bv ComfortCare

Als freelance ComfortZorg consultancy bedrijf ondersteunt BV ComfortCare de ruimte zorgsector door het aanbieden van ComfortZorgadvies.

[bv ComfortCare @bvComfortCare]

It’s more important to be here because we where nominated, then to win!

[bv ComfortCare @bvComfortCare]

We staan met Attractive2Wear in de startblokken om vol enthousiasme te starten aan de Acceleratiedag Radicale Vernieuwers van @SocInnFabriek @RadicaleV_VL #radicalevernieuwer2019

[Jo - Dementia ComfortCare @DementiaJo]

The 3 tutors of the brain as tactile, proprioceptive & vestibular sensory input are responsible for determining the body position sense, body scheme & body feeling. #Dementia intervenes in the way that these are processed by the brain because of the sensorymotor desintegration.

[Jo - Dementia ComfortCare @DementiaJo]

From my own therapeutic experience I see a strong explanatory path for paratonia in people with #dementia in the decline of the body feeling, body position sense & body scheme caused by the sensorimotor disintegration of the demented brain. Paratonia = a signal behavior!

[Jo - Dementia ComfortCare @DementiaJo]

Paratonia, #dementia & care according to the turn only once principal: appliance of care specific adaptation of the own clothes, gentle washing without using running water & incontinence material with belly band principle = minimal care related manipulations & repositioning 👍🏻

[Jo - Dementia ComfortCare @DementiaJo]

If too many manipulations are performed, paratonia will increase & caregivers will mobilize through the muscle tone, which causes muscle damage & encourages contracture formation. It’s not only positioning what is important, but also how care is caried out in combination with it!

[Jo - Dementia ComfortCare @DementiaJo]

1-on-1 care has become at least even more important in this Corona time, on the one hand to minimize the risk of infection & to maintain care efficiency, without having to sacrifice the degree of exposure to workload for the care provider and care quality for the care recipient!

[Jo - Dementia ComfortCare @DementiaJo]

The active stimulation & passive support approach of paratonia in #dementia can only be successfully implemented with a multidisciplinary team that communicates in an interdisciplinary way & collaborates in a transdisciplinary way, without applying: not in my job description!

[Jo - Dementia ComfortCare @DementiaJo]

Measure the presence of paratonia! It’s extremely important because in the early stage of #dementia there is still the opportunity to tackle paratonia with an active stimulation strategy including ADL training, fine motor exercises, functional gait & balance training!

[Jo - Dementia ComfortCare @DementiaJo]

Paratonia = increased risk of loss of motor functionality = increased fall risk! Detect the presence of it in persons with #dementia early by applying the Paratonia Assessment Instrument to determine the presence of it & the Modified Ashwoth scale to determine its gradation.

[Jo - Dementia ComfortCare @DementiaJo]

Paratonia & passive support strategy over 24 hour:
- specifically stabilized & informed positioning in bed & wheelchair,
- correct use of the passive hoist, the accompanying sling & the sliding sheet,
- ‘morning’care according to the turn only once principal.
#dementia

[Jo - Dementia ComfortCare @DementiaJo]

If due to the progressive nature of #dementia the active stimulation strategy in function of paratonia becomes less obvious, the angle of approach must be changed in the multi-, inter- & transdisciplinary collaboration! Within the ComfortCare approach, ADL must be shifted to PDL.

[Jo - Dementia ComfortCare @DementiaJo]

Fetal posture and the consequences of it as contractures, pressure ulcers, cachexia, sarcopenia and/or swallowing pneumonia occurring in persons with advanced #dementia can be prevented by positioning them in a stabilized & informed manner according to their specific brain need!

[Jo - Dementia ComfortCare @DementiaJo]

Try to swallow while you push your head backwards against your own hand quite powerful. It will become clear that swallowing is not so easy anymore, despite the fact that otherwise we never have to think about swallowing itself. Posture is all decisive! #dementia

[Jo - Dementia ComfortCare @DementiaJo]

The head & back pushing backwards into the mattress in supine position is noted contradictory to what we think of fetal posture. Together with embracing arms it’s an attempt to control the upper half of the body, against gravity that toke control over the lower part. #dementia

[Jo - Dementia ComfortCare @DementiaJo]

Should we as caregivers contribute to the development of contracture with people with advanced #dementia, or quite the contrary?! The number of far too many passive mobilizations, posed by stubborn physiotherapists with a therapeutically outdated persistence, will not contribute!

[Jo - Dementia ComfortCare @DementiaJo]

Physical exhaustion, cachexia & sarcopenia are just around the corner caused by the hopeless struggle performed by the person with #dementia in non supported fetal position. This due to the energy-hungry continuous performed paratonia in order to fight destabilizing gravity!

[Jo - Dementia ComfortCare @DementiaJo]

To realize pressure ulcer prevention, persons with evolved #dementia must also be cared for according to the ‘turn only once’ concept. The min. of manipulations & repositioning gives less deformation force on the skin, as second cause of pressure ulcer besides pressure force.

[Jo - Dementia ComfortCare @DementiaJo]

To realize pressure ulcer prevention, persons with further evolved #dementia must be positioned on a stabilized & informed way in bed & wheelchair so paratonia is lowered against gravity as the destabilisator & passive mobilisator, so less pressure & deformation force is reached!

[Jo - Dementia ComfortCare @DementiaJo]

To realize contracture prevention, persons with evolved #dementia must be cared for according to the ‘turn only once’ concept. The min. of manipulations performed @ low speed & with little force = less paratonia so the risk of muscle damage as a cause of contracture is minimized!