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Effective Interventions with Dementia and Difficult Behaviors
On this track we will discuss excess disability. Key factors regarding excess disability concerning dementia related cases are understanding excess disability and how to avoid excess disability through identifying problems and finding the right approaches. If you believe that an understanding of excess disability may benefit the caregiver of your client, you might consider playing this track for him or her.
3 Factors Regarding Excess Disability Concerning Dementia
Factor #1 - Understanding Excess Disability
Karen stated, “My mom can still take care of herself pretty well considering how forgetful she is. But so often it is quicker and easier if I just take care of her and do things myself. For instance, the other day she got up and got dressed. She made breakfast for herself. After a while I noticed she was not eating. So I encouraged her to eat and told her we had to leave soon. About ten minutes later, I checked on her. She had only eaten a few bites. I would have been late for work at that rate, so I started feeding her.”
I stated to Karen, “The incapacity a person displays which is greater than the true disability is called excess disability. Think about it. Could Elaine do more for herself than she is currently doing?” Karen agreed that Elaine could be more capable if allowed more time for certain tasks or if she received better guidance. Think of your aging client with dementia. Have you found that if clients do not use skills, they lose them? Could excess disability be the reason for a rapid decline in some clients with dementia?
Factor #2 - Avoiding Excess Disability
Three Problems that Lead to Excess Disability
I asked Karen if she felt that Elaine could feed herself. Karen stated that Elaine could feed herself. I explained to Karen that she would not create an excess disability by feeding Elaine occasionally. I stated, “However, if you start to take over all or most of the time, you will create an excess disability. Your definition of success for Elaine must change as the dementia changes her.
If you do not regularly assess your mother and adapt the amount of help you are providing accordingly, you may either not help enough or help too much. Either way you could create that excess disability.” In addition to regular assessment and adapting help, I also reminded Karen that if a person with dementia does not use certain skills, he or she will lose them.
Think of your Elaine. Could your client’s skill sets be viewed as “use it or lose it?”
Factor #3 - Approaches
3 Approaches to Avoid Excess Disability
Karen stated, “I should probably think through how to help without doing too much. If I give her more time and guide her step by step, maybe she’ll be able to do more.” Karen began to do as little as possible, but helped when she was needed.
Think of your Elaine. Is your aging client with dementia in danger of gaining excess disability due to excessive or inadequate care-giving? Would it be helpful to play this track for the caregiver of your client?
On this track we have discussed excess disability. Key factors regarding excess disability concerning dementia related cases are understanding excess disability and how to avoid excess disability through identifying problems and finding the right approaches.
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