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A Novel Video-based Education and Analysis System for Caregivers of Cognitively Impaired Seniors

By Miwako Honda, M.D., Director of  (Guest Post)

In a rapidly ageing society, Behavioral Psychological Symptoms of Dementia (BPSD) management is one of the key challenges. Moreover, nursing staff caring for elderly patients with BPSD have potential to burn out quickly when adequate training and resources are limited. The high turnover rate of caregivers in nursing homes and hospitals is a critical global issue.

The french-origin, multimodal and comprehensive care methodology, Humanitude®, focuses on perception, emotion and verbal communication to provide care for patients, especially fragile elders. It has been taught widely in hospitals, nursing homes, assisted livings and homes for more than 40 years. Relationship-based care is the key of this methodology.

Many nursing homes and hospitals in France, Germany, Switzerland, Belgium, Luxemburg, Italy, Portugal, USA, China, Thailand and Japan have started to implement the Humanitude® methodology. The training has been done in hands-on style at each community. The demonstrated effect of the training is a significant reduction of BPSD and prescribed anti-psychological medications for elders residing nursing homes. In addition, satisfaction among caregivers who have received the training has increased, resulting in a significant reduction of turnover.

In the past 6 years, the Humanitude® has expanded its training platform to video-based education. Professional caregivers record videos of their care in difficult situations. The videos are then evaluated by certified trainers. Through the evaluation, trainers are able to identify and advise caregivers on which part of multimodal communication is missing. The accumulation of data from the videos and evaluations has made it possible for Humanitude® to develop an auto-video analysis system (informatics) through artificial intelligence—which is now available. Currently, there are 4 ongoing governmentally funded studies on this methodology with informatics researchers in collaboration with physicians, nurses and psychologists.

In Japan, a rapidly growing ageing population, the management of people with cognitive impairment is crucial. In response to this challenge, Fukuoka city, which has a population of 1.5 million, launched the project “Humanitude City”. In 2016, a 2-hour workshop was held for family caregivers who are taking care of cognitively impaired elders at home. The workshop included auto-video analysis. 148 family caregivers were enrolled the study. After the workshop, a post card to teach the point of care was sent weekly for 12 weeks. In 3 months follow up of this low cost intervention, family caregivers reported a significant reduction of burden, as well as improvement of BPSD for the elder. Fukuoka city is continuing its project for an additional 3 years.

Want learn more about this project? Join Miwako Honda, M.D. in Montreux this September 18-21 for the Global Ageing Conference. Presenters Miwako Honda, M.D, Yves Ginest and Yoichi Takebayashi will share the basis and philosophy of the Humanitude® methodology, scientific research results and the future of dementia care. Register here.

 

About the Author

Dr. Miwako Honda, Director, Geriatric Research Division, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
Dr. Miwako Honda, earned both a law degree from Keio University and a medical degree from Tsukuba University. Dr. Honda currently serves as director of geriatric research division of National Hospital Organization Tokyo Medical Center, Japan. She had completed fellowship of geriatric medicine at Cornell University and has many experiences of clinical research. She started to implement Humanitude to Japan in 2011, and has developed training system for professional caregivers, education curriculum for medical and nursing schools in Japan.

Emi Kiyota Completes Her Loeb Fellowship at Harvard!

Photo above: Bob Lagoya, Emi Kiyota,, Anny Wyatt and Earl Ford memorialize the occasion.

On May 26 Emi Kiyota, Ph.D., President of Ibasho and Global Ageing Network Board Member, received a certificate marking the conclusion of her year-long Loeb Fellowship at the Harvard University Graduate School of Design Commencement Ceremony.  The Global Ageing Network’s Eduation Manager, Bob Lagoyda, joined Emi’s long-time friend, Ibasho Board Member and Manager of Palliative & Residential at CaringKind, Ann Wyatt and Ann’s partner, Earl Ford, to celebrate this professional milestone with her.

Emi’s journey with Ibasho and reflection on the impact that this past year at Harvard will have on her work are well captured in her Loeb Fellowship Video:  https://youtu.be/l7vNxgeUKGI

Congratulations, Emi!

