Tag: best dementia care Philadelphia

Personalizing care techniques can reduce behavioral and psychological symptoms of dementia

The most effective care begins with forming a connection, which includes meeting clients where they are in the disease process.

The Tailored Activities Program (“TAP”) aims to reduce behavioral and psychological symptoms of dementia (“BPSD”). This is often what we struggle with as family members and caregivers. How do we engage the person with just enough activity to make them feel loved and needed?

Unchecked challenging behaviors can lead to increased healthcare costs, caregiver burden, and care recipient placement into facilities. There the person living with dementia usually faces pharmacological intervention, which may exacerbate these challenging behaviors or worse.

An Australian trial randomized 180 participants living with dementia by placing them into two groups. One group received 8 home care visits using the training from TAP to train the caregiver and engage with the person living with dementia. The control group received three phone calls with the caregiver about basic dementia related materials from a book, and did not involve the care recipient. Follow up continued four and eight months after the home care visits and phone calls.

The trial was done with individuals living at home or with relatives, outside of formal care facilities.

The results of the TAP pilot trial:

The TAP pilot trial showed overall reductions of incidences of challenging behaviors or BPSD. There were also reductions in other specific behavioral categories as defined by the study:

BPSD overall: F(1,41) = 7.58, p = 0.009, Cohen’s d = 0.72,

Shadowing: F(1,4) = 58.9, p = 0.003, Cohen’s d = 3.10, agitation, Wald X2(1) = 6.0, p = 0.014, Cohen’s d = 0.75

Repetitive Questioning: F(1,22) = 5.94, p = 0.023, Cohen’s d = 1.22

Argumentation: Wald X2(1) = 6.6, p = 0.010, Cohen’s d = 0.77 ()

To read more about the study, click here.

In many ways, TAP is like the Positive Physical Approach to Care as pioneered by Teepa Snow. NursePartners has embraced this methodology since the inception of our GEM division in 2015. It builds on the intuitive notion to engage with people living with dementia according to their life experiences and interests. By appealing to their sense of self-worth, we can prevent or mitigate some of the most challenging behaviors.

 

NursePartners trains all carepartners in the GEM methodology as perfected by Teepa Snow.

All carepartners are trained to engage with clients, focusing on what they still can do and letting go of what they cannot. Even at the most advanced stage of dementia, you can find new ways to say hello and make the person feel valued and with purpose.

To learn more about how we can engage your loved one living with Alzheimer’s disease, Frontotemporal dementia, or another form of dementia, call us at 610-323-9800.

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Caring for the Caregiver

Both formal and informal (family) caregivers provide care for older adults.  It is important that carepartners practice self care, in order to continue being effective in their roles regardless of whether they are compensated for caregiving services.

Formal carepartners are better able to establish personal boundaries if they are working set hours at established rates via a reputable company.  Although paid carepartners are connecting and building a relationship with the older adult, there are times that they are able to take care of themselves.

In contrast, family caregivers often find themselves in a caregiving role unexpectedly.  They usually find themselves faced with some of all of these predicaments:

  • The needs of the care recipient are increasing over time.
  • The caregiver had another relationship with the care recipient before the illness.  This often complicates the dynamics of the developing relationship as the care recipient feels embarrassed of their condition and the caregiver becomes stressed.  Communication issues and stress can fuel tension.
  • The caregiver does not necessarily know about the disease progression or have medical training.  They may be in denial of basic facts concerning the care recipient’s condition.
  • The caregiver needs to work at least one other job to support themselves and possibly their families and/or care recipient.
  • The caregiver is giving up opportunities for self development, career advancement, and/or building their own immediate families.  The can cause built up feelings of resentment, inhibiting the quality of care of the older adult.
  • The caregiver needs to navigate internal family dynamics.  Typically children are allocated responsibilities based on geographic proximity or other circumstances.  A child without their own family or job may be the first candidate to move in with mom and dad.  Children usually disagree about the equity of task distribution, leading to feelings that can compromise the level of care provided to the care recipient.
  • The caregiver may be caring for an older adult for the first time.
  • They or members of the care team are in disagreement on the basic facts of the situation, such as the validity of the disease diagnosis.  
  • Informal caregivers are always on call.

Regardless of whether you use formal, informal, or both methods of care, it will take more than one person to care for an older adult, especially someone living with a progressive disease such as Alzheimer’s or another form of dementia.  

One important step is developing relationships with other informal caregivers, through organizations such as ARTZ Philadelphia and the CARES program of the Lutheran Settlement House.

ARTZ Philadelphia organizes a meeting of caregivers on a periodic basis to discuss ongoing challenges.  They also host separate events that are meant to provide bonding opportunities for the caregiver and care recipient.

