Dementia in Independent Senior Housing: Concerns, Barriers and Solutions

Transcription

1 Dementia in Independent Senior Housing: Concerns, Barriers and Solutions LeadingAge NY April 13, 2016 Kelly Papa, MSN, RN Masonicare Corporate Director of Learning The Big Question How can we create systems to support people affected by dementia in Senior Housing? 1

2 The Challenge in Independent Housing Housing for older adults was not built to support people with cognitive impairment. The additional funding needed to support staff levels to support people with dementia does not exist. Staff usually does not have the education or experience needed to support people affected by dementia. Communities does not have the level of activities needed. There is a lot of fear, frustration and worry. 2

3 Alzheimer s Disease and Related Dementias What is Dementia? What is Alzheimer s Disease? What changes do we see? Types of Dementia Alzheimer s Disease Vascular Dementia Dementia with Lewy bodies Mixed Dementias Parkinson s Disease Frontotemporal Dementia Cruetzfeldt Jakob Disease Normal Pressure Hydrocephalus Huntington s Diease Wernicke Korsakoff Disease 3

4 FAST 10 Warning Signs 1. Memory loss that disrupts daily life 2. Challenges in planning or problem solving 3. Difficulty completing familiar tasks 4. Confusion with time or place 5. Trouble understanding visual images or spatial relationships 4

5 6. New problems with words in speaking or writing 7. Misplacing things and losing the ability to retrace steps 8. Decreased or poor judgment 9. Withdrawal from work or social activities 10. Changes in mood and personality What does it feel like to have dementia? How would I experiences everyday events? How would I feel about my ability to participate in my own self care? How would I want others to treat me? What would you want the day to be like? Feel like? 5

6 Resources Tips and Techniques for Supporting Residents with Alzheimer s Disease Using the Habilitation Model: A Guide for Staff in Independent Senior Housing Caren Silverlieb, MMHS, Jewish Community Housing for the Elderly Paul Raia, PhD, Alzheimer s Association of MA and NH Funded by The LeadingAge Innovations Fund Habilitation Therapy: The whole is greater than the sum of its parts. 1. The Physical Environment 2. Knowing and Understanding the Individual 3. Our Communication with Residents 4. The Resident s Communication with Us 5. Purposeful Engagement 6. Education 6

7 Recognizing and Responding to Changes Appearance Communication Cognition When it is Time to Intervene Repeating questions or stories Inability to keep track of daily tasks Wandering Withdrawal Paranoid, delusions or hallucinations Depression or suicidal statements Behaviors affecting other residents Repeated calls to staff or police Decreased personal hygiene 7

8 Supporting Someone in Early or Middle Stage Homemaker and care services Reminders about meals and events Assistance with paying bills and setting up calendars Medication dispensers Arranging apartment to de clutter and placement of important items or numbers Safety checks, fall prevention Plans for walking outside the building and transportation to appointments Recognizing / responding to changes (nutrition, medical, vision, etc.) Education for staff, families and residents Supporting Someone in Late Stages When the person is unable to eat or dress independently, has weight loss, becomes incontinent, or is unable to ambulate safely, for their comfort and quality of life it is time to consider 24 hour care, hospice care or care in a long term care facility. 8

9 Habilitation Therapy: The whole is greater than the sum of its parts. 1. Knowing and Understanding the Individual 2. The Physical Environment 3. Meaningful Engagement 4. Our Communication with Residents 5. The Resident s Communication with Us 6. Education Look for the Bright Spots and the Knowledge Gaps! 9

10 What Can Be Done? Educate staff Educate residents, families and care providers Advocate for funding for programs that delay or avoid nursing home placement (24 hour adult day care, etc) Develop specialized/secure floors/areas with the appropriate level of funding, staffing and activities Partnerships with community (Universities, Police, etc) Creativity! Shared Learning The Study Circle Question For whom, or what, are the gaps in care for people living in Senior Housing affected by dementia? 10

11 Inversion Game What do we not want to do when people affected by dementia come to our communities? 11