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A Person-Centred Approach to Alzheimer’s Disease

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According to Alzheimer’s South Africa, there are more than 36 million people with dementia worldwide and the number is expected to rise to over 115 million by 2050. In South Africa, the USA and Germany there is an incidence rate of one case in approximately 68 inhabitants, which means that about 730 000 people in South Africa have dementia.

The numbers alone underscore the need for caregivers in nursing homes to be able to effectively communicate with a person living with Alzheimer’s disease. According to Nicolene Schoeman, a Consultant at Oticon South Africa, the adoption of a person-centred approach when dealing with persons who have Alzheimer’s disease could not only lead to an improvement in their quality of life but also decrease the effects that institutionalisation may have on a resident of a nursing home.  

“Very little training is given to nursing home caregivers who deal with persons that are living with Alzheimer’s disease,” says Schoeman. “The person-centred approach requires a change in the caregiver’s communication and listening skills in order to facilitate a more appropriate interaction process.”

Person Centred Care (PCC), as introduced by Kitwood in 1997, is an ethical approach to caring for persons living and dying with dementia, and evaluates the care being delivered, through the eyes of the person receiving that care.  It is a holistic and comprehensive delivery care system that meets each individual's core needs of love, identity, comfort, inclusion, attachment and occupation. It acknowledges and accepts each resident as a whole person and provides moral and ethical development of care staff.

Schoeman’s masters’ dissertation was entitled ‘The influence of a communication orientated workshop on the interaction between nursing home staff and persons with Alzheimer’s Disease’. The study investigated the interaction between nursing home caregivers and persons living with Alzheimer’s disease within a nursing home environment, both before and after the attendance of a communication-orientated education workshop for the staff.

“The results showed a significant change in the communication and listening skills of the caregivers. Not only did it increase their knowledge and understanding of the disease but it also changed their perception towards persons living with Alzheimer’s disease in a positive way,” explains Schoeman.

Alzheimer’s disease and related dementias can gradually diminish a person’s ability to communicate. Not only do people with dementia have more difficulty expressing thoughts and emotions, they also have more trouble understanding others.

“There is a definite need to implement dementia care that is based on the principles of person-centred care,” says Schoeman.  “The approach will enable caregivers to observe the behaviour of a resident and to recognise differences. A good example is when the resident starts speaking less often and starts relying on gestures, that it might be because they are finding it difficult to come across the right words,” explains Schoeman.

“It requires a great deal of patience and humility to provide a person living with Alzheimer’s disease the care and dignity that they need.  Listening carefully, not just to what they are saying, but what they are not saying, is important. Always remember that the resident is not less of a person, just because they have Alzheimer’s disease,” concludes Schoeman.

(Press release, Oticon)

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