Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Interventions for Dementia
Manifestations Behavioural Interventions
  • Impaired recall of recent events
  • Use reminders (notes, single-day calendars, cues)
  • Talk with the client about recent events
  • Impaired functioning, especially complex tasks
  • Gradual withdrawal from activities
  • Lowered tolerance of new ideas and changes in routine
  • Avoid stressful situations
  • Do not ask for more than the client can do
  • Keep the environment, schedule, routine the same
  • Maintain normal mealtime routine
  • Have items in the same place and in view
  • Difficulty finding words
  • Anticipate what the client is trying to say
  • Provide word or respond to thought/feeling
  • Repetitive statements
  • Be tolerant and respond like it is the first time stated or heard
  • Decreased judgment and reasoning
  • Assess safety of driving and other desired activities
  • Allow performance of skills as long as safe
  • Becoming lost
  • Accompany on walks
  • Provide safe and secure walking area
  • Inconsistency in ordinary tasks of daily living
  • Ignore inconsistencies
  • Help to maintain consistency by keeping needed items in view and maintaining routines
  • Increasing tendency to misplace things
  • Keep items in the same place and in view
  • Find things and replace or hand to the client without focusing on the forgetfulness
  • Narrowing of interest
  • Living in the past
  • Maintain familiar social, physical, mental, and work activities
  • Self-centred thoughts; restlessness or apathy
  • Focus on the client and listen
  • Allow pacing or sleeping
  • Preoccupation with physical functions
  • Assist in maintaining normal physical functions (basic and instrumental activities of daily living)
  • Increased forgetfulness (meals, medications, people, self )
  • Place food where client can see and reach it
  • Hand medications to client
  • Remove mirrors
  • Untidiness, hoarding, rummaging
  • Put things away as desired; do not expect client to put them away
  • Provide a chest of drawers for hoarding or rummaging
  • Difficulty with basic activities of daily living
  • Keep needed objects in sight/reach
  • Do for the client what he or she cannot, but allow the client to do as much as possible
  • Provide assistive equipment: shower stool, elevated seat
  • Wandering, becoming lost
  • Close and perhaps lock doors on stairways and rooms that the client should not access
  • Fence the yard
  • Place cues to help recognize rooms or objects
  • Avoid physical and chemical restraints while providing areas for wandering and resting
  • Uncoordinated motor skills, poor balance
  • Have non-shiny floors without contrasting colours or patterns.
  • Provide soft environment.
  • Repetition of words or activities
  • Provide environment where repetitive activities can safely be done
  • Reversed sleep-wake cycles
  • Provide activities in daytime
  • Provide room where the client can safely be up alone for a time.
  • Put back to bed with usual bedtime routine
  • Loss of contact with reality; hallucinations, confusion
  • Make available materials for activities that the client enjoyed throughout life
  • Keep picture albums with old pictures
  • Keep the client’s room location and layout unchanged
  • Remove confusing stimuli
  • Ignore hallucinations unless they are distressing to the client; remain calm; act normally
  • Withdrawal
  • Provide meaningful stimuli
  • Provide place for quiet time
  • Agitation
  • Remove objects that could be damaging
  • Provide space
  • Impaired judgment
  • Provide safe environment
  • Have unsafe objects out of sight
  • Altered sensory-perceptual functioning
  • Provide good lighting
  • Have non-shiny floors without contrasting colours or patterns

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