The month of October has been like a roller-coaster ride of energy and emotion. I have been on the road teaching, learning, and interacting—spreading the word about the importance of and the need for quality dementia care delivered by a skilled interdisciplinary team. Along the way, I have experienced a variety of responses that have left me both excited and a little bit concerned.
On October 9, I was at Creighton University for the wonderful twenty-fifth anniversary celebration of their occupational therapy (OT) program. I was pleased to participate as I presented Occupational Therapy for Individuals With Dementia—Opportunities in Long-Term Care.
The event was lovely as many proud alumni gathered with faculty and students. Dr. Florence Clark, president of the American Occupational Therapy Association, was the keynoter, and she presented (virtually) her summary of how OT appears wonderfully positioned for the future and to fit well within health care reform.
I learned much from Dr. Clark, including:
- The provision of services that help "prevent" chronic disease and prevent health complications associated with disease states will become ultra-important for managing growing chronic conditions such as Alzheimer's disease and related dementias (ADRD).
- There will be much focus on providing care that can decrease lengths of hospital stays and decrease hospital readmits.
- It is more important than ever for OTs to be able to collect data that show how our services decrease costs and increase quality.
These points of emphasis, and others Dr. Clark shared, helped me gain validation that our Dementia Capable Care teachings are perfectly aligned to support the emphasis of care today and well into the future. Cool.
After Dr. Clark, I was up. Presenting in a campus classroom, I began, "When I was a new graduate (over 22 years ago), providing OT for the elderly in nursing homes was not seen as exciting. In fact, it was the proverbial ‘losers' who went to work in nursing homes. It was the therapists (and others) who couldn't find jobs anywhere else, or so some thought. Simply said, it wasn't very sexy. But what could be more sexy than a job full of challenges and unfathomable rewards?
"The elderly and those with dementia," I continued, "are some of the most challenging, worthy, and underserved clients you could ever find. The moments spent learning their life stories and other wisdoms . . . priceless. And the reward of helping a person who has been living with emotional and functional deprivation find purpose and success again . . . well . . . I have no words for this reward." A couple obvious "lumps in the throat" within the audience encouraged me to continue.
The students, faculty, and alumni watched and listened as I shared more, and many leaned in and wrote down every word. But along the way I noticed a couple students glancing out the window looking at the beautiful hues of the fall leaves against the bright blue sky. I don't have them yet, I thought. I'll try harder.
Next were my short videos of some of the wonderful people with dementia I have been privileged to serve. In one video, I'm working with Adel, a wonderful woman in end stage/Allen Level 1. Adel looks pretty helpless, and yet we bond and interact during a brief sensory stimulation program. Adel watches me intently; laughs and smiles as I sing to her, massage her hand, and simply let her know I care. Next is Milton, who is performing in middle stage/Allen Level 3. In this video I provide a brief demonstration of how the right coaching, cueing, and encouragement transforms Milton from "No, I can't. You do it." to actively and successfully shaving his face.
Ok, now not one person is looking out the window. Instead, all have been riveted to Adel and Milton, and I can see their smiles and hear their "ahs" as they watch intently. Thanks, Adel and Milton. Your spirits continue to teach and inspire. I am grateful.
After the presentation, a few attendees lingered with questions such as, "How can a new grad find a good job in a nursing home?" and "I'm working as an OT and want to train nursing aides and others. How do I convince my boss to send me to one of your training programs?" I was pleased, as clearly our message had been well received and the students and practicing OTs in the audience were ready to serve.
Once I answer all of "my students'" questions, everyone trickles out. I'm left standing alone in the classroom. A strange experience for me, as I secretly want to end my career teaching at a college. A likely impossible task for someone who possesses only a bachelor's degree, but I get a taste, and I love it! Not that I'm close to ending my career, but I do fantasize about one day carrying my briefcase through a beautiful historic campus, feeling satisfied and energized after spending time with amazing students. Now, standing at the head of the empty classroom, I feel satisfied and inspired. More seeds planted here. Good, I think. Time to head home.
It wasn't until I was on the return flight late that Saturday evening, somewhere between Nebraska and North Carolina, that I came to realize all the seeds that had been planted inside of me. Dr. Clark and the students sent me home with something burning inside my head and my heart. I now had this message that wanted to EXPLODE out of me as I looked down at the lights shimmering from the communities some 35,000 feet below . . . "I know there are many of you living with Alzheimer's that are in need, and we are ready to help."
On October 15 and 16, Chris Ebell and I presented our Dementia Capable Care: Dementia Therapy Intermediate program in Chattanooga, TN. We were thrilled to have over 55 participants, many from one of our long-standing customer partners. Once again, the energy was amazing as these experienced therapists came back to learn even more about assessing and treating those with ADRD. I was feeling real good to have another large corporation demonstrate its ongoing commitment to making life better for those with ADRD and its commitment to supporting the ongoing learning of its therapists. I left this training event feeling that all participants would make a big difference in the lives of the clients they served. A great group!
On October 21 and 22, I had the pleasure of attending and presenting at the fall conference for the National Association of Rehab Agencies (NARA) in Las Vegas. I had not been at this conference in years, and I certainly questioned why, as it's a very well-run and informative event. I enjoyed presenting Dementia Capable Care: A Win-Win Business Opportunity to over 100 attendees, including high-level managers, owners, and executives.
I felt their interest in the topic and received many wonderful comments such as, "If I had dementia, I would want you to care for me." That was certainly nice to hear, but, I wondered, how many are willing to take the plunge and commit to educating and supporting their therapists to best serve those with ADRD? Unfortunately, as we know, most OTs, PTs, and SLPs are not adequately trained to evaluate and treat those with ADRD out of school; therefore, it's up to employers to prepare their therapists for this area of specialization. I can only hope that my audience of decision makers found the topic of caring for clients with dementia as "sexy" as the latest technology. There are many new technology products available for therapy; some were demonstrated at this conference, and many people were interested in them. While I believe in the value of technology, I hope the value and benefits of training and preparing staff to enrich the lives of clients with dementia will not be left behind. Time will tell. I hope my message of need and advocacy penetrates. Yes, technology is cool, but nothing is as valuable as:
- Providing a hug or a gentle touch at just the right time to "tame" a behavior.
- Building a therapeutic relationship to gain trust and agreement to engage in exercise, ADLs, and LIFE.
- Having the knowledge to help people at every stage of dementia successfully participate in meaningful activities.
- Having the expertise to advise, guide, and educate families and professional care staff.
- Having the skills to facilitate Best Ability to Function and maintain a person's health and emotional well-being.
In summary, this was a whirlwind month in which I met many who have a responsibility to enrich the lives of people with dementia and to support loved ones. While researchers fight to find a cure, therapists and others must step in now and help those with ADRD live with purpose and quality and successful daily experiences. Medicare is not our barrier, as we have fought hard and won the opportunity for therapy service reimbursement. The only potential barrier is us. Serving someone with dementia takes commitment. It is not easy, but it is worth it. There are over five million people in the US who hope we will stand up and take on this challenge, as they are in need, and waiting . . .