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  • GAPNA 2020 National President Deborah Dunn, EdD, MSN, GNP-BC, ACNS-BC, GS-C interviews Dr. Ron Billano Ordona, DNP, FNP-BC about providing home-based primary care during COVID 19.

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Lonhala Magnair

Virginia

Chapter Supports Dementia Care Educational Event

By Pam Martin, Joyce Perkins, Judith DellaRipa

Circle Center Adult Day Services sponsored “Best Practices in Dementia Care” with Teepa Snow, MS, OTR/L, FAOTA, on December 11, 2019 at Diversity Richmond. GAPNA Central Virginia Chapter supported the event with a $300 donation.

Our name was included on the brochure and our pens and notepads were included in attendee bags. They planned for 250 professional and family caregiver participants and the room was full.

Teepa, with occupational therapy credentials and years of professional and personal experience in caring for patients with dementia, created an experiential and interactive learning opportunity.

Laughter as well as serious facts helped professional and family caregivers to identify new perspectives and skills. The presentations for this event focused on dementia screening and assessment and on creative and practical tips for getting through the day.

The prevalence of dementia is increasing. Persons who provide care are themselves at risk. There is no cure and it is progressive. Teepa shared some assessment and screening tools such as AD8 Dementia Screening Interview, clock drawing, and a timed naming of animals/categories activity.

Baseline determination ideally would happen around middle age and then the same tool would be used annually to detect changes. Proactive care planning would be done with instead of for the person with dementia to maintain personal autonomy and dignity.

Attendees learned there are now many known types of dementia and different kinds manifest according to the area of the brain that is damaged. Memory loss may be an initial symptom and there may even be more than one type or a mixed dementia.

The left brain is largely responsible for vocabulary and language comprehension and often is the most severely damaged. The right brain area is responsible for music, poetry, prayer, counting, healing, and comfort as well as the section for “forbidden words.”

Communication may be possible using music, etc., when language is no longer working for the person with dementia. Damage to the fronto-temporal-parietal area in the right hemisphere may produce anosognosia.

This deficit of self-awareness means the person is unaware of their own existence, which may look like denial. The disease can appear as young as 40 and progression may be slow, 15-25 years before function deficits, and require intervention for safety and well-being.

The amygdala, or the primitive survival part of the brain, is activated when a threat is perceived. It takes charge and reacts with fright, flight, fight, hide, or seek behaviors. Understanding the way adults with dementia interpret or misinterpret cues can help us in planning care that helps patients feel safe and cared for.

Disruptive behavior has meaning, and it can often be de-escalated by taking the time to “enter their reality” and find out what is happening for the individual with brain failure.

Pam Martin
Joyce Perkins
Judith DellaRipa