Dealing with dementia

By: Pamela Cowan, Leader-Post

REGINA — Who will care for baby boomers?

That’s something Joanne Bracken, CEO of the Alzheimer Society of Saskatchewan, is asking more often these days.

“Baby boomers often didn’t have very many children, so the number of available family caregivers is going to be shrinking just as we have our largest demographic moving into the area that’s going to need and have to rely on care,” Bracken said “Who is going to be providing the care to help people stay at home as long as possible?”

While more people with dementia stay in their homes or assisted living facilities longer, those moving into long-term care have multiple conditions and require complex care — and most have dementia.

“We need to be prepared to educate people and to learn how to best provide care for people with dementia,” Bracken said.

Last week, the province allocated $10 million from its Urgent Issue Action Fund and an additional $3.8 million to address issues identified after health region CEOs toured long-term care facilities.

Some regions will use the money to train staff in the Gentle Persuasive Approach, which helps them better care for residents with dementia.

Developed in 2004 at St. Peter’s Hospital in Hamilton, it teaches staff to recognize “responsive behaviours” — when patients act aggressively — and to understand they don’t act out on purpose.

Staff are taught to see the world from the patients’ perspective, said Gretta Lynn Ell, executive director of continuing care, programming and utilization of integrated health services with the Regina Qu’Appelle Health Region (RQHR).

“Sometimes, they’re responding back because they’re frightened, they’re misinterpreting the environment — they don’t know how to interpret the environment because their perception has been altered by their disease process,” Ell said.

A person with dementia might be upset by a loud radio or bright lights. Others become confused and frustrated when asked a complex question.

“They don’t know what the person wants and they don’t know how to respond,” she said.

Staff learn techniques that can eliminate a lot of behavioural issues and de-escalate the situation, like giving an agitated individual some space.

Staff receive a full day of training. In August, 18 people completed the RQHR’s first certified coach training workshop. By mid-December, the region will have 18 more coaches. There will be at least two in each of the region’s larger long-term care facilities and one in most rural facilities.

Some staff from the Regina Lutheran Home, the Lumsden and District Nursing Home, Santa Maria and the Extendicare homes have already participated in training sessions held by the Saskatoon Health Region.

“Staff in long-term care facilities who have worked there for a significant number of years tell us that the needs of the clientele have certainly changed and they feel they need better skills to provide the kind of care they want to provide,” Ell said.

The Alzheimer Society doesn’t endorse one particular model of care, but encourages care providers to recognize that people with dementia require individualized care. Bracken noted a lot of challenging behaviour is due to the nature of the disease.

“Everything that a resident does has meaning behind it ... I heard someone make a comment about people with dementia coming into long-term care and they’re wandering in the hallways and going into other people’s rooms,” she said. “When you’re not familiar with the environment and you don’t know which room is yours, we should expect people with dementia to do those types of things.”