1. Communicating with Dementia Patients of Different Severity Levels
Michael Ciulla, Kurt Karis, BS, Tria O’Maille, MA. BC-DMT
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Euclid Hospital
Department of Geriatric Behavioral Medicine, 4th floor-Upma Dhingra, MD
Anxiety, Schizophrenia, Depression
However, Dementia is the most frequent reason for admission
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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
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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”
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Research Question
How effective are these means of communication?
In Mild Dementia?
In Moderate Dementia?
In Severe Dementia?
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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
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Methodology
Mini Mental State Exam (MMSE)
Used to evaluate cognitive function
This exam will give a result out of 30 possible points
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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.
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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.
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Results
Results will be calculated based on the patients’ MMSE scores
Patients’ score will be out of a possible 30 points
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Results
MMSE scoring
24-30: normal cognitive functioning
19-32: mild dementia
11-18: moderate dementia
<10 severe to end stage dementia
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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
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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
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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
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Discussion
All conclusions are hypothetical and are based on my daily experiences in the Geriatric Behavioral Medicine Department at Euclid Hospital
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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
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