Sometimes it’s as simple as looking at a family photo, or watching an old sitcom, like I Love Lucy. For dementia patients, presenting with delirium, connection is the key, according to Jeanne Mathis Halpin, RN, and clinical supervisor on the medical/oncology floor.
To help patients make connections, nurses create individualized Adult Cognitive Education (ACE ) boxes filled with items designed to help patients cope with the anxiety and confusion of delirium superimposed on dementia (DSD). Tactile stimulation of stuffed animals can offer comfort, old photographs can bring back memories, and spark interesting conversation, puzzles, and games can occupy the mind, and grooming items can provide a familiar ritual.
Halpin says that patients who normally have some level of confusion (dementia), may become extremely confused when they become ill (delirium). Delirium is an acute, reversible change in mental status that occurs in over 40% of persons with dementia. The goal of the ACE boxes is to manage this condition in order to help the patient.
ACE boxes are part of a program in a National Institute of Health funded trial to improve the care of older adults with delirium superimposed on dementia. The principal investigator is Donna Fick, PhD, GCNS-BC, FGSA, FAAN, and professor of nursing at Penn State University.
An added benefit of the ACE boxes is improving the nature and tone of a family visit. The items inside the box can help family members make that vital connection with a loved one by reminding them of the things that they do remember.