Spring 2022 Newsletter
By Michael Gallagher, PhD., Emily McIndoe, Robert Hogue, and Kerry Jordan, PhD, RN, CNS, CNL-BC
Department of Exercise and Sport Science and the School of Nursing
University of Central Arkansas
In the last 40+ years, the focus on patient health care has changed from a one-size-fits-all to a holistic and person-centered approach to therapy. This person-centered approach is now recognized as desirable as society moves away from reductionism and treating individuals simplistically to understanding and addressing the whole-person with regards to chronic diseases such as dementia (Greene et al., 201). The benefit of a holistic approach is care that not only applies to the person with chronic disease but also to their caretakers. Benefits also apply to the professional community through interprofessional education and collaboration.
There are six dementia care management programs used around the world that incorporate person-centered care and each of these programs includes some level of interprofessional education and collaboration ranging from care management teams of four to eight different professions. Nurses led many of these interprofessional teams. The professions for collaborative care in dementia may include nurses, physicians, counselors, psychologists, exercise specialists and therapists, occupational and speech therapists, and pharmacists (Dreier-Wolfgramm et al., 2017). However, depending on the program’s goals, care management programs do not need to include every profession for the program to be successful. For example, a person-centered approach may include collaboration among nurses, occupational or speech therapists, or just exercise specialists and speech therapists. The goals of the program dictate the number of professions involved. Care management programs for people with dementia not only help persons with dementia in the program but also may provide respite for the caretaker, further education on dementia, or both. Education for both persons with dementia and their caretakers may include signs of disease progression, approaches to slow disease progression, management of activities of daily living, management of episodes of forgetfulness and agitation, and how to stay connected and engaged with their loved one or client.
One of the most impactful pieces of information to provide those affected with dementia is that a person with dementia can live a high-quality life. The appreciation for providing a means to have a high-quality life is present in care management programs that focus on the person instead of the dementia diagnosis. Interprofessional collaboration achieves this united appreciation by providing a community that allows each profession to contribute to the benefit of an individual and/or caretaker. One such care management program, DementiaNet, highlights the role of interprofessional education to “increase collaboration, knowledge and skills acquisition” towards effective interprofessional collaboration (Oostra et al., 2021). Additionally, teams should provide access to varying levels of generalized and tailored care to promote physical, psychological, and social well-being improvements among persons with dementia (Kuipers et al., 2019). Collegiate interprofessional education can lead towards effective interprofessional collaboration as these soon-to-be professionals are able to apply the educational concepts from the classroom or online resources through the UAMS Arkansas Geriatric Education Collaborative to supervised real world situations. As a result, these students can further promote awareness of dementia and advocate to destigmatize the dementia diagnosis among persons with dementia, the caretaker, and the public. It is not every day that students get to experience and reflect on the impact they may have on persons with a chronic disease such as dementia. Those student experiences and subsequent reflections may be rewarding and open them up for a greater appreciation of the role of other professions, the benefits of collaborating in a person-centered approach to care, and potentially create new professional goals never considered before.
At the University of Central Arkansas, we recently conducted an 11-week interprofessional student-led clinic for people with dementia living in the community (S-TAP). We used three different professions in our program: exercise science, communication science, and nursing. Not only did this program demonstrate significant improvement in functional status for those who participated, but it also demonstrated significant impact on student attitudes toward people with dementia. As one student wrote after participating: “I feel I gained a greater understanding of older adults with dementia and learned how to connect with them better. My feelings toward them changed in the sense that I realized they are not completely helpless.”
Dreier-Wolfgramm, A., Michalowsky, B., Austrom, M.G., van der Marck, M.A., Iliffe, S., Alder, C., Vollmar, H.C., Thyrian, J.R., Wucherer, D., Zwingmann, I., Hoffmann, W. (2017). Dementia care management in primary care: Current collaborative care models and the case for interprofessional education. Zeitschrift für Gerontologie und Geriatrie, 50(Supplement 2), S67-S77
Greene, S.M., Tuzzio, L., Cherkin, D. (2012). A framework for making patient-centered care front and center. The Permanente Journal, 16(3), 49-53
Kuipers, S.J., Cramm, J.M., Nieboer, A.P. (2019). The importance of patient-centered care and co-creation of care for satisfaction with care and physical and social well-being of patients with multi-morbidity in the primary care setting. BMC Health Services Research, 19: 13
Oostra., D.L., Harmsen, A., Nieuwboer, M.S., Rikkert, M.G.M.O., Perry, M. (2021). Care integration in primary dementia care networks: A longitudinal mixed-methods study. International Journal of Integrated Care, 21(4): 29, 1-12