Sodexo’s Dignicare Enhances Dining Experience for Seniors with Dementia

By Aline Le Clef, Sodexo Belgium (Guest Post)

Sodexo’s “Dignicare” meal program focuses exclusively on seniors with dementia. Because residents with dementia, just like other groups in need of care, require a customized approach to improve the dining experience and the meal experience. To support the program in a scientific and practical oriented way, we were able to rely on the know-how and expertise of Paradox, the Regional Expertise Centre for Dementia. The result is a unique offering aimed at the elderly with dementia that focuses on nutrition through a customized range of food. In addition, Sodexo provides tips & tricks to improve the quality of the dining experience. For example, providing guidance on design and decoration (e.g. use of colour on walls and floor, attention to the presence of a calendar and clock, etc.) to create a home-like meal environment in which residents feel at home. Sodexo also attaches great importance to incentives that stimulate appetite, thinking of familiar dishes, but also specially adapted eating and drinking utensils in contrasting colours that enhance independence during the dining experience. In short, Dignicare contributes greatly to a pleasant meal time and increases the quality of life of seniors with dementia.

Drawing from its many years of experience within the healthcare sector, Sodexo works in cooperation with the client to create a unique dining profile of each resident. Therefore they are able to offer meals that match the resident’s personal preferences and limitations, such as:

Finger-foods

Motor and/or cognitive impairments may be a significant obstacle during the dining experience.

Finger-food facilitates the dining experience for seniors who have difficulty eating with utensils.

These meals are in all respects the same as those prepared for other residents, except for its shape. The dishes are prepared in a way that makes it easy for them to pick the food up and eat with their hands. The plates and glasses are specially adapted as well. Thanks to finger-food the transition to assisted eating is delayed, which relieves the assistance during meals. In addition, this concept has a positive effect on food intake with less risk of malnutrition. Moreover, some seniors will begin to use utensils again. In short, finger-food increases autonomy during the dining experience and results in a more pleasurable dining experience and increased dignity.

Home Made Soft

Home Made Soft stands for home-cooked meals where the texture of the dishes can be individually adapted to the needs of people who have problems chewing and/or swallowing. As a result, seniors who have these limitations can again start to fully enjoy their food. The offering consists of a range of recipes that are used to carefully create and prepare the meals using the best ingredients.

Offering meals in a Skilled Nursing Home is a complex process: the different limitations and challenges of residents always requires a customized approach. This is even more the case with a specific approach to seniors with dementia. It is therefore very important that the vision of Sodexo coincides with that of the client. The commitment to work with a shared vision with respect to meals, makes every Dignicare application a unique collaboration between Sodexo and client.

Join us in Montreux Switzerland this September to attend Dignicare: Creating a Home-like, Private Environment for Residents with Dementia where presenters, Aline Le Clef and Serge De Kerf will share more about the impact of Sodexo’s Dignicare program on residents with dementia. Visit the 2017 Global Ageing Conference website to explore and register for this year’s education program.

 

About the Author

Aline Le Clef, Sodexo Belgium
Aline Le Clef certified nutritionist, is currently pursuing a Master of Science in Health Care Management and Policy. She joined Sodexo in 2008 and started in operations within the Seniors segment and subsequently became Quality Manager for that segment. Driven by her interest in elderly care Aline evolved to the position of Marketing Manager Seniors Benelux and developed Dignicare as an answer to the challenges of the future market. As our life expectancy increases, one side effect is the growing population of residents with dementia in residential care facilities. Currently 40 to 50% of all residents of 85 years and over suffer from some form of dementia. Thanks to her background as a nutritionist she is well placed to develop the appropriate initiatives to improve their quality of life, in line with Sodexo’s mission to provide innovative, tailor-made services to these residents.

Aline will presenting “Dignicare: Creating a Home-like, Private Environment for Residents with Dementia” at the 2017 Global Ageing Conference in Montreux, Switzlerland.

Nova Scotia Centre on Aging (NSCA) to Receive 2017 Award for Excellence in Applied Research

The Nova Scotia Centre on Aging (NSCA) is one of two recipients of the Global Ageing Network 2017 Award for Excellence in Applied Research. The Nova Scotia Centre on Aging, established in 1992, is a university-based research centre that conducts applied research on age-related issues. Its mission is to advance knowledge on aging to inform social policy and practice, and enhance the quality of life of older people and their families. The NSCA has worked directly with municipalities in the province of Nova Scotia to create more age-friendly communities, and this work continues to branch out to support and participate in initiatives locally, nationally, and internationally.  One of the key components of the NSCA’s success “has been its commitment to involving the community and government in the research process. It has achieved this by partnering to develop research questions, to engage in the research, to connect students and trainees with established academic and non-academic mentors, and to disseminate and implement research findings,” states Dr. Suzanne Dupuis-Blanchard, Director for the Centre for Aging Research at the Universite de Moncton (New Brunswick).

Over the past 25 years, the NSCA has led and been actively involved in a broad spectrum of over 100 research projects. Of note is the C.A.R.E tool and the Care and Construction project.