The CARES program of the Lutheran Settlement House organizes events exclusively for informal caregivers.  The creator of the CARES program, Sarina Issenberg, also provides individual counseling meetings free of charge, outside of the organized events.

It is also important to employ the help of formal caregiving services.  There are numerous advantages for having a home care agency involved.  .  Here at NursePartners, we have been extensive experience caring for older adults exclusively for over 18 years.  Although we care for older adults with a variety of chronic and progressive conditions, we formally incorporated a dementia training module into our business operations in 2015.  All carepartners and management are trained and certified in the Positive Approach to Care methodology.

We welcome the opportunity to tell you more about how we can form a new care team, or supplement one that you have established.  Give us a call at 610-323-9800 to learn more. best home care Philadelphia, dementia care Philadelphia, Alzheimer's disease Philadelphia

 

Lakeya meets with PAC Trainer at our site in Philadelphia

NursePartners’ Senior Recruiter, Lakeya Dula, completes her training to become a PAC certified dementia coach.  After on site training in Baltimore with Teepa Snow, Rebekah Wilson visited us at the NursePartners office in Philadelphia.  Rebekah served as Lakeya’s mentor throughout these past 8 weeks.  Lakeya and Rebekah used the PAC materials and tools from the course to increase Lakeya’s confidence in becoming an effective coach to our carepartners.

The Positive Approach to Care (PAC) methodology was created by Teepa Snow in response to the shortcomings of other dementia progression models.  Other models seemed to focus on the cognitive decline, versus emphasizing what the person could still do.  Each in the last stage (Pearl), a person still exists behind the ugly façade of the disease.  Teepa sought to teach others how to connect before providing care, which is the bedrock of any effective carepartner relationship.

As a dementia coach, Lakeya plays a fundamental role in training each carepartner before they begin working with us.  Lakeya leads a dementia workshop where we act out various difficult situations with our carepartners.  NursePartners’ admin takes on the role of our clients and the carepartners show us how they would respond in a given situation.  Carepartners consent to being video recorded.  This allows them to watch their own interaction later, from the view of the client.  This activity helps them break preconceived conceptions and to adapt their own care approaches to become more effective carepartners.

During this workshop, carepartners learn about the GEM levels, the Positive Physical Approach to Care, and receive a general overview of dementia.  Afterwards, carepartners must complete additional training in order to become eligible to work with any of our clients living with dementia.

Lakeya is the third member of the NursePartners administrative team to complete a certification with Teepa Snow.  Angela Geiger embraced the methodology as the basis to create the GEM division in 2012.  She became certified as the company’s PAC dementia trainer in additional to another national certification as a dementia practitioner.  Peter Abraldes developed the dementia program with Angela in 2016 to make this training a requirement for any carepartner working with a client living with dementia.  At this time, all other admin members were trained as well.  This prepared us to respond to any issue arising from clients, family members of clients, or carepartners.

NursePartners also provides training to family members and other organizations as requested.  We have seem the effectiveness of this approach in the field and always glad to help others provide more effective care to their loved ones or clients.

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Lakeya received her PAC certified dementia coach certificate!

 

Angela scheduled to be keynote speaker for “Remembering Those Who Forget”

We are excited to announce that Angela will serve as the keynote speaker for the Presbyterian Older Adult Ministry (POAM) at the event, “Remembering Those Who Forget”.  Angela will talk about her decades of experience working with those living with dementia.  She will be sure to touch upon practical care approaches that can be implemented immediately, in addition to giving her clinical perspective on the disease.  The event is open to those wanting to learn more about Alzheimer’s disease and other forms of dementia.

We would appreciate registration prior to attending the event.  This event is scheduled for next Thursday, May 2, at 8:30am to 1pm in Plymouth Meeting.  Exact details can be found via this link: https://presbyphl.org/events/presby-older-adult-dementia-workhop/

Early warning signs of Alzheimer’s disease or another form of dementia

NursePartners presents on behalf of the Alzheimer’s Association.  One of the most commonly requested presentations discusses the early warning signs of Alzheimer’s disease or another dementia.  We compare these signs with others that are more typical of age-related changes.

It is very important to remember that each person is unique, with their own baseline. If you are looking to identify a developing form of dementia, consider all factors that make up that individual, including their personality, life experiences, family, and education. Warning signs are problematic when a few more or more exist.  

The signs of normal aging are just examples. These vary depending on each person.  If you have additional questions, you are welcome to call our 24/7 line at 610-323-9800 or the Alzheimer’s Association hotline 1-800-272-3900.

If you would like to see one of our dementia practitioners or coaches speak, join us at an upcoming event or request one by calling 610-323-9800.

 

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