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8 Tips for Keeping Connected to Those with Dementia

8tipsdementia

Loved ones with dementia or Alzheimer’s benefit from interaction with others. Sometimes we may not know how to best communicate with those experiencing memory problems, which occurs with every form of dementia. Here are some tips for interacting with people with dementia:

  • Conversation with people with dementia will vary dependent on where they are; early stage versus late stage. A key issue with dementia is loss of the ability to plan, reason, and execute a plan. Thus if you ask a yes or no question and it requires reasoning, often the answer will be no, not because they are saying no, but because they cannot decide.
  • Keep conversations simple and stay away from questions except as it pertains to real time: Are you hungry, thirsty, or in pain? Keep each question as a single subject and then wait for an answer. Do not change the question, but if not answered, ask exactly the same question again.
  • Stay away from “do you remember?” In dementia, early on, people do know their memories are worsening, so asking this may increase their frustration.   When looking at pictures, ask what the person thinks is happening in the picture rather than asking them to try to identify the person. This taps into imagination and decreases the stress of trying to remember.
  • Try to keep the environment calm and free of lots of stimulation. When wanting to communicate, turn off the TV and help the person focus to the conversation. Over stimulated persons with dementia may become agitated, aggressive or withdraw.
  • As dementia worsens, the person’s world will get smaller. They often end up in a single room due to inability to cope with the wider environment. This tells you that more stimulation is not what is needed, but that there is an increase in fear due to unrecognized surroundings.
  • Do not yell, shame, or corner a person with dementia. They are adults and often that is known to them. Also, do not use reality orientation. If you ask them how old they are, they may give you a clue as to what period of time they think they are in. It is easier to go to their reality than to drag them into our reality.
  • If they have forgotten who you are, be who they think you are, or introduce yourself at every visit and who you are. If they have forgotten you, do not take it personally. They just cannot remember.
  • Engage the senses as dementia frequently affects left brain function first. Sensory experiences are in the right brain. Aromatherapy, massage, music, quiet environments, lower lights help.

About the Author:

Nancy Sterling Trimble, PhD, RN, CNP is a geriatric Adult Nurse with over 30 years of experience. She has served as a faculty member of Indiana Wesleyan University, Capitol University and Wright State University. Nancy has also contributed numerous articles to clinical publications.

nancytrimble

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7 Questions to Ask When Choosing a Hospice

Someday you or someone you love is likely to need hospice care. Before you arrive at that day as a crisis, it’s advisable to consider what is important in choosing who will provide your hospice care. You do have choices, and your choice is a critical factor in what services you receive. It affects not only services provided to the patient, but to those left behind. Below are important questions to ask when deciding who will provide your hospice care:

1. How long has the hospice been in operation?

According to a major consumer publication, hospices with over 20 years of service demonstrate stability and reliability of service.

2. Is the hospice Medicare-certified?

If the patient is a Medicare beneficiary and wants to use the hospice benefit, Medicare certification is required to enable costs to be covered.

3. Is the hospice accredited and state-licensed?

Hospices with Accreditation (JCAHO or CHAP) have been reviewed by an impartial organization and accreditation indicates they are recommended as having good standards of care.

4. Does the hospice offer services beyond those that are required by Medicare?

Many services are not required by Medicare, but may be highly valuable to patient care and comfort. Not all hospices permit patients to continue with radiation and/or chemotherapy for cancer. If a patient wants to continue to receive these therapies to reduce the size of a tumor and reduce pain, it’s important to know whether the hospice permits such therapies.  Some hospices would not be able to afford to do this but others could.

Similarly, some hospices provide an array of comfort therapies such as massage, music, art, pet and similar non-pharmaceutical interventions that can significantly improve patient quality of life. These alternative, holistic treatments are also worth considering as you weigh whether a hospice can meet patient needs.

5. Is inpatient hospice care available?

Patients receiving care in their own home may develop complicated symptoms and need to have inpatient care to control symptoms or pain. Caring for someone with a serious illness can be exhausting for caregivers, who sometimes fall ill themselves. Some hospices offer “respite” care, enabling the patient to be cared for in an inpatient environment to allow the caregiver a break of up to 5 days. Not every hospice can meet the need for inpatient care. It’s an important option for the comfort of the patient and the caregiver.

6. Are the doctors and nurses certified in palliative care?

Specialized study in palliative and hospice care is a demonstration of expertise in addressing the needs of hospice patients.

7. Does the hospice offer grief support services?

Grief support services are available at no cost from some hospices, and continue for up to a year following the loss of a loved one. An array of services tailored to address the needs of various family members is a good indication of strong bereavement support for family members left behind.

