Bridging the Gap in Dementia Care

September 05, 2012
Chris Perna, The Eden Alternative Blog

Following are excerpts from an article with the same title as this post written by Kathleen Lourde that appears in the September issue of Provider Magazine, both the print and on-line versions.

G. Allen Power, MD, author of “Dementia Beyond Drugs: Changing the Culture of Care,” proposes a simple yet, for many providers, radical idea: Stop thinking of dementia patients as people with diseases to be treated, and start thinking of them as people with a terrifying, shifted reality who still have lots left to give if their trust can just be earned.

 Negative attitudes toward people with dementia are a big factor in the combative atmosphere that can arise at times between those with the disease and their caregivers, writes Power in his recent award-winning book.

 “We look at the person with dementia from a single viewpoint—that of a broken person in need of medication to mitigate the decline,” he writes. “Our standardized tests reduce” the elder to a list of “disordered thinking processes, while we ignore the complex cognitive and emotional qualities that can be retained even in advanced stages” of the disease.

 During his time at St. John’s, Power has helped shepherd the skilled nursing facility’s journey toward accomplishing the goals set forth by the Eden Alternative. The years of caring for people with dementia have taught Power many lessons, some painful, some inspiring. Today, changing the way people with dementia are cared for has become something of a mission for him.

 “The most important [message] is that we need to change the way we look at people with dementia,” Power tells Provider. “We need to see the whole person, what their strengths are, and not just their disability.”

 Critical to making this happen is culture change, because without it, “no matter what philosophy you adopt, the philosophy will die,” he warns. “The system will kill it.”

 Dr. Power’s lays out for us both the challenge and the solution. Culture change must happen for us to succeed in making a true and lasting shift to person-directed care for the benefit of those living with dementia and all our Elders as well as their care partners. Otherwise, “the system will kill it.”

The Eden Alternative has been working to change “the system” for nearly 20 years. We are fond of saying “It can be different”, and we know it can be. With proper education and training we can help care partners to learn and practice a new way of caring. With the help of Dr. Power and Health Professions Press, we have created a new training called Dementia Beyond Drugs to take the principles described in this article and to teach care partners how to put those principles into practice.  Click here to learn more.

We believe the time has come to move forward with the culture change that is so badly needed. We know what we need to do and we have the tools to do it. So what’s stopping us? Please share your thoughts.

2 Comments. Leave new

I think since those suffering from dementia are a vulnerable population it is up to the family/caregivers to take the initiative to make their voices heard.
PCORI (Patient-Centered Outcomes Research Institute) is an excellent resource for patients and caregivers. Read more about it here:

Heather Downs, R.N., B.S.N.
August 24, 2015 10:56 am

I have worked in facilities that both do and do not imply the Eden Alternative, and I truly believe that it is a great program. The biggest part of the picture that the CEO’s and mentors are missing is having the correct and the correct number of staff to deliver this type of person-centered care. I have been on several sides of the spectrum, working as a CNA, a floor nurse, charge nurse, nurse manager and assistant DON. I AM Eden Certified. I have worked on and been successful at decreasing the utilization of psychoactive medications at two of my facilities and am now studying different research on outcomes of Eden Alternative for my APRN courses. The culture change is really great; picture perfect almost, but when your company is struggling for staff just to meet the minimal needs of the patients, people are first of all not happy, secondly do not have the extra time to sit and have a conversation with an elder, as they might not get the others to a meal for example. When your staff are not happy with their work environment they often portray those feelings onto their elders and co-workers. I believe that not only assuring that you have caring staff in your facility (which cant always happen if you don’t have enough to begin with), but assuring that the CNA/Nurse to patient ratio is adjusted to be feasible of delivering this extraordinary care is taken into consideration. It is a real struggle, I know, but just sharing from experience.


Leave a Reply