Category Archives: Hospital Professionals

Is it Possible for Doctors to Provide Compassionate Care?

The Physician’s Oath promises to approach all patients with integrity, candor, empathy, and respect.  I believe that most doctors take their oath seriously.  I believe most doctors study very hard because they truly want to help other people and make a positive difference in the field of medicine.  Doctors have a tremendous responsibility in today’s messy healthcare environment.  They work long hours, have many patients and deal with lots of complications to ultimately deliver the care that their patients need.  So, is it really possible for doctors to provide compassionate care?

I will speak only from a patient and patient advocate perspective, after having been a caregiver to my aging parents for many years.  Most doctors want to listen to their patients and get to know them beyond their medical conditions.  I really believe that.  I think most doctors would agree that the complexities of healthcare take away from the time they would like to spend with their patients and families so that they can be a source of compassion and guidance.

For doctors to provide compassionate care, they must have time.  Unfortunately,  this is rarely a luxury, if at all.  Treating patients medical needs is first and foremost when it comes down to it.  Having the time to converse and get to know their patients is almost unheard of these days.  So how can doctors provide compassionate care when the odds are stacked against them in so many ways.

In dementia training, we teach the importance of eye-to-eye contact,  slowing down, speaking with respect to another person, gently holding one’s hand to provide comfort among other simple gestures. These are signs of compassionate care that take no more time than the alternative.  Sometimes a smile or caring concern is all it takes to quickly make another person feel like they are important to another person – even if it’s brief.

Doctors are fixers, and it’s natural in their hurried days to be focused on fixing what’s wrong.  And no doubt that is monumentally important.  As healers, though, a doctor can and should practice compassionate care even though the odds are often stacked against you.  Compassionate care can be taught, learned and passed on to others. It’s an emotional, spiritual and transformational gift that you give another person shown with the simplest of gestures.

Compassion can be felt by another just by the gift of your genuine presence.

Pam Brandon is President of AGE-u-cate® Training Institute and a passionate advocate for older adults and those who serve them.  She is the creator of the Dementia Live® Simulation and Awareness Program.  

The NICHE difference: Preparing Our Long-Term Care Workforce for Tomorrow

We are thrilled to have recently announced our collaboration with NICHE – Nurses Improving Care for Healthsystem Elders, a nation-wide nursing education and consultation program designed to improve geriatric care in healthcare organizations through education and mentorship.

The NICHE Acute Care Program, founded in 1992 is part of NYU Rory Meyers College of Nursing.  The program promotes the use of evidence-based clinical interventions and establishes nurses as leaders to effect positive change in caring for the growing aging population.  NICHE empowers front-line nurses to build a team and develop organizational and workforce competencies to improve the health and wellbeing of older adults they serve.

The NICHE long-term care(LTC) program prepares nurses and certified nurse assistants (CNAs) to achieve organizational goals for the care of older adults patients.  The NICHE-LTC promotes the use of evidence-based clinical interventions and establishes nurses as leaders to bring about changes in the quality of care delivered to older adults in LTC and PAC (post-acute care) facilities.

The LTC curriculum is designed around the Centers for Medicare and Medicaid Services (CMS) Five-Star Quality Rating System so organizations uphold the nationally recognized standards for LTC.  A few examples of Quality Measures include:

  • Ability to move independently and participate in activities of daily living
  • High-risk residents with pressure ulcers
  • Re-hospitalizations, emergency department visits, and discharge to the community
  • Moderate to severe pain
  • Falls with major injury
  • Antipsychotic medications

NICHE resources include highly engaging webinars, Need to Know patient and family consumerism, LTC Leadership Training, Implementation Courses, and Clinical and Quality Improvement Modules, and an Evaluation and Recognition Process.

Our shared mission that quality training empowers staff will lead to higher CNA retention and improved care:

  • Nursing homes whose nursing staff have enhanced knowledge and skills perform better on quality metrics.
  • CNA’s who receive specialized training on common health issues experienced by older adults are capable of providing better care to residents and feel more confident in performing their work.
  • Opportunities for CNAs to participate in training programs not only empower them with knowledge and skills to carry out their work but also reinforce their important role in achieving organization-wide quality improvement goals.
  • CNA’s who receive high-quality training are more likely to report that they are satisfied with their jobs and job satisfaction is directly linked to CNA retention.

Quality elder care is critically important and NICHE programs provide the tools and resources that elevate Acute and Long-Term care organizations to a level of excellence.  As the need for dementia training increases, our relationship with NICHE will serve to better prepare the workforce for the special needs of those living with cognitive differences.