Innovative Tool Engages Caregivers

The C.A.R.E tool is a validated psycho-social assessment tool, and Caregiver Risk Screen. This innovative practice supports the integrated care of care receivers and caregivers by offering a framework for engaging caregivers in a discussion about their concerns and expectations. The tool has been used in multiple research studies and evaluation initiatives since its development to understand its utility in practice and its impact with different caregiver populations. Furthermore, the C.A.R.E. tool as a stand-alone intervention has positive implications for the caregiver and practitioner, impacting the practitioner by increasing practitioners’ appreciation of caregivers’ situations, enhancing caregiver-practitioner relationships, and providing evidence to support referrals to services and supports for caregivers. During the past decade, the C.A.R.E. Tool has prompted a growing paradigm shift in how national, provincial and local health systems think about who they serve.

CARE & Construction Team

The Care and Construction project examined to what extent and in what ways differences in the nursing home model of care (staffing and physical design) impact resident quality of life. More than 1,600 participants provided information through surveys, interviews, focus groups, and case studies that included interviews, participant observation, and activity monitoring. The research produced new partnerships with researchers, government and sector decision makers, two sector workshops, knowledge series brochures, academic and industry publications, video and Café Scientifque. By translating research into the Care and Construction project into practice, the NCSA learned of the value that being involved in large scale research initiatives brought to the nursing home sectors. One of the project beneficiaries is Shannex Incorporated, stating that “the project demonstrated the synergies that can be generated when research and practice collaborate. Through our active engagement in the study, we were able to identify ways to put the findings into action. The results of the study have been used to enhance our philosophy of care and emphasis has been placed on the importance of relationships between and amongst clients, staff and families.”

The Nova Scotia Centre on Aging will receive the award at the 2017 Global Ageing Network/CURAVIVA Global Ageing Conference which takes place on September 18-21 in Montreux, Switzerland.

Interfaith Elder Care Group of Lebanon Reaffirms Their Goals of Cooperation and Peace

By Julie Celeste Pimentel (Guest Post)

The second Lebanon Interfaith Elder Care Group conference was held in Mzaar, Lebanon on April 22, 2017. The purpose of the conference was to further the understanding of the challenges and goals of the group, composed of Managers of Senior Care centers throughout Lebanon.

Reference to “the war” is frequent in Lebanese conversations with the words, before, during and since being denominator of the civil conflict that took place from 1975 to 1990. The social structure of the population and more significantly, the family structure were forever changed during those 15 years with civilian fatality estimates as high as 200,000. Because of these changes, the need for Elder Care is near crisis.

The Group, with representatives of Shia, Sunni, Druze, Maronite, Latin Catholic, Armenian Christian, and Protestant Christian communities, was formed at the first conference in Cyprus in 2015 and the cooperation among them is considered a phenomenon. Although there are 53 long-term care centers in Lebanon, only on Assisted Living Center, Moadieh Evangelical Center of Beirut exists in Lebanon.

With the need for assisted living care rapidly increasing, Joyce Eid, General Manager of the Moadieh Center became profoundly interested in implementing the National Evangelical Church’s vision for changing the social environment to one that would provide elder care for anyone in need, no matter his or her religious belief.

Speakers at the conference were:

Rick Stiffney, CEO, Mennonite Health Services (Indiana, USA)
Topic – The Board/Executive Relationship: Developing our Missions and Capacities Together

Philippe Saad, Architect (Massachusetts, USA)
Topic – Design Considerations for Today’s Seniors: Planning for Wellness Not Sickness

Nadim Abi-Antoun, COO, Presbyterian Homes (Illinois, USA)
Topic – Service Delivery Models for seniors: Technology and Innovation in Senior Services

David Reimer, CEO/President of Palm Village Retirement Community was the consultant for the conference, supported by funds from Ken Enns Memorial Donations. Eid first met Reimer when she visited Palm Village in 2012 for the purpose of learning the operations of an Assisted Living Center. They were connected through Mennonite Central Committee.

As a result of the conference the attendees affirmed the need to continue to share practices and education and to establish a formal legal organization in Lebanon. They hope to be a model for peace, not only in this interfaith group, but also for other programs that will prosper with an all-inclusive policy.

For information contact conference attendee: Julie Celeste Pimentel, Managing Partner, Celeste/Daniels Advertising and Design – julie@celestedaniels.com, +001 541 344 2308.

Photo credit: Members of Lebanon Interfaith Elder Care Groups and Speakers from United States. Photo taken by Julie Celeste Pimentel.

