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Seeking the solutions
Caring for a person with Alzheimer’s disease or related dementias (ADRD) is an intricate process. Poor outcomes, such as too many hospitalizations, negative behaviors, and overuse of psychotropic medications, have been pervasive. Innovators in memory care services are taking new approaches to ADRD focused on person-centered care, improved quality of life, and a perspective that sees not disabilities but abilities. Empowerment: Taking a New Approach to Dementia Part 2
Filling the gaps with a cognitive assessment
According to Kim Warchol, an occupational therapist and nationally recognized specialist in dementia care, effective care for those with ADRD starts with a thorough cognitive assessment.
“If someone begins to experience changes in thinking, that person needs to visit a physician specialist, such as a neurologist, for symptom evaluation. This can determine the root cause of their memory loss—whether it is normal aging or a disease process,” Warchol says.
Along with a physician specialist assessment to identify the root cause of the cognitive changes, the person should be seen by an occupational therapist specializing in dementia therapy. This professional can conduct functional cognitive assessments that help to identify the stage of the disease and can also assess the demands of everyday life, creating plans that improve the person’s safety and level of function.
Too often specialized assessments by a neurologist or occupational therapist are skipped, Warchol notes. As a result, treatment interventions and care plans can be insufficient or inaccurate.
Understanding the dementia stage or cognitive level of a person with ADRD is essential to developing an appropriate care plan.
Furthering workforce development
Another essential step in effective ADRD care is what Warchol calls a “dementia-capable workforce,” one that supports people through every step of their experience of the disease.
Key also to a strength-based care is proactively valuing each resident’s uniqueness, Warchol notes. For example, StoneGate Senior Living, a leading provider of senior living services in Texas, Colorado, and Oklahoma, offers a Music & Memory™ program to help reawaken memories for residents with ADRD. A personalized playlist of songs sparks renewed meaning and connection.
Staff training also includes the critical element of behavior management. Warchol points out the need to stop thinking of negative behaviors—such as agitation, aggression, and anxiety—as normal symptoms of dementia. “Instead, we need to think of these expressions as a normal response to a situation, such as being forced to shower. Then, as care partners, we need to understand how we can approach situations differently to cultivate trust and agreement.”
Finding the light within
One of the greatest rewards of this new approach to dementia care is its positive impact on residents’ families.
Warchol recalls the story of a daughter who moved her mother into a dementia care facility. She was told there was little hope for improvement. The mother hadn’t spoken a word in several years, couldn’t walk, and was described by her daughter as a shell of her former self. As a part of a preadmission interview with the memory care facility, Warchol picked up on “glimmers of the mother’s capabilities that were perhaps being shrouded in the negative paradigm, such as, ‘We were told Mom can’t do anything anymore.” Warchol probed and heard the report that her mother could hold a magazine and turn the pages.
“Why weren’t the abilities to focus attention and use hands to hold and use meaningful objects being promoted? Why wasn’t she talking? It appeared failure to thrive may have begun,” Warchol explains.
The daughter moved her mother to Warchol’s memory care facility. Within days, the mother was walking through the garden, talking about flowers, and picking up bowls in the kitchen to assemble ingredients.
“We called the daughter to share the good news,” Warchol remembers. “She was at first incredulous. ‘Put my mom on the phone,’ the daughter said. Her mother’s words to her daughter: ‘You did good. I’m happy.’
“These were the first words the daughter had heard from her mother in years. Exceptional memory care can’t heal the brain and reverse the disease process, but we can stop the suffering by uncovering and facilitating use of abilities retained—and by healing the human spirit that remains bright within.”
By: Sue Carrington
About the Author: Sue Carrington is a seasoned and purpose-driven journalist, with a focus on healthcare innovation. She has pursued her love of words through a diverse array of callings – from book editor to radio news director, public relations manager to corporate writer and freelance writing entrepreneur. Sue is a native of the Washington, DC, area.
Part 2 of a 2 Part Series. For Part 1 Click Here
Empowerment: Taking a New Approach to Dementia Part 2
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