All posts by Pam Brandon

“Remember This” Changes the Conversation about Dementia

Dementia Friendly Fort Worth recently sponsored Remember This, a participatory performance experience by the Texas Tech University School of Theatre and Dance.  Created and produced by Dr. Tyler Davis, Genevieve Durham DeCesaro, Rachel Hirshorn-Johnston, and Dr. Annette Sobel,  Remember This is about changing the conversation about dementia.

Remember This is poignant, inspiring, humorous and creative.  

Remember This is designed to spotlight conversations about and perceptions of dementia by using a myriad of performance approaches, including dance, improv comedy, and scripted theatre taken directly from interviews with people living with and around the disease.

The creators worked to research and publicize the humanity, as opposed to solely the tragedy of the disease, by approaching it as a set of interwoven stories.  Remember This is designed to promote a larger and louder public conversation about people living with dementia as well as the communities (e.g. caregivers, families, community business owners, hospitals, etc.) who care for and serve them.

The creative ensemble that performed, several who had loved ones with dementia, was simply an amazing work of art.  Hats off to the visionaries, researchers,  and creative minds of Remember This.  Having young people share in the dialogue is expanding the generational reach of dementia.

Thank you to Dementia Friendly America, of which Dementia Friendly Fort Worth is a part of, Alzheimer’s Association and many others who are changing the conversation to the broader public about dementia – how to better understand dementia,  openly accept persons living with dementia as vital members of the community, and to help those caring for persons with dementia.  And finally, to provide more funding for training, support, resources, and research – all urgently needed to meet the fast-growing numbers of persons living with dementia and those caring for them,  in the U.S. and throughout the world.

Pam Brandon is President/Founder of AGE-u-cate Training Institute and a passionate advocate for older adults and those who serve them.  Pam is the creator of the internationally acclaimed Dementia Live® simulation and awareness training program.

 

Can we Age Well through the Challenges of Aging?

Until a miracle cure is found to stop, reverse or drastically slow down the aging process,  the news flash of the day is that we will all leave this earth someday.  In our anti-aging driven society of wrinkle reducers and body re-shaping, the fact is that all of us are, shall I say it – AGING!  The question is not that we are aging, but can we age well through the challenges of aging?

Unlike what many marketers would have us believe, aging is not a disease.  Normal aging is associated with changes, some of these being:

  • Vision – decreased depth perception and ability to distinguish dark colors.  Often this includes decreased night vision.
  • Hearing – loss is gradual;  in the 65 – 74 age group 25% hearing loss is average, with men experiencing more than women.
  • Smell – by age 80, 40% of older adults may experience changes in ability to smell.
  • Touch – the number of nerve receptors in skin decrease and difficulty in the ability to discriminate temperature increases with age.
  • Psychosocial – memory and reaction time typically being to decline at about the age of 70, leading to slower response time, decreased reflexes in the feet and learning time takes longer.

These age-related changes can be challenging, especially if we don’t accept these as a reality of normal aging.  For instance, vision changes require that we see our eye doctor on a regular basis so that symptoms such as cataracts can be corrected.  Hearing loss can be treated with hearing aids.

Other changes are more complex which can be related to a number of chronic illnesses, such as diabetes, medications, and dementia.  The “snowball” effect of age-related changes such as falling, depression, memory loss, loss of peripheral vision, weight loss, for example, is not a normal part of aging and needs to be addressed in order to age well.

To age well we:

  1. Must accept the normal changes taking place as we age
  2. Address these changes with regular health care visits
  3. Understand that an unhealthy lifestyle such as lack of physical exercise, unhealthy eating, over-consumption of alcohol, drug or medication misuse,  and lack of social interactions will have a domino effect on normal aging.

Age is the greatest factor in developing Alzheimer’s, Parkinson’s disease and other neurological symptoms, heart disease and other chronic illness.  For the 78 million boomers marching toward old age who want to age well, the best first step is to realize that you have the ability to choose if this will be your course of action.  To age well, we must take on the aging challenges intentionally.  Not by ignoring that we are aging, or allowing ourselves to wallow in the woes of aching joints.

“Know that you are a perfect age.  Each year is special and precious, for you shall only live it once.  Be comfortable with growing older.”                              ….Louise Hay

Pam Brandon is President/Founder of AGE-u-cate Training Institute and a passionate advocate for older adults and those who serve them.  She is the creator of the internationally acclaimed Dementia Live Simulation program.  She may be contacted at pam@ageucate.com

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Personhood and it’s Value in Dementia Care

Quite simply, the definition of personhood is the quality or condition of being an individual person.  At the core of personhood is the self- who we are are, our values and beliefs.  It’s who makes us who we are.  Being able to recognize the “self” of personhood is key to understanding and practicing person-centered care for persons living with dementia.

