Small Steps Lead to Steady Success

Hello everyone, 

When we consider integrating changes to a philosophy of care it is important to remember that small, gradual changes can lead to more lasting success. Attempting to take on too much, too quickly can result in frustration or a feeling of being overwhelmed. 

When it comes to managing behavioral symptoms related to dementia, consider having nursing staff choose a few residents with less challenging behavioral symptoms to begin. Staff can hold weekly “huddles” to discuss ideas, challenges and successes they have had with individual residents. This can help them build confidence in their abilities and foster teamwork as well as trust in the approach to care that we are encouraging. 

Have a great week!


Winning tidbits: suggestions from direct care workers

Hello everyone,

Our friends at nursing home facilities in Pennsylvania have sent us some wonderful tidbits for our tidbit contest. We’ll share a few with you each week.

To start, Kacie Szczech, a CNA at St. Mary’s Villa, has a great idea for residents who wander and like to take other people’s things. She suggests leaving a “treasure box” of miscellaneous items placed in frequented areas for the resident to go through and take some things, such as: towels for folding, empty containers, stuffed animals, and large costume jewelry (if safe). Our research team likes this approach because it does not try to restrict or change the resident’s behavior, but rather supports wandering as an unmet need. Nicely done Kacie!

Janet, another staff member at St. Mary’s Villa, shares her approach to caring for residents with insomnia. She creates and keeps a bedtime routine to signal the resident that it is time to settle down: remove glasses, turn off lights in the room, draw the shades, turn off TV, offer snack prior to lying down, check and change brief. Our team liked this tidbit because it focuses on a common issue for the evening shift staff, and is a simple suggestion that does not require any additional resources to implement.

Have a great week!

Reducing inappropriate behaviors

Hello everyone,

Since we recently received a question from one of our study participants about how to deal with sexually inappropriate behaviors exhibited by some residents with dementia, we thought we would address this in a tidbit to give you all some strategies for how to respond when this happens at your nursing home.

This information comes from the Nursing Home Toolkit

Examples of sexually inappropriate behaviors include socially unacceptable behaviors toward self in public (such as disrobing, fondling and masturbating) and inappropriate behaviors directed at others (such as sexually explicit comments and inappropriate touching). Behaviors that are considered sexually inappropriate may be related to the human need for intimacy, although it may also be triggered by something in the environment such as suggestive television programs.

When a resident is exhibiting behaviors that are sexually inappropriate, remain calm and professional and gently—yet firmly—redirect the behavior by telling the person it is inappropriate and unacceptable.

When responding to these behaviors:

  • Let the person know how their behavior affects you and others. For example, “Mr. Jones, I don’t like it when you take your pants down. It makes the other nurses and me very uncomfortable.”
  • If the behavior persists, walk away and tell the resident, “I will come back once you stop exposing yourself so I can take care of you. Right now I am uncomfortable staying here.”

Some strategies to reduce sexually inappropriate behaviors include:

  • Redirect behavior through the use of food, drink or conversation.
  • Distract the person through activities that have meaning for the person and involve the use of the person’s hands, such as exercise or folding towels.
  • Provide stuffed animals to the person for grasping/fondling.
  • To help prevent disrobing and masturbation, choose clothing for the person to wear that opens in the back.
  • Identify and try to eliminate any triggers to the behavior.

As always, please feel free to share your experiences with us, and what has worked for you to help you deal with these challenges.

 Have a great week!

Share your ideas with our care community- Tidbit suggestions

Hello everyone,

Now that we’ve reviewed the four components of “DICE” for assessing and managing behavioral issues with residents who have BPSD, it’s your turn to show us how you have used this process in your own facility.

Please send us a brief example of how you or your staff have used DICE when addressing a specific behavioral issue of a resident. The best examples will win a prize for their facility, and we’ll share the examples in future tidbits so everyone can benefit! We look forward to hearing from you. Send suggestions to!

Have a great week!