Cleveland Clinic Science Internship Program, OCEI Communicating with Dementia Patients of Different...

Cleveland Clinic Science Internship Program, OCEI

Communicating with Dementia Patients of Different Severity

LevelsMichael Ciulla, Kurt Karis, BS,

Tria O’Maille, MA. BC-DMT


Michael’s Science Internship Experience

• Euclid Hospital

• Department of Geriatric Behavioral Medicine, 4th floor-Upma Dhingra, MD

• Anxiety, Schizophrenia, Depression

• However, Dementia is the most frequent reason for admission


What is Dementia?

• Dementia is the loss of cognitive, verbal, and physical functions in the brain

• Examples include Alzheimer’s Disease, Vascular Dementia, Parkinson’s Disease

• Latin roots: de mens meaning without the mind

• Death of neurons in the brain that are never repaired or replaced


Research Question

• According to psychiatrists, communication with patients suffering from dementia must be very personal and direct.

• Eye contact, slow, clear voice in a low tone, approaching patient from the front, and formulating simple questions which would require an answer of “yes” or “no”


Research Question

• How effective are these means of communication?

• In Mild Dementia?

• In Moderate Dementia?

• In Severe Dementia?


Hypothesis

• Patients with mild dementia will be able to respond to the method of communication proposed by psychiatrists

• Patients with moderate dementia and severe dementia will not be able to respond to such communication in the same way in which the mild dementia patients responds


Methodology

• Mini Mental State Exam (MMSE)

• Used to evaluate cognitive function

• This exam will give a result out of 30 possible points


Methodology

• MMSE score will be used to determine the loss of cognitive function in each patient

• After the exam is completed and score is calculated, patients will be observed during a daily behavioral therapy session as well as a dance and movement therapy session.


Methodology

• The way in which the patients respond to the therapists in these therapy sessions will show if these types of communication are effective for patients with different progressions of dementia.


Results

• Results will be calculated based on the patients’ MMSE scores

• Patients’ score will be out of a possible 30 points


Results

• MMSE scoring– 24-30: normal cognitive functioning– 19-32: mild dementia– 11-18: moderate dementia– <10 severe to end stage dementia


Conclusions

• After observation in group therapy sessions, the following results could be expected:• The patients with mild dementia would be able

to communicate verbally and through creative expression with a wide to moderate range of movement


Conclusions

• The patients with moderate dementia would be able to communicate verbally, but with a more narrow vocabulary than that of the mildly demented patients, and most would be able to show some degree of creative expression with a moderate range of movement


Conclusions

– The patients with severe dementia would communicate verbally, but in short sentences followed by long pauses. At this stage in the disease, the patients’ vocabulary is especially limited. Minimal patients would be able to show creative expression, and if able, movement would be minimal


Discussion

• All conclusions are hypothetical and are based on my daily experiences in the Geriatric Behavioral Medicine Department at Euclid Hospital


Acknowledgements

• Kurt Karis• Tria O’Maille• Upma Dhingra, MD• Nursing staff of

Department of Geriatric Behavioral Medicine at Euclid Hospital

• Patrick Finnegan• Nedra Starling• Rosalind Strickland• Office of Civic

Education Initiatives• Cleveland Clinic

Cleveland Clinic Science Internship Program, OCEI Communicating with Dementia Patients of Different...

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