Another perspective on the Virtual Dementia Tour
Several years ago, I attended a seminar on how to decorate an Alzheimer's unit in a skilled nursing facility. While fascinated by what patterns, textures, and nuances should and should not be used in that situation, I never really knew how the residents FELT about their surroundings. I simply took the information as factual based on research, and moved forward with an internal renovation.
A recent experience at the American Healthcare Association Convention really changed my perspective on how our elderly population may view their environment, and how we as care givers or visitors may unknowingly make them feel.
In the Opening Session of the AHCA Convention, the Virtual Dementia Tour (by Second Wind Dreams) was advertised as an available activity for attendees. Since I had enjoyed the decorating seminar I attended a while back, I thought this activity could give me an even better view of the needs in our Memory Care units at Nexion. In addition, my mother-in-law is currently suffering from Mild Cognitive Impairment, which will likely result in Dementia, so it couldn't hurt to learn more about the condition.
Like Gary Tetz described, the experience was unsettling. When I arrived for my previously scheduled session, the moderator had me take a brief survey, and started handing me supplies to be used in the tour – a pair of rubber gloves, a pair of heavier gloves, a set of bumpy shoe inserts, a set of headphones, and a pair of glasses. I thought, “OK – This is about what I'm expecting. They will lead me through a hallway as I wear items to impair my hearing and vision – I just wonder how they are going to inhibit my ability to remember things or complete a basic day in my life.”
When I put on the headphones, I started hearing multiple voices at varying decibels talking about completely random topics and day-to-day noises like running cars and dishes clanking in a sink. The glasses, in my opinion, were extreme – I really could not see a thing – I could make out images, but certainly could not ascertain details. The shoe inserts and gloves were just uncomfortable enough to affect my basic motor skills.
A moderator took me by the arm and told me that I would not be allowed to ask any questions or ask for help during the tour, and that I would be asked to complete five very basic tasks. From that moment on, I barely could hear a word he said – something about putting on a sweater and something about a pill. Hmmmm… I am led into the room and the moderator leaves. I could see that there was a woman in the corner of the room seemingly doing paperwork. I spotted a table with what looked like a pile of laundry. I went over to the table and fumbled around, unable to really make out what each item was – I'm pretty sure I found some socks and a blanket – no sweater. I stood there in silence wanting to ask for help, but I was unable to. A few moments later, the woman from the corner came over and took my arm and led me to another table and said something about a task. I think I saw a deck of cards, a belt, and maybe some coins. I had absolutely no idea what to do. I began thinking back to the directions I was given, and BAM!!!! I heard a door slam VERY LOUDLY through the headphones. I nearly jumped out of my skin. The voices continued, and I started feeling a little sad as I tried to stare at the items on the table and figure out what I was supposed to do.
A few moments later, the woman from the corner came and guided me by the elbow to another table where I saw a prescription bottle, more coins, a pitcher, and a glass. Aha! I could remember something about a pill, but my spurt of confidence quickly went away. WHAT about the pill? Was I supposed to remove a pill? If so, what was I to …. LOUD SIRENS PASSING filled my headphones. My level of anxiety was heightened even more. I JUST WANTED TO ASK FOR HELP or to ask someone to repeat themselves! (The entire tour lasted 10 minutes, so there was a considerable amount of downtime, and a total of 5 tasks I was asked to complete). After minutes of staring helplessly at the table of items and getting the sense that someone was watching how pathetic I was, the original moderator came to get me and said I could take off the items I had been provided. I filled out another survey, indicating that I was unable to complete basic tasks, and explained how I was FEELING during the tour. I was nearly in tears.
Once I finished the survey, a volunteer nurse told me more about how it is to provide care in a Memory Care unit. Once I realized this woman didn't have wings and a visible halo, I began to focus on what she was saying. She explained to me how to approach someone who has dementia as not to startle them. She explained that someone with dementia could get agitated very easily by normal sounds in a dining room, so it may be a good idea to let them eat at a different time so they get the proper nutrition rather than refusing to eat because they are uncomfortable. It went on and on. I made strong mental notes of all of my feelings and of everything she said.
Please note that I continue referencing FEELINGS. I am not a clinician – I am the Director of Purchasing. While I do not give hands-on care, I am acutely aware that each decision I help make touches the residents daily — it's what I am most proud of in my role. I do visit facilities as frequently as I can, and my level of respect for our caregivers grows with every minute of a visit. Most of all, though, my love for our long-term care population grows exponentially with each visit.
My experience in the Virtual Dementia Tour WILL affect my next visit. I don't ever want any of our residents to feel the way I felt that day in the demonstration. While I'm sure the activity depicted quite an extreme case, many of our residents and family members experience some aspect of dementia long before it is ever diagnosed and addressed.
In my next facility visit, if I see someone who looks confused or who looks like they may want to ask me something, you better believe I'm going to approach them correctly - with love, respond – loud enough for them to hear, and offer my assistance - with open arms FULL of compassion!
Lassie Pappas is the Director of Purchasing at Nexion Health.