Case Study [PDF]


As National Director of Clinical Development for Legacy Healthcare Services of Raleigh, NC, Ann Irwin was part of a group of 70 Legacy employees and affiliates to attend a Dementia Capable Care course in order to increase their skills as clinicians. With estimates that up to 80 percent of skilled nursing facility patients have some degree of dementia, Irwin recognized the critical need for enhanced staff training in long-term care settings.

"It was truly an 'aha' moment when the light went on, and I saw how the principles of Dementia Care Specialists (DCS) training created a framework for us to identify and foster the humanity and ability of the person," said Irwin. "We left that seminar convinced we had been introduced to an approach unlike anything we had previously been exposed to and we saw it as extremely useful in interacting with the patients we serve in skilled nursing facilities."

Since then, Legacy has arranged for additional employees to attend specialized training and subsequently identified six sites where they conducted interactive webinar training. Next, they made available the DCS DVD series, which allowed their therapists to absorb the information at their own pace while earning continuing education credits. Most recently, Legacy sent a number of therapists and nurses to the Dementia Capable Care: Instructor Program.

Training additional staff in dementia care allowed Legacy Healthcare Services to further distinguish itself as a provider of excellence in the field of long-term care rehabilitation.


"What we found when we got back to the trenches was that the program is most effective when made an integral part of a team approach—what DCS calls 'speaking a shared language' among caregivers," Irwin added. She agreed that the multiple modes of learning tools provided by DCS contributed to successful implementation.

"Providing caregivers with training options has been received extremely well by our staff and the staff at the facilities we contract with," said Irwin. "We are headed to a point where we achieve a critical mass—where the nursing and activities staff of the facilities we serve are as invested in the program as we are."

Irwin finds real improvements in patient care and contact as a result of the DCS training. Novice therapists rarely have skill for interacting with dementia patients. The traditional treatment approach is compartmentalized as a stand-alone occupational, physical, or speech therapy issue. Without a holistic approach, the treatment regimen may overlook inherent patient skills. DCS teaches how to shift the paradigm and focus on what the patient can do rather than on what limitations exist.

"DCS has opened up our minds to incorporate the dementia component in the overall treatment, to standardize the curriculum and make it a part of the culture of the institutions in which we serve," Irwin explains.

In addition to the therapeutic improvements, contract therapy companies such as Legacy have realized tangible economic benefits by implementing the training. Improving clients' physical and mental acuity diminishes the need for more acute care. As therapists understand and implement the approach, clients are better able to participate in therapeutic activities, and they remain on the caseload longer. This, of course, has a net positive impact upon a facility, including an increase in reimbursement revenue through Medicare Parts A and B.

"The amount of therapy we provide has positively impacted the quality of residents' lives. That's beneficial to all parties."