Improving the Patient Experience: Best Practices for Becoming Dementia Friendly

The future success of providers hinges on an understanding that societal health is more than just about population health and that ACO players are not just hospitals, physicians and long-term care entities. Rather, employers, banks, supermarkets–in short, the community–all play a role when it comes to understanding dementia, including Alzheimer’s. Caring for family caregivers in the workplace and creating dementia-friendly communities are key issues that society has to address together.

Looking at the top utilizers of health care, Ian Morrison in a Hospitals & Health Networks article suggested, “The best management of many of these top 5 percent utilizers may end up looking a lot more like social work than medical care. Housing, transportation, income support, nutritional support and counseling may be more beneficial than any form of conventional medical intervention.”

We have identified three areas that when addressed can position organizations strategically as the provider of choice for boomers, older adults and their family caregivers.

1. Improve the experience of employees by identifying, embracing and creating programs for family caregivers in the workplace.

2. Improve the patient/resident/person experience by becoming dementia friendly.

3. Strategically position the organization from a marketing perspective by leading dementia-friendly initiatives in your community.

Let’s look at the second one in-depth.

By becoming dementia friendly, providers in turn become safer, provide higher quality and gain a distinct market advantage. Being dementia friendly complements other provider mandates and helps providers anticipate the trends impacting health care.

It Starts with Culture

When working with providers, it is essential to know from an attitudinal and cultural standpoint where the organization ranks. We use the “Attitude Toward Dementia including Alzheimer’s Disease” tool with clients to identify key strengths and potential areas for improvement in a dementia care environment.

Put Yourself in Their Shoes

Many readers may have participated in aging sensitivity training sessions where the physical challenges that older people experience are simulated. What if people also could experience the cognitive and sensory challenges too?

The Virtual Dementia Tour® (VDT), founded by my friend, P.K. Beville, is an award winning, scientifically-proven method of training designed to build sensitivity and awareness in individuals and health care providers.

When you are culturally ready, it’s time to perform an environmental assessment. The “Person-Centered Dementia Care Assessment Tool” is a best practice tool developed by the Wisconsin Department of Health Services Bureau of Aging and Disability Resources. It reviews environment, language and communication, care plans, problem solving, activities, communication and leadership, team structure, knowledge and training, policies and procedures. Another toolkit is the “Environment & Communication Assessment Toolkit (ECAT) for Dementia Care.”

Admissions – Get to Know the Person

There are several programs we recommend to help document a person’s story on admission, which in turn aids person-centered care.

The Alzheimer’s Society in the U.K. has the “This is Me” assessment. It provides information that can help health and social care professionals build a better understanding of the person. A variation of this tool is “Get to Know Me” created by Ellen Belk.

Gary Joseph LeBlanc has created The Hospital Wristband Program to raise awareness and ensure staff is aware of an underlying dementia diagnosis or someone identified at-risk of cognitive impairment. A dementia screening is added to the admissions process to identify cognitive impairment even if there is no prior diagnosis. Those identified with a prior diagnosis or identified at risk have a Purple Angel affixed to their hospital wristband and on their door, reminding those entering to keep the patient’s special needs in mind.

Other Best Practices

The referenced programs above are a start. In our white paper, “Dementia Friendly as a Strategic Business Imperative for Hospitals and Health Providers,” we outline much more.

• Hire a dementia care coordinator, in essence a navigator for this specific population. The NHS utilizes this position in the U.K.
• Educate staff with tools such as the Alzheimer’s Association’s Dementia Friendly Hospital Initiative (DFHI): Care Not Crisis.
• NICHE Nurses is the leading nurse driven program designed to help hospitals and health care organizations improve the care of older adults. There are only 620 hospitals designated under this program so there is a long way to go.
• Senior ED – more than 50 U.S. hospitals have opened EDs for elderly patients since 2011 and at least 150 more have senior-specific EDs in development.

While hospitals have been the focus of this article, it probably is stating the obvious to note that these dementia-friendly initiatives must start in physician practices. And for any program to be successful, providers must engage family caregivers. Few do so effectively.

Want to learn how to become dementia-friendly? Download my white paper, read it, then be in touch so we can work together to create communities of caring that positively impact the lives of those with dementia.