Presentation by Dr. Sherri Bernier, Ed.D.

1. The Elevator Stops At OZ:
Entering The World of
Dementia
Dr. Sherri Bernier, Ed.D.
Bernier, 2009

2. Abstract
There’s no place like home…
Harr and Kasayka (2000) state that
“to create comfortable and secure
environments and programs that
foster human dignity and individuality,
we must understand how the ‘the
power of place’ influences the
preservation of resident personhood”
Bernier, 2009

3. Achieving a harmonious environment
and enhancing the “quality of life” in
those afflicted with dementia must
include opportunities for freedom of
choice, sensory stimulation, and
social interaction. Allen-Burge,
Stevens, and Burgio (1998)
contended that challenging behaviors
associated with dementia include
behavioral deficits such as the
functional domain of peer interaction.
It is imperative that all healthcare
disciplines be educated and trained to
Bernier, 2009

4. “enter the world of dementia” in the
quest to cultivate pleasant
relationships and to decrease
agitation in those they serve. This
method supports innovated
techniques and creative interventions
for the helping professional in the field
of dementia care.
Bernier, 2009

5. Achieving a harmonious
environment means promoting:
Autonomy: freedom of choice
A sense of control
Socialization
Sensory stimulation
Least restrictive surroundings
Caregivers trained to meet both
emotional and physical needs of the
person afflicted with dementia
Bernier, 2009

6. The Approach:
Remember when interacting with
someone who has dementia, you are
entering “their world”
Always approach from the front
It is of the utmost importance to make
eye contact so that the person
remains focused
Bernier, 2009

7. Dining
Early afternoon dinners are
recommended due to “sun-downing”
Finger foods for those in mid-latter
stages of the disease; i.e. chopped
ham and pickle
Pasta that can be eaten with a spoon;
i.e. elbow macaroni
Bernier, 2009

8. Environmental Safety:
Well lit rooms
Furniture should not clutter living
space
Lock away small items that could
easily be put into pockets or mouth;
i.e. silverware, keys, small easily
swallowed or breakable items
Be cautious of the noise level
Bernier, 2009

9. Supporting Language
Become familiar with the cognitive impaired
person’s vocabulary: frequent used words
When words are not used appropriately, do
not correct the person
Be attentive to the person’s body language
Keep conversations simple and direct
Encourage person to speak using
gestures,cues, and supportive devices
Bernier, 2009

10. Dealing with Poor Judgment and
Insight
Limit choices
Encourage fidelity: trust and
loyalty
Do not use authoritarian or
judgmental approaches
Dismiss yourself at the first
display of aggressive behavior
Bernier, 2009

11. Behavior Interventional Studies
Holmberg (1997) -Walking Program-71%
reduction in agitation
Buettner et al.(1996)-Recreational Therapy-30%
decrease in staff incident reports of aggression
Williams et al.(1994)-In-service Training-significant
decrease in incident reports
Gerdner (2000)-Music Therapy-65% decrease in
observed agitation
Hussian (1988)-Stimulus Enhancement-85%
reduction in frequency of observed behaviors
Cleary et al.(1988)-Special Care Units-53%
decrease in agitation level
Snowden, Sato, & Roy-Bryne (2003)
Bernier, 2009

12. Communicating in the “Time-Line”
of the Dementia Resident
By asking open-ended questions, find out
where in ‘time’ the resident is at that
present moment
Enter into the resident’s moment; i.e. if the
resident is crying about a person such as a
parent, ask questions about the event that
is going on
By entering their world, we may decrease
agitation and can become part of a
pleasant interaction
Bernier, 2009