Therapeutic Engagement

Karen Love & Elia Femia, PhDCo-Founders ~ FIT Interactive

Person-Centered Dementia Caring: Crossing the Quality ChasmPatient-Centered/Person-CenteredIOM Report - IOM, 2001 report - Crossing the Quality Chasm;

Affordable Care Act

Called for a redesign of the nations healthcare system and a shift from a clinical/disease model of care to a person-centered one.

Models of CarePerson-centered orientationMedical-disease orientationFocus on holistic bio-psycho-social-spiritual dimensions; Based on relationships that foster self-determination, normalcy, choice, purpose, belonging, security and responsibility to optimize health and well-being.PersonalIndividualized practicesBehavioral expressions

Focus on medical and disease condition; Typically based on efficiencies of the provider of services or supports.Less personalNon-pharmacological practicesBehavior problems

Concerns That Coalesced a National InitiativeNAPA too narrow and silent on person-centeredFragmented and often impersonal careOveruse of antipsychoticsAging demographics

Concerns Coalescing a National InitiativeToo narrow a focus on Alzheimers diseaseFocus on CURE and treatment not CARENo one with dementia represented on Advisory Council No mention of person-centerednessApproach is the conventional clinician/disease ethos

National Dementia InitiativeLed by CCALKaren Love - FounderJackie Pinkowitz - ChairLeadership TeamJayne Clairmont -English Rose SuitesAngela Lunde MayoLene Levy-Storms UCLAAnne Montgomery US Senate Aging Committee

Good Person-Centered Models for Dementia Care

Understanding the WHAT of person-centeredness is important; understanding the WHY is life changing.

The WHY of Person-Centered Dementia CaringOptimizing Well-beingDoing things that continue a sense of normalcy, having fun, and experiencing purpose and meaning.

Maintaining PersonhoodIf you had dementia, what would be important in your daily life ?

There is a physiological basis for well-being

LIMBIC SYSTEM

The Power of the Limbic SystemControls humans emotional feelings and memories

Supporting Meaningful Life and EngagementPeople living with dementia are not as able to initiate activities on their own such as finding interesting things to do.Imagine sitting on a plane for 3 hours WITH NOTHING TO DO OR LOOK AT.

Therapeutic EngagementPositive Approaches to Person-Centered LivingResearch EvidenceWhat is done and how its done are key to optimizing well-being.

Boosts mood and sense of worth and value;Reduces anxiety, agitation, and boredomEnhances physical functionImproves quality of sleep

But REMEMBER, ITs THE WHY THAT REALLY ENABLES US TO ACT.18

Positive Approaches:BUILD A PERSONAL RELATIONSHIPFacial and bodily expressionTone of voice use a normal tone at normal speedConversations deep knowingQuality of time not quantity of time

WHY?WHY? PEOPLE EXIST IN RELATIONSHIP WITH OTHER PEOPLE19Reciprocity

Laughter

We focus so much on day to day caregiving that we lost the moments of light heartedness21Quality not quantity

Positive Approaches:BUILD COMMUNITY AROUND THE PERSONMake them feel includedProvide a sense of purposeEnsure that the environment reflects that purpose

WHY?WHY? PEOPLE ARE SOCIAL BEINGS AND NEED A CONTEXT TO EXPRESS THEIR PERSONHOOD23

Personal Interests and hobbies

Activity and exercise

Spirituality

Children

Positive Approaches:SUPPORT THE RHYTHMS OF DAILY LIFEWhat goes on in your day are the same as what goes on in their day.Ask them directly.

WHY?WHY? BEING RECOGNIZED, RESPECTED, AND GIVEN CHOICES HAS AN IMPACT ON MY SENSE OF SELF28Building on visceral feelings and memories

Trying new things

Susan Axelroad ipad and mom30Spontaneity

CD music in car Debbie MC getting ice cream31 Touch

Pets

Passive engagement

Positive Approaches:NURTURE THE ENGAGEMENTHOW MANY PEOPLE DOES IT TAKE TO CHANGE A LIGHT BULB?

WHY?

35You never know unless you try

[FIT video clip]36Thank you.To access a copy of this presentation, go to www.fitkits.org then click on COMMUNITY and PRESENTATIONS

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