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What is “Normal” When Talking about Grief?

Grief
Intense grief can be a new and frightening experience. Most people feel like strangers in unfamiliar, uncharted territory when experiencing grief for the first time. Fear of “going crazy” may prevent the griever from asking others if this experience of grief is normal.

The truth is that people grieve differently and one person’s experience may look very different from that of another.

Though everyone grieves in a unique way, certain thoughts, emotions and behaviors are almost universal to acute grief. Following are some of the most common:

  • Overwhelming sadness and tearfulness
  • Feelings of emptiness and loneliness
  • Difficulty with concentration and memory
  • Problems falling and/or staying asleep
  • Changes in appetite
  • Lack of energy and/or motivation
  • Decreased interest in things that formerly held your interest
  • Desire to withdraw socially from others
  • Restlessness and/or increased anxiety

Just knowing these grief symptoms are normal may be enough to calm your fears. However, if you still have questions about your grief journey, attending a support group may help. Listening to the stories of other grievers can assist in understanding your own grief symptoms. Grief support services are available at Ohio’s Hospice of Dayton through Pathways of Hope. Contact Pathways of Hope at 937-258-4991.

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Exchanging a Bear Hug

20160712_145601_resizedOhio’s Hospice of Dayton volunteer Judy Cole has touched the lives of hundreds of patient families over the years by creating handcrafted Memory Bears from the belongings of loved ones who have passed away. For the past two years, she has been making Memory Bears for another group – kids attending the grief program of Camp Pathways.

Judy was presented a framed thank you card signed by the Yellow Group campers who received her Memory Bears as souvenirs of Camp Pathways 2016 – along with a bear to call her own. We like to think of it as an exchange of bear hugs.
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PARO – A Positive Substitute for Pet Therapy

Some people complain that technology can be dehumanizing. Those people have not yet had the privilege of meeting PARO.

PARO is the nickname of an advanced interactive therapeutic robot that is being used at Ohio’s Hospice of Dayton with patients. Designed to look like an adorable baby harp seal and covered with synthetic fur, PARO is loaded with sensors in his long whiskers and entire body, enabling him to react to sound, light and touch. PARO blinks his eyes, moves his head, makes sounds and reacts as a real animal does when interacting with a human. PARO evokes the same emotional pleasure as a pet therapy animal but can serve patients in situations where real animals cannot.

Ohio’s Hospice of Dayton added two of the baby seal robots to the clinical team a few years ago as part of an innovative approach to patient care. For patients in settings that do not permit animals, such as nursing homes, PARO is a tool to encourage patient interaction.

Occupational Therapist Angelene Volpatti highlights how PARO affected one patient. “The patient was well-educated and confined to a wheelchair in a nursing home. Her children were literally all over the country – Alaska, Florida and Washington state. They spoke frequently by phone, but conversations were limited mostly to what the patient had to eat and how she was feeling.

During our first meeting I discovered the family were animal lovers and always had pets. Pet therapy was not offered by the nursing home, so we brought PARO to visit. The patient responded to PARO just like she would a pet, speaking to him and petting him, smiling and enjoying PARO’s reactions. She immediately relaxed and was less physically contracted. The conversations with her children became more rich, as she talked about PARO and together they reminisced about pets.”

Research with PARO has shown that patients experience a reduced heart rate, reduced blood pressure and are more calm after interacting with the robotic seal. They engage in more social interaction. Such positive outcomes, without the potential side-effects of pharmaceutical interventions, are convincing evidence of the value of robotic therapy.

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Staff Honored for Years of Service

Our staff provides superior care and services for our patients and families we serve daily – we think it’s worth celebrating, especially those who have contributed years of service to our mission.

Staff from Ohio’s Hospice of Dayton were honored for their years of contributions at the Ohio’s Hospice Staff Recognition Breakfast on Thursday, June 23.

The following were recognized:

