Monotony in Nursing Homes Can Cause Behavior Problems
At one time it used to be thought that over-stimulation could cause behavior problems in people with dementia. This notion has been overturned and it is now believed that the opposite is much more likely. Walk into most nursing homes and one of the most common observations is that routine rules and activities, for their mostly older client group, are few and far between. Recent studies have found that nursing homes with few activities and low levels of stimulation had actually increased the number of behaviors that people found difficult to manage.
It is believed that some people with dementia can receive so little stimulation that they may reach a state of sensory deprivation. Put in this situation, the theory goes, and many people will respond by using self stimulation or behaviors that show their discontent to the situation they are in. Studies have shown that in younger people social deprivation results in hallucinations, perceptual distortions which then lead to problem behaviors.
It is not hard to imagine and you can see it yourself when you work, visit friends and relatives or loved ones, in some nursing homes for people with Alzheimer's. Often the major difficulty is that too few staff are employed to care for too many people. Interactions between staff and residents in many nursing homes are minimal unless physical needs are being attended to. People with more complex physical needs take time away from people who do not. People in individual rooms, although they get more privacy, can become very isolated and even in shared living areas seating arrangements can minimize interaction (a good example is the spin dryer plan, where all the chairs have their backs to the wall).
Visiting relatives often have busy demanding jobs and home lives, so visits are often brief. Problems with verbal communication can make them think their visits are unappreciated or even go unnoticed. Relatives are not encouraged or taught how they can get more out of a visit to their loved ones. Relatives may feel that entertaining their loved ones by, for instance, taking them out, using photos to do reminiscence, is not their role when they pay so much to have their loved one cared for. It is a difficult balance.
Loneliness and boredom are common in care homes but they can be minimized and so can difficult behaviors. Research has shown that providing sensory stimulation decreased behavioral disturbances, especially vocally disruptive behaviors such as screaming.
Nursing homes should always have a dedicated member of staff who provides a program of activities. Part of the care staff's day should include time with residents for individual and group activities. Nursing homes should have transportation for trips out. They should also have outside areas such as gardens to promote exercise, independence, and of course, sensory stimulation.
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