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New philosophy for treating dementia patients
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cjh1203 posted:
There is a fascinating article in the current New Yorker about a facility in Arizona using a completely different approach to dealing with dementia patients than has been used in most memory-care facilities. Unfortunately, you can only read part of the article unless you are already a subscriber or sign up to subscribe to the digital edition.

Staff of the facility, including administrators, doctors, nurses, and even maintenance workers, observe patients carefully and take their cues from the patients rather than following the fairly narrow regimen of a standard memory-care facility. By watching the patients, they are often able to get to the source of anxiety, agitation or even violence and address that, rather than going the standard drug route. They have been able to get almost all of their patients off anti-psychotic drugs and reduced their meds significantly overall.

One illustration given was the case of a man who became very angry and agitated when he was being bathed or dressed. Someone noticed that he liked to watch TV during those times, but people kept getting between him and the TV, blocking his view. Once he was given a clear view of the TV, he was fine. In a normal facility, he would have probably been labeled uncooperative or difficult and given medication for his behavior.

They find the things that make patients happy -- for instance, one man loved being told he was handsome -- and the entire staff will tailor their behavior toward those patients based on that.

They also do not have a schedule for anything. Staff members do not have to have patients dressed or bathed by a certain time in the morning and, as long as basic hygiene is maintained, staff are free to take their patients' wishes as guidance. Patients are also allowed to eat at any time of the day or night and snacks are passed like hors d'oeuvres several times a day, since dementia patients often forget to eat and end up losing a lot of weight.

The goal of this philosophy of care is to keep the patient happy, rather than trying to regulate their behavior to keep them manageable. Keeping them happy seems to lead to much less agitation and violence.

Other facilities are now following The Beatitudes' model. Think what a difference it could make for the families of dementia patients, as well as the patients themselves, to see happiness as the primary consideration in care.

I hope you'll all get to read the article.

Carol
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Judith L London, PhD responded:
Hi Carol,

I know about the article. The stories in my first book, Connecting the Dots..., all point to the benefits of respecting and seeing the person with Alzheimer's as a person first, a person who cannot change what is happening to himself. The only people who can change the situation are the caregivers. When the environment adapts to the needs of the person with this disease, problems diminish. Both parties connect and communicate and may even feel happy. It's up to us to read the signals. However, harried caregivers find that a real challenge.
 
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trwebster responded:
Interesting. I work as a care-giver for a moderate-severe Alzheimer's client, who a couple of months ago was very stressed after the Hospice aide came to give her a shower. I sat down with T and eventually discovered that she was upset with herself because she couldn't think 'nice thoughts' about the aide whose own personal hygiene left much to be desired. We got another aide and T usually goes to her shower with little grumbling now. I'll see if I can find that article.
Terry


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