5 Years

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(Listed alphabetically) Janet Allen, Doug Arnett, Lisa Balster, Lisa Bateman, Ciara Bayne, Kathy Berthy, Jennifer Bloom Long, Paula Booth, Michelle Bowman, Tina Brewer, Gretchen Buchanan, Marlene Cobb, Laurie Combs, Nancy Conatser, Linda Cummins, Mark Curtis, Dana Datz, Dominic DeAloia, Jessica Dutton, Lynn Edwards, John Eshelman, Robin Ferguson, Diane Foreman, Linda Gault, Lorraine Gilkison, Carl Gill, Susan Good, Tiffany Harris, Kate Hawvermale, Will Henry, Jennifer Hrovat, Robert Huden, Suzanne Jackson, Shea Johnson, Tiffanie Johnson, Brenda Jones, Catina Lamb, Christina Lawrence, Jenny Liew, Stacey Lykins, Rebekah Marlow, Jacy McCain, Amanda McCoy, Donna Molton, Birdie Napper, Susan Page, Adriana Palamariu, Letitia Person, Ashley Puchalski, Lisa Rhoden, Faith Richardson, Tim Robinson, Anna Rymer, DeShay Scandrick, Patricia Scheper, Carrie Schroder, Nancy Silverman, Gayle Simmons, Sandra Simpson, Jaime Sowers, Lesa Stewart, Theresa Sugrue, Bob Tangeman, Brittany Thiel, Melinda Tobin, Angelene Volpatti, Kevin Wardlaw, Stephen Wetterhan, Megan Wissinger and Miriam Wolf

10 Years

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(Listed alphabetically) Jamie Doughman, Vickie Hartke, Lisa Hayslip, Debbie Holt, Janet Koehl, Amy LeVan, Connie Pappas, Craig Thacker,  Michael Toerner, Kashauna White, and JoAnne Wynn.

15 Years

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(Listed alphabetically) Heather Bolton, Janet Dickens, Gloria Entela, Susan Freeman, Marianne Montjoy and Dr. Ruth Thomson

20 Years

Donna Braun-Slyman

Quarter Century Club

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Dena Wenzler

With gratitude, we thank our staff for all they do at Ohio’s Hospice of Dayton!

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AmeriCorps Volunteers Visit Ohio’s Hospice of Dayton

The flower beds at Ohio’s Hospice of Dayton were recently given extra care, thanks to the giving hands of AmeriCorps NCCC volunteers from the North Central Region.

From Vinton, Iowa, the group of 18-24 year olds volunteered at Ohio’s Hospice of Dayton and worked seven hours on Monday, May 16 planting annuals and maintaining our flower beds.  The group was led by our lead landscaper Miriam Wolf.

The volunteers are participating in a 10-month program traveling in the Northwestern region to help strengthen communities and their own leadership skills.  Currently, eight members are here in Dayton for two months working with the Aullwood Audubon Center and Farm as part of a grant.

The staff from Aullwood suggested the volunteers extend their services to Ohio’s Hospice of Dayton to help meet the 80 hours of community service they are required to meet.

One of the volunteers Keira Larson, 23, from Chandler, Arizona has never had exposure to a hospice and mentioned the other members were new to the environment as well. “We have been very fortunate with our experience,” Larson commented.

“I think that the young adults volunteering at Ohio’s Hospice of Dayton are gaining a new story and experience to share,” said Team Leader Ashley Frampton. “Many have never been to a hospice before, and I think it is good for them to familiarize themselves with what is in their home community. I hope they all walk away from the day with a new perspective and knowledge.”

Frampton went on to say volunteering at a hospice is a great way for them to help out at a place with which they are unfamiliar.

“I am proud of my team for taking the initiative and reaching out to help organizations in the community where we are living and serving,” Frampton said, “It is the first time they have volunteered at a hospice and I hope it is not the last.”

The volunteers were given a tour of our Hospice House and educated on the mission and services we provide. After learning more about hospice, the volunteers felt so good about the work they were doing for our organization that they came back to serve another day.  We were happy with the news!

Ohio’s Hospice of Dayton thanks the AmeriCorps Volunteers for their hard work and wishes them well in their valuable work.

Learn more about AmeriCorps NCCC

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Green Energy Ohio Tour Highlights Ohio’s Hospice of Dayton

GEO-Tour-LogoOhio’s Hospice of Dayton is excited to be included on the Green Energy Ohio Tour taking place Friday, Saturday and Sunday, June 3, 4 and 5. This free event features self-guided, guided or open house tours across Ohio highlighting homes, businesses and public places that are using green technologies.

Alternative energy sources such as solar, wind, biomass and green design will be among the featured designs included in the tour.

Ohio’s Hospice of Dayton will share information and a tour of the solar panel array that provides energy and climate control for a storage building located on the campus at 324 Wilmington Avenue in Dayton. According to facilities manager and solar advocate Mark Wagner, the solar energy produced at the Ohio’s Hospice of Dayton site produced energy in the first 12 months of operation equivalent to:

  • powering 3 homes annually
  • removing 4 cars from the road
  • planting 1,140 trees
  • the power produced by 18 barrels of oil
  • The array has offset 45,570lbs (21 metric tons) of carbon emissions in its first year. This is equivalent to CO2 emissions from:
  • 2,372 gallons of gasoline consumed
  • 22,501 pounds of coal burned

And greenhouse gas emissions from:

  • 7 tons of waste sent to a landfill
  • 50,559 miles driven by an average passenger vehicle

The solar system includes 96 solar modules, 2 inverters and produced 30,000kWh in the first year of operation. Those participating in the Green Energy Ohio tour can visit the site and learn more about it Friday, June 3 from 4 to 6 pm, Saturday, June 4 from 10 am to 4 pm and Sunday, June 5 from 1 to 4 pm.

