Dementia Beyond Drugs: A Book by Al Power

        Al Power, MD

Along with St. John’s Home, Al Power hosted the informal gathering in Rochester, New York earlier this month.  He is an Eden Mentor at St. John’s, a long term care community in Rochester.  He’s a geriatrician, author, blogger, musician and public speaker.  Whatever label you apply, he is a man who has thought deeply about dementia and aging, and is working to change our approach to both.

His book Dementia Beyond Drugs: Changing the Culture of Care will make you question your assumptions, and might make you more optimistic about the future of aging and dementia care.

In plain language and personal stories, the book lays out the problems with our current model of dementia care.  Expanding on a philosophy developed by Bill Thomas, founder of the Eden Alternative, Al writes that some of the disabilities of people with dementia are caused by our medical and social systems.   Even with advances in medicine, people in nursing homes still suffer.  Through a series of personal stories and examples, he shows that loneliness, boredom and helplessness cause much of frail elders’ suffering.  The current model of care (not the people providing the care) contributes to these problems, he says.   Based on clinical research and his experience at St. John’s, Al believes unnecessary medication (particularly pills given for behavioral issues) is more harmful than helpful.
 
The solution to this systemic problem is to transform our culture of care to meet the needs of the person being cared for, he writes.    On the surface, this involves changing the physical environment.  The lighting, noise and hospital-like settings of many long term care facilities are not well-suited to elders with dementia (or any of us, for that matter).  

The more difficult task is changing how we engage with people with dementia, forming close relationships with each person to understand his needs.  Communication difficulties common with dementia make it hard to know what a person wants or needs unless you have a close relationship with him and understand his work and family history, likes and dislikes.  Drawing on his years of experience, Al gives specific examples of how paying attention to each person’s needs can solve “problem behaviors” and reduce the need for drugs.  Dementia Beyond Drugs contains specific suggestions for handling communication, personal care, wandering, aggression, paranoia and other challenges common to dementia.

At St. John’s Home, Al is leading several efforts to transform care using the Eden Alternative model and tools.  Broadly speaking, this means changing the physical environment, procedures and entire culture to meet the needs of the elders being cared for.  Al’s work at St. John’s includes:

• Working with staff, residents and community to develop solutions in line with Eden Alternative philosophies
• Providing training and education programs such as Richard Taylor’s talks to the St. John’s staff and community
• Launching Eden-related pilot projects within St. John’s
• Proposing and implementing organizational changes, including self-directed teams that bring day-to-day decisions closer to elders and those who care for them
• Planning for Green House Project homes (two are currently under construction).

Outside of St. John’s, Al’s ideas are equally relevant.  Whether you are a person with memory loss, a family member or professional caregiver, Dementia Beyond Drugs will help you rethink dementia, aging and eldercare.

 

Comments

[margaret]

This looks fantastic.

Thanks!