Care Challenges in Dementia

Dr.Groulx states that potential causes of wailing and screaming are the patient is in physical pain that they cannot communicate. Hunger, mental pain, depression, and medical or physiological factors may all be causes. Changes in the patient’s environment, the environment may be over stimulating/ under stimulating. The patient feels unsafe. Psychiatric causes such as if the patients need to love and be loved are not being met; the patient may feel loneliness and/ or abandonment. Psychosis, with its accompanying psychic pain and symptoms and deep anxiety may as well be causes of wailing and screaming.
In assessing this behavioural problem, Dr. Groulx suggests trying to understand what the person is feeling or the need that they are trying to communicate. Try to find a specific solution for the patient by using the five “Ws,” who, what, where, when and why. Dr. Groulx indicates assessing the patient using Dr. Jiska CohenMansfield, Theoretical Framework, which assesses the patient’s habits and personality, their current condition (Physical and Mental), and their Environment (Physical Psychosocial) to see if there have been any changes. A standard medical checkup should be completed
In regards to intervention, Dr. Groulx suggests beginning with a nonpharmacologic approach. Identify the need that is not being satisfied. Adapt the intervention to the patient’s needs, personal characteristics and environment. These approaches may include Speaking, touching (holding their hand, massaging the patient), placing the patient closer to where there is more action may all be ways to alleviate feelings of loneliness. Putting up pictures of “new family” of nursing staff can help with emotional needs. Providing regular zootherapy, or having a “live in” pet, calming music or having family members record their voices may also help with patients emotional needs. Providing the patient with uncomplicated and repetitive manual exercise, such as folding towels can help the patient feel useful and have a sense of worth. If none of these approaches work and a hidden medical problem has been ruled out, the use of medication to reduce anxiety, tension or depression may be a solution.

Dr. Amella and