Volume 1 Volume 2 Volume 3 Volume 4

About the Authors
Acknowledgments
Preface
User’s Guide

1. The Senses
   
   Sensory Stimulation
   
   
2. Vision
   
   How Vision Changes with Age
   What Staff Can Do
   Before Personal Care
   Keeping Residents Active
   What the Environment Can Do
   Lighting
   Ways to Improve Poor or Inadequate Lighting
   Color and Pattern
   Room Features
   
   
3. Hearing
   
   How Hearing Changes with Age
   What Staff Can Do
   Communication Techniques
   Socialization
   What the Environment Can Do
   Excess Noise
   Acoustical Treatments for Hard Surfaces
   
   
4. Smell and Taste
   
   How Smell and Taste Change with Age
   What Staff Can Do
   Incorporating Positive Smells and Tastes
   Using Smells with Personal Meaning
   Minimizing Negative Smells
   What the Environment Can Do
   Reducing Negative Odors
   Using Positive Smells and Tastes as Room Cues
   Using Aromatherapy
   Planting Therapeutic Gardens
   
   
5. Touch
   
   How Touch Changes with Age
   What Staff Can Do
   Incorporating Touch into Therapeutic Activities
   When Touch Is Not Appropriate
   What the Environment Can Do
   Improving the Textural Environment
   Avoiding Abrasive Elements
   Regulating Temperature
   

Bibliography
Index

Volume 2

About the Authors
Acknowledgments
Preface
User’s Guide

1. What Are Functional Abilities?
   
   Functional Abilities in Older People
   A Myth About Aging
   When Functional Abilities Become a Problem at Home
   Moving into Long-Term Care Facilities
   What is Excess Disability?
   Functional Abilities in Older People with Dementia
   Physical Factors
   Cognitive Factors
   Social Factors
   Environmental Factors
   Assessment as a Multidimensional Process
   Assessment of Physical Factors
   Assessment of Cognitive Factors
   Assessment of Social Factors
   Assessment of Environmental Factors
   
   
2. Orientation
   
   What Staff Can Do
   Orientation to Time
   Orientation to Place
   Reality Orientation Versus Validation
   What the Environment Can Do
   Spatial Adjacencies
   Cueing
   Rooms
   Where to Find Products
   
   
3. Mobility
   
   Mobility in Older People
   Psychological Issues
   Physiological Issues
   Falls
   Mobility in Older People with Dementia
   Apraxia
   Risk of Falling in Residents with Dementia Restraints
   Risk of Falls in Residents with Dementia Restraints
   What Staff Can Do
   Contributors to Resident Falls
   When Mobility Becomes Significantly Impaired
   The Truth About Restraints
   Mobility Aids
   Exercise to Promote and Maintain Physical Conditioning
   Difference Staff Can Make in Successful Rehabilitation
   What the Environment Can Do
   Environmental Aspects that Support Mobility
   Improving Mobility in Specific Areas
   Flooring
   Furniture
   Handrails
   Communication Devices
   Residents’ Rooms and Public Areas
   Where to Find Products
   
   
4. Continence
   
   Incontinence as a Part of Normal Aging
   Incontinence Compounded by Dementia
   Changes in a Resident’s Continence
   What Staff Can Do
   Interventions
   Reducing Embarrassment When Assistance Is Needed
   What the Environment Can Do
   Finding the Bathroom
   Finding the Toilet
   Transferring to and from the Toilet
   Where to Find Products
   
   
5. Eating
   
   How Eating Changes with Age
   Social Issues
   Physical Issues
   How Dementia Affects the Experience of Eating
   Memory Problems
   Problems with Chewing and Swallowing
   When Residents Are No Longer Able to Eat
   What Staff Can Do
   Reasons that Residents May Reject Food
   Creating a Therapeutic Setting for Dining
   Administrative Support
   Interventions to Improve Eating
   What the Environment Can Do
   Finding the Dining Room
   Minimizing Excess Disability
   Where to Find Products
   
   
6. Dressing
   
   When Older Adults Have Trouble Dressing
   Physical Issues
   Difficulties of Dressing for Residents with Dementia
   What Staff Can Do
   Understanding Residents’ Feelings
   Taking a Therapeutic Approach
   Stages of Dressing
   How It Feels to Need Help Getting Dressed
   What the Environment Can Do
   Closet/Wardrobe Modification
   Recognizing the Contents of Closets
   Closet and Room Lighting
   Grooming Center
   Where to Find Products
   
   
7. Bathing
   
   How Important is Bathing?
   Why Do Some Residents Dislike Bathing?
   How Often Should Residents Bathe?
   What Staff Can Do
   Undressing Residents
   Privacy
   Running Water
   Air and Water Temperatures
   What the Environment Can Do
   Using a Tub that Fits Residents’ Needs
   Privacy Issues
   Controlling Air and Water Temperatures
   Creating Pleasant Tub Rooms
   Where to Find Products
   

Bibliography
Index

Volume 3

About the Authors
Acknowledgments
Preface
User’s Guide

1. What is Disruptive Behavior?
   
   Part Responses to Disruptive Behaviors
   Why Do These Behaviors Occur?
   Agenda Behavior Approach
   Using a Behavior Tracking Process
   
