Positive Approaches in Residential Facility Care

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Partners in FTD Care
Winter 2019

Without adequate staff preparation, transitioning a person with FTD and anosognosia symptoms into a residential care community can be challenging. Persons with FTD are often young, physically healthy and active, and exhibit a range of cognitive abilities and limitations. Staff familiar with the symptoms of Alzheimer’s disease will meet little success and increased frustration if they use the same care approaches on a person with FTD. Staff may also report being fearful of persons with FTD, who are younger and stronger than typical residents.

Facility placement is smoother when staff receive ongoing FTD education, helping them better understand that impaired judgment, not memory loss, shapes the needs of residents with FTD. Positive approaches during the initial and ongoing stages of care include the following:

  • Before move-in, work with family members to assess the specific needs of the person with FTD, outline appropriate care approaches, and identify helpful resources.
  • Educate staff on FTD prior to move-in—sharing the above-noted assessment can provide clinical and individualized care knowledge.
  • Identify specific staff who understand and are comfortable with FTD.
  • Develop and post a daily routine that the person diagnosed is comfortable with. Rewarding task completion with a favorite snack or activity may increase success in activities of daily living and medication compliance.
  • Communicate to all staff that elopement risk is greater among persons with FTD due to their younger age, inability to assess risk and preserved language and cognitive skills. Note times or situations when the person is most active, and have on hand a current photo, a list of favorite places and other identifying information in case of elopement.
  • Observe interactions between the person with FTD and others (residents, visitors, and staff). Intervene positively when necessary, especially after observing sexual advances and other potentially unsafe behaviors. Teach staff how to similarly observe and intervene.
  • Request that family members provide a private duty companion, and increase staff monitoring checks due to heightened elopement risk and other risky behaviors. Assess the individual’s response to one-on-one attention, as it may increase their discomfort.
  • Complete environmental rounds daily to ensure safety. For example, eliminate poisonous and other unsafe materials, and limit access to observable food.
  • Frequently remind staff that the behaviors of a person with FTD are not willful; they are due to physical changes in the brain. Let staff talk about how the more challenging behaviors affect them.
  • Providing modified one-on-one activities based on past interests is generally more successful than group activities. These can include exercise programs geared to a younger person, such as shooting hoops.
  • Communicating regularly with family and staff is essential as the individual’s needs change.

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