Geratec Explores New Training Approach for Dementia Care in South Africa

By Shannon Davis, Global Ageing Network

Geratec, an organization providing operational and support services to aged care providers throughout South Africa, has been exploring a new training model for dementia care. The training was launched in South Africa to help caregivers better relate to and connect with people living with dementia in care homes. It incorporates a host of learning theories, drawing on the parallels between the discriminatory practices of Apartheid and the stigmatization of dementia, to bring about a better understanding of the needs of people living with dementia.

There is a lack of education, research and resources on the African continent around dementia. In fact, there is no word for “dementia” among all of the various dialects in South Africa. Many people consider dementia as witchcraft. Further, there are no government policy of guidelines to address or improve this perception, nor any training among public health professionals. Quoting Prince (2001), who has been at the forefront of the 10/66 Dementia project in South Africa, they point out that 66 percent of the world’s people living with dementia reside in a less developed country, whilst 10 percent of the research is conducted in these countries.

Geratec’s dementia care training raises caregivers’ awareness about dementia through adult learning theory and storytelling. Adult learning theory seeks to shift perceptions about dementia through reflection and the exploration of one’s deeper beliefs. In addition, many African caregivers learn more through storytelling rather than the traditional classroom style. Subsequently, training sessions are led openly and creatively, invoking personal roots and displaying respect for the cultural heritage of its participants.

The training brings together a diverse group of caregivers and elders living with dementia, all with different cultural backgrounds and languages. It combines both narrative and experiential learning through storytelling and reflection on past experiences. The experience is informal, interactive and attendees are encouraged to participate throughout the entire session.

The first half of the training is focused on the caregiver, involving a variety of creative and personally engaging activities, including the use of the “Who am I form” to create a poster collage. The activities set the groundwork for transformative learning and allow participants to feel more at ease. The remaining time is focused on the experience of elders living with dementia. Caregivers are asked to think of an elder living with dementia whom they think they know well. They are then asked to complete a similar “Who are you” form with information about that elder. Attendees are asked to reflect on the observed behavior of people who are lonely, helpless, and bored. Reflecting in small groups on the experience of caregivers creates a platform for experiential learning.

Geratec’s new dementia care training model provides caregivers with an opportunity to deeply understand the experience of living with dementia, to create authentic relationships with the elders they serve, and to connect on a level beyond language and cultural differences, through life story work and simply being together in the world.

Join us in Montreux this September 2017 where Rayne Stroebel, Geratec’s Managing Director of Dementia Studies will share more about her organization’s work in strengthening and developing a non-western workforce in long-term care.  You can register here.

Resource: Geratec, South Africa. Rayne Stroebel, Geratec’s Managing Director, Dementia Studies. “Engaging the Non-Western Workforce in Long-term Care Facilities”. 

 

ViTA-ACH Group to Receive 2017 Award for Excellence in Applied Research

ViTA-ACH Group project, led by Kirsty Marles, is one of two recipients of the 2017 Global Ageing Award for Excellence in Applied Research this year.

ViTA is a purpose built teaching, research aged care service in Adelaide, South Australia. ViTA has been designed to provide a new approach to aged care, to maximize collaboration and promote innovation in service delivery. The aims for ViTA are to embed teaching and research within the delivery of services which promote restoration and rehabilitation for older people in short term and long term care.

The ViTA building is home for 60 older people (aged 65+). However, the service also provides short term transitional aged care services for older people living in the community. ViTA opened in 2014 and is part of ACH Group which is a not-for-profit organization which has been supporting older South Australians since 1952.

The Global Ageing Award for Excellence recognizes the ongoing commitment to quality in ageing services through evidence-based research, translation of research into practice, and dissemination of research findings through internal and external shared learning opportunities.

Holistic Approach to Research and Knowledge Development

ViTA conducted an action research approach between November 2012 and February 2017 that was employed to advance the collaborative practice within and across ViTA. The collaborative approach brought together the skills and expertise of professionals to create a culture of learning which contributes toward improving quality of life for older people. The research experience supported organizational change through engaging the ViTA workforce to shape the systems they working within and contributed to developing an environment at ViTA which balances risk with the conditions needed to innovate.

Graham Dickson, PhD, Professor Emeritus of Leadership Studies at Royal Roads University in Victoria, British Columbia, Canada, and principal partner in LEADS Global stated that Kirsty’s project was “conducted to the highest of standards of action research methodology…it is foundational to transitioning from provider centered care models to patient centered care models that are being promoted in almost all developed health care systems worldwide.”

