Richmond County Daily Journal - Caregivers Family Night to focus on FirstHealth dementia care: FirstHealth dementia care
Melanie Bunn; geriatric nurse practitioner, a dementia training specialist with
Alzheimers North Carolina and an instructor of nurses with Duke
University’s School of Nursing, .... her life’s work, ... involves the
care and concerns of people with dementia.
Bunn’s role with the Moore Regional nursing staff has focused on
building a “care-giving team” with the appropriate tools and knowledge
for the individualized care of individuals with “altered mental status.” That can mean the temporary confusion that can accompany an acute
illness or the vast mental and physical losses of advanced dementia.
The
hospital’s revised protocols on these patients with altered mental
status begin at admission during the routine medical assessment that is
required of every patient. Patients with an appropriate diagnosis get a
gray armband that identifies their altered mental status to the entire
care-giving team, and the information is documented in their patient
record.
Additional hospital protocols for patients with altered
mental status focus on individualized care approaches and specified
methods of communication. They also include environmental suggestions
for maintaining a “safe, calm, non-threatening environment” such as
encouraging frequent family/familiar caregiver visits and avoiding
visual and/or auditory elements that could disturb the patient even
more.
According to Cheryl Batchelor, R.N., Moore Regional’s
executive director of clinical operations, the protocol revisions
followed a study of the hospital’s dementia care-giving practices after
the husband of an Alzheimer’s patient had raised some concerns.
“He
felt we needed to acknowledge the special needs of people with
dementia,” Batchelor said. “We thought we were doing a good job, but we
were not looking at individualized needs.”
After hearing examples
to the contrary during a meeting with the patient’s husband and two
other relatives of patients with dementia,
Batchelor, physician champion
Jenifir Bruno, M.D., of Hospitalist Services and other members of the
FirstHealth nursing staff formed a task force with “cross
representation” from all three FirstHealth hospitals.
“We
involved as many (disciplines) as possible,” said Tabitha Stewart, R.N.,
a nurse clinician with Moore Regional Clinical Practice/Professional Development.
Team members reviewed medical literature and
contacted other hospitals and various specialists in the area of
dementia care. Results included revised educational materials and
protocols that were approved by
FirstHealth’s Nurse Practice Council.
The
admissions database was revised to improve the screening of dementia
patients, and the Information Technology department developed a special
music-only TV channel for patients who don’t cope well with noise. In
addition to Bunn, expert contacts included Dr. Eleanor McConnell of Duke’s Center of Excellence in Geriatric Nursing Education, and Alice Watkins, executive director of Alzheimers North Carolina.
As the
various initiatives were rolled out, family caregivers continued to be
involved and are pleased with the results. In a recent email, the family
member who raised the initial concerns shared the following story about
another family:
“At a Dementia Caregiver’s Support Group meeting
this week, a participant shared a story about a recent MRH ED visit
with her loved one who has dementia. The visit was precipitated by a
fall, which resulted in a nasty cut on the forehead. She
indicted that
he was given a gray wristband. But, more importantly to her, she said the staff seemed much more empathetic to his dementia and accommodating to her than during her previous ED visits, the most recent being about
six months ago.
“She additionally noted that upon asking she was
allowed to accompany him to
imaging where they provided a chair for her
while he was given a CT scan.
Read more:
Richmond County Daily Journal - Caregivers Family Night to focus on FirstHealth dementia care
Primary Phone: 910-997-3111
Primary Fax: 910-997-4321
John Charles Robbins
Editor
910.997.3111
jrobbins@civitasmedia.com
