Communicating with Dementia Patients of Different Severity Levels Michael Ciulla, Kurt Karis, BS, Tria O’Maille, MA. BC-DMT Cleveland Clinic Science Internship Program, OCEI

Michael’s Science Internship Experience Euclid Hospital Department of Geriatric Behavioral Medicine, 4th floor-Upma Dhingra, MD Anxiety, Schizophrenia, Depression However, Dementia is the most frequent reason for admission Cleveland Clinic Science Internship Program, OCEI

Cleveland Clinic Science Internship Program, OCEI What is Dementia? Dementia is the loss of cognitive, verbal, and physical functions in the brain Examples include Alzheimer’s Disease, Vascular Dementia, Parkinson’s Disease Latin roots: de mens meaning without the mind Death of neurons in the brain that are never repaired or replaced Cleveland Clinic Science Internship Program, OCEI

Cleveland Clinic Science Internship Program, OCEI

Cleveland Clinic Science Internship Program, OCEI Research Question According to psychiatrists, communication with patients suffering from dementia must be very personal and direct. Eye contact, slow, clear voice in a low tone, approaching patient from the front, and formulating simple questions which would require an answer of “yes” or “no” Cleveland Clinic Science Internship Program, OCEI

Cleveland Clinic Science Internship Program, OCEI Research Question How effective are these means of communication? In Mild Dementia? In Moderate Dementia? In Severe Dementia? Cleveland Clinic Science Internship Program, OCEI

Cleveland Clinic Science Internship Program, OCEI Hypothesis Patients with mild dementia will be able to respond to the method of communication proposed by psychiatrists Patients with moderate dementia and severe dementia will not be able to respond to such communication in the same way in which the mild dementia patients responds Cleveland Clinic Science Internship Program, OCEI

Cleveland Clinic Science Internship Program, OCEI Methodology Mini Mental State Exam (MMSE) Used to evaluate cognitive function This exam will give a result out of 30 possible points Cleveland Clinic Science Internship Program, OCEI

Cleveland Clinic Science Internship Program, OCEI Methodology MMSE score will be used to determine the loss of cognitive function in each patient After the exam is completed and score is calculated, patients will be observed during a daily behavioral therapy session as well as a dance and movement therapy session. Cleveland Clinic Science Internship Program, OCEI

Cleveland Clinic Science Internship Program, OCEI Methodology The way in which the patients respond to the therapists in these therapy sessions will show if these types of communication are effective for patients with different progressions of dementia. Cleveland Clinic Science Internship Program, OCEI

Cleveland Clinic Science Internship Program, OCEI Results Results will be calculated based on the patients’ MMSE scores Patients’ score will be out of a possible 30 points Cleveland Clinic Science Internship Program, OCEI

Cleveland Clinic Science Internship Program, OCEI Results MMSE scoring 24-30: normal cognitive functioning 19-32: mild dementia 11-18: moderate dementia <10 severe to end stage dementia Cleveland Clinic Science Internship Program, OCEI

Cleveland Clinic Science Internship Program, OCEI Conclusions After observation in group therapy sessions, the following results could be expected: The patients with mild dementia would be able to communicate verbally and through creative expression with a wide to moderate range of movement Cleveland Clinic Science Internship Program, OCEI

Cleveland Clinic Science Internship Program, OCEI Conclusions The patients with moderate dementia would be able to communicate verbally, but with a more narrow vocabulary than that of the mildly demented patients, and most would be able to show some degree of creative expression with a moderate range of movement Cleveland Clinic Science Internship Program, OCEI

Cleveland Clinic Science Internship Program, OCEI Conclusions The patients with severe dementia would communicate verbally, but in short sentences followed by long pauses. At this stage in the disease, the patients’ vocabulary is especially limited. Minimal patients would be able to show creative expression, and if able, movement would be minimal Cleveland Clinic Science Internship Program, OCEI

Cleveland Clinic Science Internship Program, OCEI Discussion All conclusions are hypothetical and are based on my daily experiences in the Geriatric Behavioral Medicine Department at Euclid Hospital Cleveland Clinic Science Internship Program, OCEI

Cleveland Clinic Science Internship Program, OCEI Acknowledgements Kurt Karis Tria O’Maille Upma Dhingra, MD Nursing staff of Department of Geriatric Behavioral Medicine at Euclid Hospital Patrick Finnegan Nedra Starling Rosalind Strickland Office of Civic Education Initiatives Cleveland Clinic Cleveland Clinic Science Internship Program, OCEI