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 Dementia Live® Sensitivity Awareness Training program and led the development of  the Compassionate Touch® training for persons living with Dementia and End-of-Life care.  

Compassion Fatigue: Caring too Much

Any senior care professional is vulnerable to Compassion Fatigue.  For example, nurses, doctors, counselors, veterinarians, therapists, social workers, chaplains, emergency response workers, and people caring for aging parents. So, what is Compassion Fatigue?

Dr. Charles Figley, describes Compassion Fatigue as, “ a state experienced by those helping people in distress; it is an extreme state of tension and preoccupation with the suffering of those being helped to the degree that it is traumatizing for the helper.”  Furthermore,  “The capacity for compassion and empathy seems to be at the core of our ability to do the work and at the core of our ability to be wounded by the work”.  Compassion fatigue results from the cumulative impact of taking care of people living with serious illness, trauma, abuse, or severe conditions.”  It’s different than job burnout, which is dissatisfaction with our job situation, not the work itself.

But how do you recognize compassionate fatigue?  The Compassion Fatigue Awareness Project tells us characteristics include:

  • Withdrawing from others
  • Difficulty connecting – detaching
  • Feeling angry that other caregivers don’t understand the nature of your service
  • Life feels too serious
  • Turning to compulsive or addictive behaviors such as overeating, overspending, alcohol, smoking, etc.
  • Physical symptoms: headaches, gastrointestinal symptoms, muscle tension.
  • Fatigue and apathy
  • Difficulty concentrating
  • Avoiding work. Calling in sick or postponing appointments
  • Thinking that this work isn’t for you (when you know in your heart you really love it)

So, how can we avoid Compassion Fatigue? The answer lies in self-care, typically physical support like regular exercise, getting enough sleep and good nutrition. However we shouldn’t stop there. Nancy Jo Bush, an oncology nurse, says that self-care also includes setting empathetic boundaries; self awareness and self forgiveness; being in tune with one’s spirituality and finding hope. Experts agree that reaching out to others and developing a support system is critical.

A friend working in hospice shared a bit of wisdom. Lighten up and don’t forget to laugh. That reminds me of an old Joni Mitchell lyric, “Laughing and crying, you know it’s the same release.” Thanks, Joni. We’ll all try to remember that!

In conclusion, who would you turn to if you needed the support of an understanding friend?

Ann Catlin, OTR, LMT is a recognized expert in the field of skilled touch in eldercare and hospice. She guides professionals in discovering Compassionate Touch in person centered dementia care. She is a team member of AGE-u-cate Training Institute.

Rural Healthcare: Helping Caregivers and Persons Living with Dementia

Access to quality rural healthcare, resources, education, and support is a growing challenge in the US and around the globe.  What does this mean for the growing numbers of persons living with dementia and their families who are caring for them?  How does this affect the quality of care being offered by nursing homes and other care providers?

There are no easy solutions as options are dwindling for many rural communities.  Closures of hospitals mean less health care professionals to diagnose Alzheimer’s and other forms of dementia.  Community education for families, often a service offered by hospitals and clinics, is then not available.  When the infrastructure of healthcare, private providers and community-based services is compromised, access to much-needed support dwindles quickly.

I recently had the honor to work with the University of Waterloo School of Pharmacy who collaborates with the Gateway Centre of Excellence in Rural Health, both in Ontario Canada.  The University will be training its pharmacy students using our Dementia Live® and Compassionate Touch® programs and beyond that, they are will be working with Gateway to reach rural communities with desperately needed dementia education and training for families and professionals.

Reaching the indigenous people of the province will be part of this project.  In the 2016 census, the indigenous or Aboriginal peoples in Canada totaled 1,673,785 people or 4.9% of the national population.   Many of the indigenous peoples live in rural areas where access to services is limited.   Bringing dementia awareness and education to rural areas will help to spur collaboration amongst various organizations who need to work together to serve their aging populations and families.

Limited access to rural healthcare is a growing initiative in the US and other countries as the aging population swells.  Because family caregivers make up the vast majority of those caring for persons with dementia, providing quality training, support and access to resources is a top initiative for healthcare, long term care services providers and community-based organizations in urban areas who can collaborate with local services, faith communities and others who have a direct reach to many of the families who are struggling.

Finding local champions who see the value of collaboration, education and support services is ultimately the best measure of success, as the communities themselves embrace the challenges and solutions for their aging communities and the unique needs of persons living with dementia and their families.

Pam Brandon is President/Founder of AGE-u-cate® Training Institute and a passionate advocate for older adults and those who serve them.