Several senior living companies were part of a roundtable that helped researchers identify five areas of change and developed person-centered practical solutions to address the unmet needs of people with dementia. The results of their work appear in the November issue of JAMDA, the journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine.
Providers that were part of the Alzheimer’s Association Dementia Care Provider Roundtable worked with researchers at Baltimore-based Brightview Senior Living, Brentwood, TN-based Brookdale Senior Living, Toledo, OH-based HCR ManorCare/Arden Courts (now ProMedica Senior Care) and Tulsa, OK-based Senior Star, along with Omaha, NE-based Home Instead Senior Care, the Alzheimer’s Association in Chicago and the University of North Carolina at Chapel Hill School of Social Work. They identified five areas, published in “What Is Really Needed to Provide Effective, Person-Centered Care for Behavioral Expressions of Dementia?” to enable care provision that addresses each individual’s condition and comorbidities, wishes, preferences and values:
- Have a foundational person-centered culture.
- Conceptualize behaviors as expressions, and focus on behavioral support.
- Recognize how routines may cause behavioral expression, and place person-centeredness before protocols.
- Ensure training that promotes a person-centered culture.
- Abandon a one-size-fits-all approach, and implement flexibility.
Apathy, depression, anxiety, delusions, hallucinations, sexual disinhibition, sleep disturbance, aggression and other behaviors are common in people with dementia and are reactions to the physical and social environment, rather than “symptoms of dementia,” the authors point out. Effective response through an individualized approach, therefore, is necessary to reduce the overall costs of dementia care and improve quality of life, they added.
“It is hoped that the five areas of guidance promoted in this article, along with progress in research and policy, will ultimately lead to real provision of effective, person-centered care for behavioral expressions of dementia, regardless of the setting in which care is provided,” the authors concluded.
Further promoting person-centered care, they said, requires developing evidence-based protocols for behavioral support approaches to care; examining the effects of modifying components of supportive approaches to care; developing consistent terms, concepts and measures; validating algorithms; developing tools to compare pharmacologic interventions with behavioral support approaches; and incorporating more person-centered outcomes in clinical medication trials.
In the policy realm, the authors said that changes need to be made in how dementia care providers and organizations are incentivized. Regular input from the field and greater understanding of person-centered practice in licensing, monitoring and regulatory settings also are needed, they said.
In addition to the aforementioned senior living providers, the following senior living providers were part of the Alzheimer’s Association Dementia Care Provider Roundtable, according to the journal article: AccentCare, Acts Retirement-Life Communities, Affinity Living Group, Artis Senior Living, Brandywine Living, Care One, Five Star Senior Living, Genesis HealthCare, Kendal, Life Care Services, Presbyterian Homes & Services, Silverado, Sunrise Senior Living and Van Dyk Healthcare.