Dementia victims have Best Friends at RJHC
By Deborah Moon Seldner
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Newly certified as a master trainer in the Best Friends Approach to Alzheimer's Care, Ronnie Schechter, RN BSN, can help employees and families throughout Cedar Sinai Park relate as friends to residents with dementia.
Based on the 1996 book "The Best Friends Approach to Alzheimer's Care," the widely accepted method teaches caregivers to use a life-affirming, person-centered approach to deal with Alzheimer's patients empathetically as friends. Schechter was certified as a master trainer by the Oregon Dept. of Human Services after completing a training program June 8-10.
Schechter, who has worked at CSP's Robison Jewish Health Center for 26 years, said that Robison nurses have used the best friends method for the past eight years under the direction of consultant Joyce Beedle, who provides monthly in-service trainings in the approach. Now Schechter will be an on-campus resource for all staff members and families of residents dealing with any level of dementia.
From 1998 to 2000, Schechter worked in Robison's early dementia unit. For the past six years she has been the resident care manager in Robison's Miriam Suite, a secure, safe Alzheimer's unit with lower stimulation and sound, which can disturb many with Alzheimer's, and more structured daily activities.
"Many people (patients and their families) diagnosed with Alzheimer's become fearful and anxious and have feeling of futility," said Schechter. "The best friends approach shows people how they can make the best of the situation."
Best friends teaches caregivers the importance of learning the person's life story, learning friendship as an art, having "the knack," and learning effective techniques for activities and communication.
"The knack is about approaching the person like a friend; about using humor, optimism and respect; being non-judgmental; and having empathy," explained Schechter. "If someone always says no, don't ask them, 'Do you want to?' Structure an activity that is fun and pleasant while caring for daily activities. ? Figure out a way so the day flows for them and is not a battle of wits over simple, everyday activities."
Symptoms of Alzheimer's include a decline in short-term memory, judgment, reasoning and problem solving, as well as confusion and an inability to manage self-care. Schechter emphasized that family's should not assume that a person with those symptoms has Alzheimer's. She said a person should always be examined by a physician to rule out reversible forms of dementia such as over- or under-active thyroid, Vitamin B12 deficiency, depression and pain.
Using a people-oriented rather than task-oriented approach allows caregivers to enjoy moments with the person, said Schechter. She added the best friend's approach works because, "friendship is understood by everyone; it's easy to be a friend."
"A person at Robison with dementia is approached as a friend," said Schechter.
Schechter praised the "wonderful" Robison staff for their dedication to that approach and the residents. She also thanked Robison Administrator Kim Levy for nominating her for one of the 40 openings in Oregon's master trainers program.
Because about half of all residents in nursing homes nationwide experience some level of dementia, Schechter said she believes having a resource person on staff will benefit the entire campus, which includes Robison and Rose Schnitzer Manor, an assisted living facility. She said she can help residents and staff cope with issues ranging from forgetfulness to anger and frustration.
"I'm able to be a resource person to try and figure out how to manage a person's care and redirecting anger and frustration," she said.
Schechter will do her first formal training with Robison's nutrition staff, but she said she is constantly doing informal training on "what does it take to be a friend."
Schechter said that any family member of an Alzheimer's patient is welcome to attend one of the monthly best friends in-service sessions for staff. For information on upcoming sessions, call Schechter at 503-535-4300.