The Memory Unit OT

Remember when that resident could not stand up on their own? Well therapy services have done wonders and now they’re up and about all the time. So are those other few residents on the unit who have always been strong ambulators. They just won’t sit down, no matter how many times you ask.

So what do we do in this situation?

Like always, we have to start by considering the ‘why’ behind the behavior we’re noticing.

Remember that dementia and other neurocognitive impairments stem from some sort of damage or trauma to the brain tissue. This, of course, means that certain areas of the brain are just not functioning at their full capacity. Therefore we cannot expect our patients and residents to perform to full capacity.

So if I’m asking my resident to stand up, and he just won’t, I’m going to ask myself an initial series of questions:

• is he looking for something or someone?
• does he need to go to the bathroom?
• is he hungry or thirsty?
• is he bored?
• does he seem agitated?

These are just a few of the many questions we could ask ourselves in this sort of circumstance and they are just the beginning of the solution to the overall ‘problem’ we’ve encountered. We ultimately need to determine if there is an unmet need present in this situation, and then determine how we as the caregivers can modify our behaviors in order to best support this individual.

So let’s go back and take a look at how this works practically.

If I’m asking my resident to stand up, and she just won’t, I need to ask myself a series extrinsic questions with accompanying intrinsic questions:

• is he looking for something or someone? have I asked him what he’s up to?
• does he need to go to the bathroom? is he hungry or thirsty? have I assessed his posture and behavior? where are we in his general routine?
• is he bored? what can I give him to do that will be meaningful and purposeful for him?
• does he seem agitated? what sensory techniques or strategies can I use to help him regulate?

By adding these additional intrinsic questions, I’m able to better modify my own behaviors in order to both determine and meet her needs.

As always, it’s not a perfect formula. There may be instances in which you still need to grab that extra set of hands. But assessing the situation from a skilled mindset while asking ourselves extrinsic and intrinsic questions is often a successful approach.

In these instances, the solution might be finding some sort of seated task to redirect to. In other instances, that might not be the solution at all. You might need to instead find strategies to promote safety within purposeful ambulation. Just remember that if you were constantly being asked to remain seated for the entire day, you would probably get frustrated (especially if you felt like you had to get something done).

Identify those unmet needs, then do you’re best to meet them.