Teaching

Dementia Care Program 
Providing expert, compassionate, life-enhancing care for seniors who have dementia is one of the most important challenges facing society and geriatric health care. Dementia affects nearly 10 percent of people over 65 and 40 percent of people over 85. Many people have a family member or acquaintance who has Alzheimer's disease, the most common form of dementia. Currently, 4 million Americans have Alzheimer's, a number that is expected to double over the next 40 years.

Dementia is defined as a global deficit in cognitive functioning, including impairment of memory due to abnormal changes in the structure and function of the brain, sufficient enough to interfere with daily living. Dementia is progressive and affects the whole brain and the whole person. The disease leads to difficulties with speaking and understanding language, difficulty performing basic routines such as dressing, impaired thinking and planning, changes in sensory perception, personality changes, intense emotional responses, and behavior problems. Eventually the person with dementia loses the ability to care for him/herself and requires some form of long-term care. When that time comes, family members want to know their loved one will receive the most expert medical and nursing care available in a safe, comforting environment that respects the dignity and humanity of each individual. Hebrew SeniorLife is answering that need with the opening of Alzheimer's Association-approved Specialized Care Unit (SCU) to provide a continuum of care for those with Alzheimer's or other related dementias.

Hebrew SeniorLife has long been in the forefront of applied dementia research, through the Institute for Aging Research and the Aging Brain Center. The decision in 2007 to convert two floors at Hebrew Rehabilitation Center to a 100-bed Specialized Care Unit underscores HSL's commitment to enhance the complete model of dementia care already offered to the 80 percent of HRC residents who have some level of dementia. Dr. Robert Schreiber, physician-in-chief, says HRC has the singular advantage of being able to keep patients in familiar surroundings during an acute psychiatric or medical episode because of the immediate availability of consultation and treatment from experts in a range of geriatric specialties. Palliative care is also integrated into all care to manage pain and distressing symptoms throughout the resident's illness. HSL also added more nursing and recreation therapy staff to provide optimal programming.

In October 2006, Paul Raia, Ph.D., director of Patient Care and Family Support for the Massachusetts Chapter of the Alzheimer's Association, made recommendations to improve the unit's aesthetics, staff education, and therapeutic programming in order to implement a "habilitation" model of care. Habilitation focuses on maintaining the skills, interests and abilities the resident has, rather than trying to bring back or rehabilitate lost function.

Twenty staff members completed 20 hours of Alzheimer's Association classes to become certified dementia trainers. They in turn provided 12 hours of comprehensive training to all direct care staff on the Specialized Care Unit. Even staff who serve meals or repair broken equipment completed two hours of training so they would be more comfortable interacting to residents.

HSL has set in place the cornerstone of dementia care: a supportive, non-challenging physical environment filled with caregivers who can respond appropriately to dementia symptoms and behaviors while supporting the preserved function and humanity of the resident.

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