Professor Thomas Kitwood was a pioneer in the philosophy of person-centered care from the University of Bradford in England and in the 1990s, connected the beliefs and values of person-centered care specifically to dementia care. His work and research gave voice and credence to the need to realign dementia care practices to a model oriented to the “personhood” of the individual living with dementia.  Although he passed away before his research was complete, his valuable work, and has been built upon throughout the world as the basis and model for providers of dementia care services, advocates and certainly the continued research on this topic.

Personhood doesn’t go away as dementia progresses.  The individual within is what makes up who we are.  In many ways, dementia does change one’s judgment, memory, sensory abilities, language, mood, and behaviors.  But what makes them who they are doesn’t change – it’s their personhood.  Unfortunately, too often our society, families and even professional caregivers treat someone living with dementia as if they have lost who they are.  When we ‘discount’ that person’s selfhood (or personhood), it alters how they think of themselves in the world, their relationships, security, and purpose.

Humans are born to relate, connect and bond.  These needs remain for a lifetime, yet far too often when someone has even mild dementia, others treat them as if those inner needs that keep them whole, are simply not important.  Sadly, those who are often the most vulnerable to this reaction are families.  The root cause of not respecting one’s personhood is often fear,  denial or the need to suddenly take control.  Losing one’s personhood robs them of the ability to hang on those basic human needs – to related, connect and bond.

Respecting one’s personhood in dementia care means that we must move into their world.  Join them where they are, in the moment, with no expectations other than to connect with the individual within.  When doing so, we are practicing person-centered care and their personhood.

Pam Brandon is President/Founder of AGE-u-cate Training Institute and a passionate advocate for older adults and their caregivers.  Pam is the creator of the internationally acclaimed Dementia Live awareness and training program and worked with recognized expert, Ann Catlin in developing the Compassionate Touch program.  

 

 

 

Keep it Simple and Engage – Tips for Effective Dementia Training

High staff turnover in long-term care is certainly not a recent phenomenon.  Going back to the 1970s studies pointed to average turnover rates for registered nurses (RNs), licensed vocational nurses (LVNs) and certified nursing assistants (CNAs) ranging between 55% – 75%.  With growing demands for these professions as our aging population explodes, many providers are reporting upwards of 100% turnover.  Many factors need to be addressed – one being how we are preparing this workforce to work with the growing numbers of older adults with dementia? Leaders have many options for dementia training.  What do we hear most often?  Keep it simple and engage the learner!

The question is –  Have we made dementia training to complex?  

Before I go further on the urgent need for more effective dementia training, I want to make note of the other factors that lead to high turnover rates.  Certainly, low wages and high stress in this field leads to burnout rates at a faster rate than other fields.   Research has also pointed to organizations that foster communications and teamwork, and rewarding employees as being a growing factor in lowering turnover and keeping high-quality employees.

Because eldercare is fast becoming about dementia care, dementia training is now front and center on the agenda of virtually every elder care provider and hospital,  and with dementia friendly initiatives, it’s safe to say that if you are NOT prioritizing this urgent need, you will be left far behind in a short period of time.  To support this effort, state and federal mandates are now in place to ensure that staff is better prepared to provide quality care to those living with dementia.

Our workforce is culturally diverse and reaches across several generational groups. The findings revealed human attention span has fallen from an average of 12 seconds in the year 2000 to just eight seconds today. Humans now have less of an attention span than a goldfish (nine seconds average). A study by Microsoft revealed that the decrease was seen across all age groups and genders in the study. Those in the age bracket of 18 to 34 had a 31 percent high sustained attention span compared to those age 55 and over at 35 percent.

What does this mean for dementia training?  With a high-turnover, a culturally diverse workforce with decreasing attention spans, we need to be able to train quickly, effectively and provide rewards for those who are using trained skills to improve care.

Here are tips for rethinking your dementia training program:

  • Communication techniques should not be overly complicated.  Simple tools that are effective and feasible to adopt will be integrated much more successfully by staff.
  • Focus on the effects of dementia, and not the disease itself.  Effects include the changes that take place with problem-solving, judgment, sensory changes, memory, mood, language, personality.  Teach techniques with role-playing and team-work rather than listening to a presentation.  Learners who are engaged retain more knowledge.
  • If you are going to teach a new tool,  having the learner go through a like experience will provide them with an inside-out understanding of the person with whom they are caring.
  • Dementia training should include techniques that will reduce stress for both care partners.
  • Think tools.  Does this training provide feasible, effective tools that caregivers can easily reach for (because they have been trained simply and engaged in the training)?  If tools are not part of the training, what they learn will soon be forgotten.
  • Reward employees with benchmark successes.  We all need to nurture care staff far more than most of us are doing!

Pam Brandon is President/Founder of AGE-u-cate Training Institute and a passionate advocate for culture change and caregivers.  She is the creator of the internationally acclaimed Dementia Live awareness and training program, co-developer of Compassionate Touch and other dementia education programs.  pam@ageucate.com