21 COGNITIVEDISORDERS 537
safety, structure, support, interpersonal
involvement, and social interaction.- Many clients with dementia receive care at
home rather than in institutional settings
(e.g., nursing homes). The caregiver role
(often assumed by a spouse or adult child)
can be physically and emotionally exhaust-
ing and stressful; this contributes to care-
giver role strain. To deal with the exhausting
demands of this role, family caregivers need
ongoing education and support from a health
care professional such as a nurse, social
worker, or case manager. - Caregivers must learn how to meet the client’s
physiologic and emotional needs and to pro-
tect him or her from injury. Areas for teaching
include monitoring the client’s health, avoid-
ing alcohol and recreational drugs, ensuring
adequate nutrition, scheduling regular check-
ups, getting adequate rest, promoting activity
and socialization, and helping the client to
maintain independence as much as possible. - The therapeutic relationship with clients
with dementia is supportive and protective
and recognizes the client’s individuality
and dignity.
For further learning, visit http://connection.lww.com.
REFERENCES
Allen-Burge, R., Stevens, A. B., & Burgio, L. D. (1999).
Effective behavioral interventions for decreasing
dementia-related challenging behavior in nursing
homes. International Journal of Geriatric Psychiatry,
14,213–232.
Alzheimer’s Association Mid-Iowa Chapter. (2002).
Des Moines, IA.
American Psychiatric Association. (2000). DSM-IV-TR:
Diagnostic and statistical manual of mental disorders-
text revision(4th ed.). Washington, DC: Author.
Boyd, M. A. (2001). Behavioral disturbances associated
with dementia: Nursing implications. Journal of the
American Psychiatric Nurses Association, 7(6),
S14–S22.
Caine, E. D., & Lyness, J. M. (2000). Delirium, dementia,
and amnestic and other cognitive disorders. In B. J.
Sadock & V. A. Sadock (Eds.), Comprehensive text-
book of psychiatry, Vol. 1(7th ed., pp. 854–923).
Philadelphia: Lippincott Williams & Wilkins.
Engelman, K. K., Matthews, R. M., & Altus, D. E. (2002).
Restoring dressing independence in persons with
Alzheimer’s disease: A pilot study. American Jour-
nal of Alzheimer’s Disease and Other Dementias,
17 (1), 37–43.
Finnema, E., Droes, R. M., Ribbe, M., & Van Tilburg, W.
(2000). The effects of emotion-oriented approaches in
the care of persons suffering from dementia: A review
of the literature. International Journal of Geriatric
Psychiatry, 15(2), 141–161.
Fung, W. Y., & Chien, W. T. (2002). The effectiveness of a
mutual support group for family caregivers of a rela-
tive with dementia. Archives of Psychiatric Nursing,
16 (3), 134–144.
Lo, R., & Brown, R. (2000). Caring for family carers and
people with dementia. The International Journal of
Psychiatric Nursing Research, 6(2), 684 –694.
Loscalzo, J. (2002). Homocysteine and dementias. New
England Journal of Medicine, 346(7), 466 – 468.
Maxmen, J. S., & Ward, N. G. (2002). Psychotropic drugs:
Fast facts(3rd ed.). New York: W. W. Norton &
Company.
Schultz, J. M., & Videbeck, S. L. (2002). Lippincott’s
manual of psychiatric nursing care plans(6th ed.).
Philadelphia: Lippincott Williams & Wilkins.
Seshadri, S., Beiser, A., Selhub, J., Jacques, P. F.,
Rosenberg, I. H., D’Agostino, R. B., Wilson, P. F.,
& Wolf, P. A. (2002). Plasma homocysteine as a risk
factor for dementia and Alzheimer’s disease. New
England Journal of Medicine, 346(7), 476–483.
Small, G. W. (2000). Alzheimer’s disease and other
dementias. In B. J. Sadock & V. A. Sadock (Eds.),
Comprehensive textbook of psychiatry, Vol. 2(7th ed.,
pp. 3068–3085). Philadelphia: Lippincott Williams &
Wilkins.
Spector, A., Orrell, M., Davies, S., & Woods, R. T. (2000).
Reminiscence therapy for dementia. Cochrane Data-
base Systematic Reviews,4, CD001120.
Williams, C. L., & Tappen, R. M. (1999). Can we create a
therapeutic relationship with nursing home residents
in the later stages of Alzheimer’s disease? Journal of
Psychosocial Nursing, 37(3), 28–35.ADDITIONAL READINGS
Hawranik, P. G., & Strain, L. A. (2001). Cognitive
impairment, disruptive behavior, and home care
utilization. Western Journal of Nursing Research,
23 (2), 148–162.
Keough, J., & Huebner, R. A. (2000). Treating dementia:
The complementing team approach of occupational
therapy and psychology. The Journal of Psychology,
134 (4), 375 – 391.
Neelon, V. J., Champagne, M. T., Carlson, J. R., & Funk,
S. G. (1996). The NEECHAM confusion scale: Con-
struction, validation, and clinical testing. Nursing
Research, 45(6), 324 – 330.
Schindler, R. J., & Cucio, C. P. (2000). Late-life dementia:
Review of the APA guidelines for patient manage-
ment. Geriatrics, 55(10), 55 – 62.