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Inservice training article for nurses and assistants caring for Alzheimer's disease patients - Alzheimer's Care Guide, Freiberg Press, Inc. (USA)
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Alzheimer's Care Guide March-April 20128
Conducting effective “Caring Encounters”
RNs, LPNs, CNAs, ADs can earn 1 state-approved CE credit for this article. Those with theCDP certificate can earn 2 CEs. See p. 13.
Evidence shows that the bestcare that caregivers can provide toolder people is one involving acts,words and gestures that comefrom the heart.Plus, caregivers need to have agenuine need to be a compassion-ate caregiver, rather than operat-ing just from a sense of duty orobligation.Caring encounters are central tothis type of care… in all types ofhealthcare settings, includingnursing homes, hospitals andassisted living facilities.
What are caring encounters?
At their simplest, caring encoun-ters are interactions wherecaregivers act in ways that makeolder patients or residents feelvalued and respected.They are essentially conversa-
tions during which the caregiv-
er:
• encourages the elder to talkabout things of interest tothem,
• listens attentively,• speaks in a language the eldercan understand,
• shares the elders’ feelings ademotions,
• provides comfort, using com-passionate touch when appro-priate,
• and is always kind–just likethey would be with a dearfriend or family member.
Caregivers should befriendly and courte-ous during each andevery encounter with
their elders
Caring encounters are interactions where caregiversmake their elders feel valued and respected.
Take the initiative
Researchers say caregiversshould try and have as many ofthese interactions as possible withtheir elders.And they should be proactive
in terms of creating opportuni-
ties for such encounters… elders
often refrain from starting a
conversation only because they
think caregivers don’t have the
time, or don’t want, to talk with
them.
Dr. Lise-Lotte Jonasson, ofLinköping University, Sweden,says even the simple passing on ofinformation can start a caringencounter, if done properly.“If the information is given in apolite manner, backed up byappropriate, pleasant body lan-guage, then there will be aninteraction.”
Proven benefits
Why are caring encounters soimportant?Because they have been asso-
ciated, in studies, with major
benefits for your elders.
For one thing, they are consid-ered by researchers and expertsworldwide, to be the fundamental‘building blocks’ that help front-line caregivers develop positiverelationships with elders.
This ensures that their elderswill live happier and more digni-fied lives, regardless of disease ordisability.In addition, caring encounters
are valuable means to resolve
difficult caregiving situations.
The International Journal ofNursing Studies reports that, inone study by Lund University, inSweden, properly conducted caringencounters were useful in calmingdown elders, who had becomeacutely confused and agitatedfollowing hospitalization.And the benefits go both ways.Caregivers who engage in car-
ing encounters are generally
more satisfied with their job,
less vulnerable to stress and
happier, according to research.
Caring encounters arevaluable in calming con-fused and agitated elders
9Alzheimer's Care GuideMarch-April 2012
Person-centered care
But there is more. Caring en-counters go hand in hand withperson-centered care. In fact, theyare one of the most effective andall-encompassing ways to makeperson-centered care possible inthe first place.And here is why. Key to good
caring encounters is the caregiv-
er’s ability to relate to their el-
ders’ situation, Jonasson says.
This encourages “elderly patientsto open up and share difficulties.”Thus, caring encounters make iteasier for nurses and CNAs toidentify problems and needs thatwould otherwise remain undetec-ted.Not only that, but Caring En-counters are also valuableforopportunities for getting toknow each elder in their unique-ness.Through properly conducted
conversations, attentive care-
givers can learn about the el-
der’s interests, hobbies, favorite
activities, little habits, family
members, past jobs, achieve-
ments, what makes them smile,
what makes them sad, memo-
ries they cherish, and so on.
This information is priceless.It allows caregivers to delivercare that is shaped around theelder’s personal history, prefer-ences and needs, according to theprinciples of person-centeredness–a key to good quality of life forelders in all healthcare settings.
Caregiver qualities
So far, we have seen what caringencounters are and why they areso important. But what caregiverpersonality is needed to interactwith elders in a caring way?“The ideal caregiver is an ea-
ger, loving, sympathetic and
supportive person,” Jonasson
says.
A nurse or aide, who not onlyprovides care that helps preventdisease, but also supports theelder–through presence, touch andlistening–is realizing their ambi-tion of being valued and respected.
Nurses and CNAs, who excel in caring interactions with their elders arefriendly and courteous during each and every encounter, and try to develop abond with their elders, by finding a common interest with them.
Through their conversa-tion, caregivers gain
information that’s pricelessfor developing person-cen-
tered care
What about your patient/
resident visits?
So far so good. To ensure theirencounters with elders are caring,caregivers just need to engage inthe right behaviors and avoid thewrong ones.But a common finding of many
of the studies on caring encoun-
ters is that nurses and assis-
tants often don’t realize they
are acting in an uncaring way
during their visits with their
elders.
So, just knowing the differencebetween caring and uncaringencounters, although crucial, maynot be enough, in some cases.Caregivers also need to be able
to look at their encounters in a
critical way, and ask them-
selves whether or not these are
actually caring.
They can do this by observingthe elders.Do they look at ease, happy,relaxed and glad to be givenattention?Are they willing to share theirstories or emotions?If not, then, the encounters are
likely to be uncaring and need tobe improved accordingly.
Key strategies
More than twenty years ofresearch shows that nurses andCNAs, who excel in caring interac-tions with elders, consistently usethe following strategies.x Are friendly and courteous,
during each and every en-counter.This goes beyond using kind
and respectful manners. Italso involves speaking in away their elders can under-stand, for example, by avoid-ing medical or complicatedterms.
x Try to develop a bond withtheir elders, by finding acommon interest with them,and using it as the basis forconversations.
Caring encounters make iteasier for caregivers toidentify problems and
needs that would otherwiseremain undetected
(Encounters, cont’d p. 11)