Whole Body, Whole Care

How do we offer our care partner’s the best care? One of the most significant findings point to a team of multiple disciplines to address the whole person.

Dementia care research continues to show the value of the inter-disciplinary team. Starting in the 90’s research included looking at dementia special care. Gerdner & Beck1 (2001) defined the inter-disciplinary team of a dementia special care unit to include a registered nurse, activity director, social worker, registered dietician, physician, Certified nurse’s assistant, physical therapist, occupational therapist, music therapist and family member/care partner. Do not panic–research also found few care units actually had every discipline represented.  However, a retrospective study found that the stronger inter-disciplinary teams were, the stronger family members’ rating of satisfaction with care.2

A care facility study found a dementia-specific inter-disciplinary team resulted in higher satisfaction among residents, caregivers, and nurses as well as satisfaction for 79% of the physicians (Benedict et al., 2006; Counsell et al., 2000).3 The value of the inter-disciplinary team continues to be affirmed today.

Most recently a Parkinson’s study found that inter-disciplinary team home visits were highly satisfying for the individual with advanced Parkinson’s disease and related disorders.4 The team includes a movement disorders neurologist, social worker, and nurse with the individual and caregiver. The team goals include a complete history, physical, detailed medication reconciliation, psychosocial needs assessment, and home safety assessment. A comprehensive, person-centered plan is developed with the entire team communicating as the plan is implemented. Quarterly home visits of all disciplines are included.

Consider your care team. What disciplines are represented? Most of us can say we have some clinical support from doctors, but do we have anyone committed to your care partner’s psychosocial health? Have you considered adding a dementia-specific physical therapist and occupational therapist? Is there someone offering dementia-specific activities for life enrichment?

There are many options offered through Medicare home health, homecare providers as well as adult day centers, and memory care communities. There is far more to address beyond the clinical medications. The best part—your satisfaction with care will increase as you include more care disciplines for your partner.

Footnotes

1Gerdner, L. A., & Beck, C. K.  (2001).  Statewide survey to compare services provided for residents with dementia in special care units and non-special-care units, American Journal of Alzheimer’s Disease and Other Dementias, 16(5), 289-295.

2McCarty, C. (2011). The impact of hospice and Dementia Special Care Units on End-of-Life care for individuals with dementia, Scholar Commons, USF.

3Benedict, L., Robinson, K., & Holder, C.  (2006).  Clinical Nurse Specialist practice within the Acute Care for Elders Interdisciplinary Team Model, Clinical Nurse Specialist, 20(5), 248-251.

4Fleisher J, Barbosa W, Sweeney MM, Oyler SE, Lemen AC, Fazl A, Ko M, Meisel T, Friede N, Dacpano G, Gilbert RM, Di Rocco A, Chodosh J. Interdisciplinary Home Visits for Individuals with Advanced Parkinson’s Disease and Related Disorders. J Am Geriatr Soc. 2018 Jul;66(6):1226-1232. doi: 10.1111/jgs.15337. Epub 2018 Apr 2. PMID: 29608779; PMCID: PMC6105368.

Author: Cate
Passionate about dementia care and quality of life throughout the last days of life----sums up Cate McCarty, Dr. Cate, Dementia Coach. With close to forty years of long-term care experience in nursing and recreation, a Master's in Thanatology and a PhD in Aging Studies, Dr. Cate seizes every opportunity to translate research into quality of life for individuals with dementia and all of us who have the honor to "rub elbows" with them.

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