident in a room or restrain for convenience.
Exam Tip
The best answer usually validates feelings, redirects gently, protects safety, and reports sudden changes.
A resident with dementia insists they must pick up children from school. What is the best response?
A normally alert resident becomes suddenly confused. What should the CNA do?