Further, Dr. Kate Barnett, Managing Director with Stand Out Report, states that “the ViTA research project was a well-thought out, evidence based approach to developing systems that maximize collaboration, create efficiencies and maximize resident outcomes.” She adds “the unique operational model for ViTA which has developed from the research is an excellent example of how applied research can contribute to developing a research and learning culture within an aged care organization.”

ViTA will receive the award at the 2017 Global Ageing Network/CURAVIVA Global Ageing Conference which takes place on September 18-21 in Montreux, Switzerland.

Join Us in Our Fight Against Elder Abuse

World Elder Abuse Awareness Day is June 15, 2017.

The theme of this year’s World Elder Abuse Awareness Day is “Understand and End Financial Abuse of Older People: A Human Rights Issue”.

While the  topic of elder abuse has started to gain visibility, it remains one of the least reported, investigated, and nationally addressed forms of violence against elders worldwide. Financial abuse among older adults can take many forms. In developed countries, it often includes acts of theft, forgery, misuse of property and power of attorney as well as the denial of funds.  In less developed regions, it can include property grabbing, moral and spiritual accusations, banishment from homes and denial of family inheritances.

Financial and material exploitation often deprives elders of a life of dignity and can lead them to a life of poverty, hunger, homelessness, poor health and wellness and even premature death.

The Global Ageing Network is deeply concerned about any and all abuse and neglect against older adults. The fact that it happens at all is a travesty and we must take all measures to put an end to it.

On June 16th, the Global Ageing Network will join other NGO’s at the United Nations in observance of its 12th Annual World Elder Abuse Awareness Day event.

The 2017 theme will focus on improving our collective understanding of elder abuse while exploring effective means of strengthening protections against the financial and material exploitation of older adults– including through the empowerment of elders themselves.  The event will further inform the thematic discussions of the upcoming 8th Session of the General Asembly’s Open-ended Working Group on Ageing, which will take place in July 2017.

Objectives include:

  • Frame financial exploitation and material abuse of older persons within the context of human rights;

  • Promote research across countries to identify the scale and severity of financial exploitation and its impact on older persons, their families, communities and countries in order to raise public awareness and to inform appropriate responses;

  • Stress the urgent need for Member States to take concrete action and develop specific measures to address and monitor financial exploitation and material abuse in the context of an ageing society;

  • Share good practices of legislative initiatives and programmatic interventions on detecting and dealing with financial exploitation.

Join us and colleagues around the world in our fight to end elder abuse. Show the world you care about ending elder abuse and neglect by wearing purple on June 15th and tell us what you are doing to combat it in your community.

For ideas on how you can raise awareness and engage your community around the topic of elder abuse, download the International Network for the Prevention of Elder Abuse’s (INPEA) World Elder Abuse Awareness Day Community Toolkit.

How To Redefine the Role of Nurses in Aged Care

Last September, the Global Ageing Network (formerly IAHSA) convened a forum on the role of nurses in long-term care.  In the past, the role of a registered nurse was defined in terms of physical labor involved in the implementation of physical tasks or the emotional labor involved in day to day resident, patient and/or family interactions.  It was proposed during the forum that, in expanding these roles, an RN’s energy should be more focused on “intellectual labor”–prioritizing training, strategic planning and delegation. Read More…

By Geralyn Magan Aging services organizations should stop defining the role of the registered nurse (RN) in terms of the physical labor involved in clinical tasks, or the emotional labor involved in keeping residents and family members happy. Instead, says Christine M. Merzeder, clinical coordinator at Paracelsus Recovery in Zurich, Switzerland, RNs should be encouraged…

Source: How To Redefine the Role of Nurses in Aged Care | IAHSA

Language Guidelines Seek to Change Attitudes about Dementia

According the World Health Organization (WHO), there is estimated to be 47 million people living with the dementia this year alone. This number is expected to double in 20 years.

In many countries, the symptoms associated with cognitive decline are stigmatized, perpetuating a lack of awareness and leaving individuals and caregivers affected by the condition with limited resources for support.

To further educate the public about dementia and to empower those most affected by the disease, Alzheimer’s Australia created “Dementia Language Guidelines”—a conversational roadmap to foster understanding, awareness and sensitivity to the experience and needs of individuals with dementia as well as the people who care for them. The guidelines offer new language in an effort to shift our attitudes about the condition and to, ultimately, change the way people with Alzheimer’s Disease and dementia are viewed and treated in society.

The guidelines can be used to facilitate dialogue in both personal and professional settings, to lay the ground work for new understanding and to inspire more positive engagement with people living with dementia–and their families.

After all—words do have power.

You can find the guidelines here.