   
2. Wandering
   
   What Is Wandering?
   Motivators for Wandering
   Past Responses to Wandering
   Strategies to Address Wandering
   What Staff Can Do
   Inhibitors to Social Involvement
   Promoting Social Involvement
   Orientation
   Excessive Walking
   What the Environment Can Do
   Promoting Social Interaction and Diversion
   Orientation to Place
   Limiting Wandering into Nonresidential/Private Areas
   Excessive Walking
   Where to Find Products
   
   
3. Attempting to Leave
   
   Whey Residents Might Want to Leave
   Patterns of Leaving
   Determining Appropriate Interventions
   What Staff Can Do
   Addressing Patterns of Exiting
   Methods for Decreasing Exiting
   When a Resident Successfully Leaves a Unit
   What the Environment Can Do
   Minimizing Confinement and Regulating Stimulation
   Modifying Doorways to Reduce Exiting
   Security Systems
   Elevators as Specific Problem Areas
   Windows as Specific Problem Areas
   Where to Find Products
   
   
4. Rummaging and Hoarding
   
   Common Reasons for Rummaging
   Common Reasons for Hoarding
   What Staff Can Do
   Creating Places to Rummage
   Increasing Sensory Stimulation
   Providing Opportunities to Be Productive
   What the Environment Can Do
   Creating Places to Rummage
   Creating Places of Productivity
   Returning the Idea of Control
   Where to Find Products
   
   
5. Combative Behaviors
   
   How Problematic Are Combative Behaviors?
   Causes of Combative Behaviors
   Physiological Issues
   Emotional Issues
   Environmental Issues
   Addressing Combative Behaviors
   Identifying the Causes
   Using Restraints
   Agitation as a Precursor
   What Staff Can Do
   Staff Training
   Approaches to Use During Personal Care
   Interventions for Overstimulation
   Intervening in a Combative Situation
   What the Environment Can Do
   Addressing Combative Behaviors During Bathing
   Addressing Environmental Auditory and Visual Causes of Stress
   Where to Find Products
   
   
6. Socially Inappropriate Behaviors
   
   Disruptive Vocalizations
   Contributing Factors
   Assessing Behavior
   Discussing the Behavior with Direct Care Staff
   Inappropriate Sexual Behaviors
   Resident Sexuality
   Underlying Causes
   Repetitive Behaviors
   What Staff Can Do
   Disruptive Vocalizations
   Sexual Behaviors
   Repetitive Behaviors
   

Bibliography
Appendix A: Behavior Tracking Form
Appendix B: Sensory Stimulation Assessment
Index

Volume 4

About the Authors
Acknowledgments
Preface
User’s Guide

1. Overview of Home-Based Philosophy of Care
   
   Models of Care
   Medical Model
   Residential Model
   Hospitality Model
   Conclusion
   
   
2. Personalization
   
   Expressing the Self
   Understanding the Self
   Marking a Territory as Your Own
   How Personalization Changes with Age and Relocation
   Preserving the Self
   Relocation
   How Dementia Affects Personalization
   What Staff Can Do
   Developing Policies to Encourage Personalization
   Helping Residents with Personalization
   What the Environment Can Do
   Residents’ Bedrooms
   Private Bathrooms
   Bedroom Entryways
   Exterior Window Treatments
   Interior Shared Spaces
   Tub Room
   Outdoor Shared Spaces
   Where to Find Products
   
   
3. Roles and Activities
   
   Definition of Self
   Well-Being
   How Roles and Activities Change with Age and Relocation
   Loss of Roles and Activities
   New Roles and Activities
   Role Confusion
   Relocation
   How Dementia Affects Roles and Activities
   What Staff Can Do
   Providing Appropriate Activities
   Making the Activities Work
   What the Environment Can Do
   Domestic Activities
   Work Activities
   Leisure Activities
   Where to Find Products
   
   
4. Privacy
   
   Letting Your Hair Down
   Self-Reflection
   Control
   Protecting Information About the Self
   How Privacy Needs Change with Age and Relocation
   Decreased Social Support
   Health Problems
   Relocation
   How Dementia Affects Privacy
   What Staff Can Do
   Develop Policies to Protect Privacy
   Recognize Residents’ Privacy Needs
   What the Environment Can Do
   Shared Residents’ Bedrooms
   Residents’ Bathrooms
   Hallways
   Indoor Shared Spaces
   Outdoor Shared Spaces
   Where to Find Products
   
   
5. Autonomy and Control
   
   Choice
   Well-Being
   How Autonomy and Control Change with Age and Relocation
   Social and Physical Losses
   Relocation
   How Dementia Affects Autonomy and Control
   What Staff Can Do
   Developing Policies to Encourage Control
   Providing Meaningful Choices
   What the Environment Can Do
   Private Areas
   Choices
   Orientation Cues
   Access to the Outdoors
   Activity Choices
   Where to Find Products
   
   
6. Residential Design
   
   What the Environment Can Do
   Spatial Adjacencies
   Scale
   Purpose-Specific Rooms
   Décor
   Where to Find Products
   

Bibliography
Appendix A: Resident’s Social History
Appendix B: Hanging Pictures and Artwork
Appendix C: Toxicity of Common House and Garden Plants
Index