Person Centered Dementia Approaches Dr. Margaret Kimbell V.P. Community Living VAHQ 38th Annual Education Conference November 2015

Erickson Living

Integrated Health and Wellness

Person-Centered Approach “Caring enough to understand the individual and customizing our approach to recognize the person’s gifts, their needs, their preferences, and their goals”

Person-Centered Approach Self- Actua lizatio n Esteem Love & Belonging Safety Physiological Quality of Care

Person-Centered Approach Self- Actua lizatio n Esteem Love & Belonging Safety Physiological Quality of Life

Dementia

Disease/Condition = Dementia Syndrome Memory/Remembering Paying attention Speaking and under- standing language Problem solving Orienting to day, year, season Orienting to where they are Orienting to who they are Alzheimer’s Parkinson’s Stroke Infection of Brain Thyroid Deficiency Vitamin Deficiency

The Four “A”s of Dementia & the Brain Agnosia Apraxia Amnesia Aphasia

How Would You Feel If:

Triggers to Actions/Expressions Emotions Actions

Explore the need expressed through Actions and Expressions Self- Actua lizatio n Esteem Love & Belonging Safety Physiological

Explore the need expressed through Actions and Expressions Self- Actua lizatio n Esteem Love & Belonging Safety Physiological

Think Comfort! The 5 W’s Who What When Where And … Why? Unmet need ? PCA Approach to Service Plan Approaches Evaluate the Approaches

Examples in action George 90 year old gentleman with dementia Married with children and retired from a highly successful career – college educated Actions and Expressions Does everything briskly Has reverted back to his native language Has struck out at staff and other residents Often refuses care (ADL) Does not like to be told what to do Does have the ability to self sooth

Think Comfort! The 5 W’s Who What When Where And … Why? Unmet need ? PCA Approach to Service Plan Approaches

Examples in action Faye 74 year old woman with dementia Widowed and remarried with one step son; college educated Actions and Expressions Often stays to herself in her room – thinks the other people are “crazy” Paranoid and accuses staff of taking things she cannot find Does not like to be told what to do Aware that something is not “right with my mind” Often self-loathing

Think Comfort! The 5 W’s Who What When Where And … Why? Unmet need ? PCA Approach to Service Plan Approaches

Faye

PCA Quality Outcomes Quality of Care- Clinical Falls Antipsychotics Weight loss Pressure Ulcers Resident to resident/staff altercations Quality of Life - Observation Are you seeing purposeful engagement? Are you hearing conversations and laughter? Do the residents look happy and engaged? Are the families relaxed and communicate well with the staff?

Questions?