It is the first of several green approaches to energy and efficiency planned for the Ohio’s Hospice of Dayton campus.

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Ohio’s Hospice of Dayton First in Nation to Earn Pathway to Excellence® Designation

National designation recognizes commitment to superior care and superior services for the Dayton region.

Ohio’s Hospice of Dayton® is the first hospice in the nation to earn Pathway to Excellence® designation. While 134 hospitals nationally have achieved this standard, Ohio’s Hospice of Dayton has become the first hospice dedicated to providing end-of-life care to do so.
Ohio’s Hospice of Dayton President and CEO Kent Anderson celebrated the announcement, saying “I am so immensely proud of our nursing teams in achieving this wonderful distinction and accreditation. In my 20 plus years in healthcare this is by far the most talented team of nurses and nursing leadership I have had the privilege of serving with.”

The American Nurses Credentialing Center’s (ANCC) Pathway to Excellence Program is an organizational credential to recognize healthcare facilities that have created positive work environments where nurses can thrive.

Greg Toman, board chair for Ohio’s Hospice of Dayton, said, “I am proud to be part of an organization that continually strives for excellence. Achieving the Pathway to Excellence accreditation reflects the commitment to our mission by our nursing team. Being the first hospice in the country to achieve this status reflects Ohio’s Hospice of Dayton’s national leadership in hospice care.”

Pathway-designated organizations participate in a rigorous review process that determines organizational commitment to nursing excellence. Nurses in the organization verify the organization meets the high Pathway to Excellence standards by participating in a completely confidential online survey.

Those achieving designation are deemed to be among the best places for nurses to work, with high nurse satisfaction and retention. Research shows that healthy work environments improve not only nurse satisfaction but also patient satisfaction and quality of patient care.

“The designation of Pathways to Excellence belongs to the nursing staff of Ohio’s Hospice of Dayton who give of themselves each day to provide superior care and services to our patients and families,” says Chief Nursing Officer Mary Murphy. “It is their work that I honor today. I am proud to be part of such an exceptional team.”

Organizations seeking the Pathway to Excellence credential must meet 12 practice standards that establish a positive work culture and environment as defined by organizational practices and policies. The standards include

  •  Nurse shared governance
  •  A strongly safe environment
  •  Mechanisms to address patient care and practice concerns
  •  A sound orientation program
  •  Strong professional development support
  •  Competitive wages and benefits
  •  Recognition for professional achievement
  • Healthy work-life balance
  •  Collaborative interdisciplinary approaches to care
  •  Strong nurse leadership and
  •  Evidence based practice focused on patient outcomes and quality.
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Celebrating Our Solar Successes On Earth Day

Warehouse Solar ArrayOhio’s Hospice of Dayton is celebrating Earth Day everyday with financial savings and a reduced carbon footprint thanks to solar power.EarthDayHOD

As part of Ohio’s Hospice of Dayton’s Renewable Energy Program, Ohio’s Hospice of Dayton will participate in the 2016 Green Energy Ohio (GEO) Solar Tour June 3-5. Facilities Coordinator Mark Wagner will host visitors to share information about the impact 96 solar electric panels have had on power usage. The amount of energy produced since May of 2015 has offset 36,000 pounds of carbon emissions and is the equivalent of powering two average homes. The amount of carbon and greenhouse gas emissions offset can be represented by having planted 922 trees, 17,509 pounds of coal burned, 38 barrels of oil consumed, six tons of waste sent to a landfill, and removing three cars from the road over the past nine months.

Like GEO, Ohio’s Hospice of Dayton is promoting sustainable energy practices. Future plans like roof-mounted solar arrays and a solar car canopy will further reduce Ohio’s Hospice of Dayton’s electricity consumption by more than 10 percent. As opportunities arise to implement additional sources of renewable energy, Mark will be reviewing all options. “It’s a great idea to implement a renewable energy source, such as geothermal, wind or solar at the earliest stages of a new building or a facility’s refurbishment,” he says. By adding renewables into the mix from the start, companies can save on installation costs and have a better impact on the environment.

Please join Mark at Ohio’s Hospice of Dayton and be a part of the Solar Tour in June. For more information, contact Mark at mwagner@hospiceofdayton.org.

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