Dementia. The word alone strikes fear in the hearts of most people over the age of 50. The fear of dementia rivals the fear of cancer for most in this age group.
Why do we think of dementia with such dread? Is it the sense of insecurity we feel knowing we are not in control of our thoughts, feelings or actions? Or, is it the uncertainty? We don’t know when it will occur or at what stage in our lives. More importantly, we don’t see anyone get better, no one is cured and the outcome is always bad. The signs are subtle and the dilemma for most of us lies in the unknown. If you misplace your car keys, is that a sign of early dementia? Most of us misplace our keys from time to time. It’s only if it occurs with more regularity, or we leave them in an unusual place (like the refrigerator), that there could be a problem.
According to the Centers for Disease Control, five million people in the U.S. are living with Alzheimer’s, the most common form of dementia. One in three over the age of 85 have dementia. It is expected that the world-wide incidence will double in 20 years. It is the fifth leading cause of death in the U.S. Total health care expenditures for all forms of dementia in 2017 was $257 billion dollars. This number will rise as more people are affected by the disease.
Aside from the gloom and doom, there are two constants regarding dementia; it starts slow and there are early warning signs. Before there is a diagnosis of dementia there is cognitive decline. Think of it as dementia in its infancy. Cognitive decline can be discovered early and treated to help slow the progression to dementia.
Knowing this fact has lead two Maryville, TN. therapists, who are experts in dementia, on a quest to battle dementia before it robs clients of their ability to live independently.
THE GOAL: FIND DEMENTIA BEFORE IT IS TOO LATE
As I was interviewing the two therapists about their novel dementia program, I could see and hear the passion in the discussion. Anyone could tell that both were intensely concerned about people with cognitive (memory) issues.
Becky Martin, Speech Language Pathologist, and Karen Nolan, Occupational Therapist, are both certified Dementia Care Specialists. They have started Memory Care T.E.A.M.S as part of Speech Pathology Services of East Tennessee based in Maryville, TN. They both have years of experience with the elderly population. Their experiences with dementia range from mild cognitive decline to full blown memory loss in patients requiring 24/7 care.
“We were seeing clients in the later stages of dementia, at a time when their caregivers were in crisis,” states Nolan. “Caregivers by that point were very frustrated and didn’t know what to do. It was too late to try to keep the client in the home. But the caregivers did not know their options. Suddenly, they realized that their loved one needed placement in a facility. But it takes time to work out the details. We want to help families before it gets to a crisis stage. With early intervention, we can help families form a plan for the future. That takes loads of stress off the family members.”
“We saw a need for early intervention in the treatment of dementia,” states Martin. “We want to start working with those clients who have mild memory problems or early stage dementia diagnosis. Data shows that with early recognition and treatment, the onset of dementia is delayed. If we can slow down the disease process as well, we can help clients stay in their home and ‘age in place’. This is what most elderly people want to do.”
HOW IS THE CLIENT EVALUATED?
Martin and Nolan both use a complex battery of tests to assess cognition. The testing is comprehensive. Not only is the mental status measured, but also assessments are made of swallowing, self-care tasks, and communication skills. Clinicians also work with family members to assess the safety of the home environment. The importance of safety evaluations in the home cannot be underestimated. “We don’t want to hear about another elderly person who has walked away from his/her home or left the kitchen stove on all day,” stated Martin. “We place a strong emphasis on safety.” “Based on the test results, an individualized comprehensive treatment plan is formulated for that client,” says Nolan.
NEXT, THE THERAPY
The process is all about building skills that allows the client to perform day-to-day activities the rest of us take for granted. For example, the client may need to modify their diet to prevent choking. Another client may need to learn to use an assistive device to help him/her dress. Clients are taught “compensatory strategies”, a high-level term that refers to optimizing day-to-day functioning. “Sometimes environmental modifications such as grab bars, shower chairs, and other items are recommended as part of the safety aspect,” states Nolan. The caregivers or other family members participate in the program as well. They will reinforce the training for the client. A secondary benefit for the caregiver is knowing how to deal with a loved one with mental or physical limitations. Empowering the caregiver with information helps control the stressors that many of them face while caring for a loved one with dementia.
While a decline in function can be anticipated, the T.E.A.M.S. will be able to re-evaluate clients every six months, or earlier if needed, and adjust the treatment plan accordingly. Clients and loved ones can be assured that as functioning declines, the T.E.A.M.S. will ensure the most effective plan is in place.
The Memory Care T.E.A.M.S. includes a social worker who will assist clients and loved ones with access to resources and support. The social worker helps with finding community resources, creating self-care strategies, exploring meaningful daily activities, and planning for the future. Additionally, the social worker can provide individual therapy that addresses the challenges of the diagnosis.
THE FUTURE OF DEMENTIA CARE
Those who work in health care and with the elderly in particular know that dementia treatment is not a “one size fits all” fix. Medications are part of the picture, but alone they do not stop the progression of dementia. As is the case with most chronic diseases, treatments are multiple and varied. There is no cure on the horizon. The best hope is to use all available resources to keep dementia a manageable disorder we can live with. Martin and Nolan will also be giving a Let’s Talk series which will cover a range of topics, such as Caring for a Person with Dementia. They will also be working with East Tennessee Technology Access Center (ETTAC) and hosting a book club for those with cognitive decline. Their goal is to provide a team approach to enhancing lives through early intervention.
HOW TO CONTACT THE MEMORY CARE T.E.A.M.S
Becky Martin and Karen Nolan can be reached at:
Speech Pathology Services of East Tennessee, LLC (865) 982-3400
Feel free to call for more information or a consultation.