Monday, November 26, 2012


We all want the time we spend with our loved ones to be fun and rewarding.  With just a few alterations we can make the time spent with a person with memory loss truly fun for all.

Consider smaller get togethers of 1-4 people at a time

Individuals with memory loss are often overwhelmed by large crowds.  Often it is difficult if not impossible for them to interact with large numbers of people at the same time and they simply shut down and withdraw from the activity.   We often see them sitting on the sidelines looking lost.  When these feelings persist they often ask to leave shortly after have arrived.

Consider short visits of 30 minutes at a time
It takes a lot of energy for the person with memory loss to “stay in the moment”.   They will get tired very quickly as they strain to understand and be a part of the conversation.  Again, the unwanted result is often their insistence on leaving.

Be prepared with topics from their past for conversation starters
Conversations about current events often leave the person with memory loss “out of the loop”.  Their short term memory loss makes it difficult if not impossible for them to understand and stay with a conversation that is focused on recent topics.   Prepare prior to the visit by thinking of old stories or events from their past.  Manage the conversation by bringing up a story that has potential meaning for them.  If they remember the story they can join in.  If they don’t remember the story, it was your story not theirs.  The approach doesn’t frustrate them and allows them to  maintain their dignity.

Refrain from the use of the words “No” and “Do you remember?”
Often the person with memory loss will offer information that isn’t accurate.  Telling them “No, that isn’t right” or correcting them will only make them feel inadequate and frustrate everyone.  Learning to go with the flow will make the conversation much more pleasant.   

Saying “Do You Remember”, when they are challenged by memory loss, often increases their feelings of inadequacy.  You can bring up the same topic with a simple “I was thinking..." followed by the topic you want to address allows them to join in if they remember and keeps the pressure to remember off of their shoulders.

The gift of a rewarding conversation is indeed priceless!

Monday, August 20, 2012


I asked a colleague of mine if occupational therapy could be utilized to improve the lives of residents with dementia, she quickly and loudly answered “YES!”  Lynn Dennie, COTA, was kind enough to provide the following description of the vital role therapy can play in managing the care of dementia clients at the same time addressing the potential of increased revenue through therapy.  Following are her thoughts....
How many times has it been heard: “John is being treated...but he has dementia.”?  What is being said when this statement is made?  When a statement is made is there limitations made in client care and the revenue that can be generated as well?  As the awareness of dementia grows, so does the cost in caring for clients with dementias, but are we leaving health care dollars on the table?

The Risk Factors involved with dementia care are falls, skin integrity, dehydration/malnutrition and decreased socialization/interaction with others just to mention a few.  These risk factors can all add up to added health care costs for all involved whether in nursing facilities, assisted living environment, or in a client’s home.

The costs related to care for the client with dementia can become a burden for all involved, causing us to work “harder instead of smarter”.  With increased risk factors, the cost of care for dementia clients also increases.  For example, risk factors lead to increased risk documentation (incident reports), increased need for safety equipment, increased use of medications (as warranted through documentation), and can ultimately increase the need for more staff to monitor the dementia clients safety, producing a feeling at times of “chasing the tail”.  Not only do cost accelerate, but slowly the approach of staff/care givers become reactionary instead of proactive.  This can lead to loss of staff retention due to “burn out”, and costs associated with proper replacement of staff.

So the question remains, what can be done?  It begins with accurate assessment of the individual with dementia.  Therapy can be utilized to assist in decreasing associated risk factors, such as falls; thereby strengthening the components associated with therapeutic interventions with set protocols, and staff/family education. Decreasing risk factors has the potential, then, to decrease healthcare costs.

What is the result of Instituting Dementia Interventions?  Through consistent dementia assessment and programming, there can be a decrease in cost factors, a staff focused on being proactive, increased client/family satisfaction which will lead to increased in overall reputation and as an end result enhances census development.  Finally, a facility’s financial performance is enhanced by revenues obtained by therapy. 

So are we leaving those health care dollars on the table?  We are when we do not meet the needs of the dementia client.  However, when therapeutic interventions address risk factors as well as when specialized dementia programming is implemented, a facility’s revenues can be enhanced and in turn operational costs reduced.

Monday, April 30, 2012


I want to tell you about another great tool to assist you in assuring that the information you share with physicians is accurate and valuable.  In a previous blog I told you able the KNOW IT ALL BEFORE YOU CALL tool from AMDA.

They now have a companion piece called KNOW IT ALL WHEN YOU'RE CALLED.  This excellent tool contains the same questions you will be answering enabling the physician to follow you and get all of the information you are sharing.  Take a look at both tools at

These tools will empower both the nurses and the physicians to communicate effectively with the desired goal of addressing the clinical needs of the individual without rehospitalization.