Personal and Physical Care Needs

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Personal and Physical Care Needs

From Nursing Care In Late Stage Huntington Disease

In Huntington's Disease there are cognitive changes and impairments. The cognitive areas that affect a persons performance include their speed, reasoning, planning, judgment, decision making, emotional engagement, preservation, impulse control, temper control, perception, awareness, attention, language, learning, memory and timing.

Overall this affects how a person with Huntington's Disease attends to their activities of daily living and how they respond to their personal environment.

Caring for a person with Huntington's can be very challenging at times due to the cognitive changes in the brain. They may request things to be done now and if you do not attend to their need immediately they may become agitated, disruptive and more demanding.

Sometimes in the long run, it can be more efficient for you to do what they want right away, as to prevent a more disruptive, agitating behavior to progress. This type of behavior may also occur when the client has problem with preservation or getting stuck on a thought or request, and asking you to do the same thing over and over and over again. Such as positioning their pillow as it is never right for very long or even asking for a cigarette.

These types of behaviors become more and more common in advanced stages of Huntington's Disease. Both can be managed in a similar way, by setting a routine and certain rules that all caregivers and family stick by. If you are unable to attend to them right away give them an exact time that you can meet with them such as in fifteen minutes or at six oclock, and most importantly follow through with your set time.

Do not tell them " in just a minute " or " When Im finished " as a minute to them is just exactly sixty seconds, and they will continue to reapproach you, which in turn frustrates you and the client. Attending to these simple requests in a routine, calm, supportive manner helps the client to feel good and even make them happy.

Do not pass off their disruptive, demanding and agitated behavior as bad behavior as this is part of the disease, this is due to cognitive changes in the brain.

Other behaviors which may result due to lack of impulse control and anger over their lost independence maybe hurtful comments and profanity directed towards family and caregivers. This type of behavior can be very hurtful even though as family and caregivers we understand it is part of the disease.

You always have to remember not to take this type of behavior to heart, continue to be polite and supportive. Many times you will even find that the person with Huntington's Disease will apologize for their behavior outbursts.

By understanding the cognitive changes in the brain, you as caregivers can begin to find causes of inappropriate behaviors. It may initially seem like a difficult complex situation that is out of control, but in the end there is a very simple solution, set routines and stick to them. And always remember to listen to what your client is saying, whether it be verbally or in their non-verbal cues.

Huntington's Disease is also a movement disorder with a presence of involuntary movements which most persons with Huntington's are not bothered by and may not be even be aware of. These movements are worsened by anxiety, stress and depression, while decreased during sleep and vary with posture and positioning.

There is also an impairment of voluntary movements which correlates more with functional disability as they have slow and uncoordinated fine movements and some rigidity.

So basically, persons with Huntington's Disease have difficulty and eventually are unable to plan, laying out or gathering items needed to complete a task such as brushing their teeth and unable to complete the steps of the usual everyday task. The cognitive issue effects planning and organizing the task while the movement disorder effects physically completing the task.

It is typical for a person to loose interest in attending to their hygiene so establishing a self - care routine is important and give no more assistance in care than is needed. Encourage tasks by prompting or giving cues.