The Physician and Pharmacist as Teachers in an Alzheimer's Facility

The Physician and Pharmacist as Teachers in a Specialized Alzheimer’s Facility: 25 Years of Experience Susan Gilster PhD Susang@hcmg.com susang@careleadership.com www.alois.com www.careleadership.com 513-673-1239 Susan Gilster PhD

Susan Gilster PhD

Alois Alzheimer Center May 1987, first AD facility in the US Continuum of care (Assisted-Nursing) Day and respite-to support care in home 5 self contained households/units Gardens-designed for stage of disease Redefined success-they would not get better and go home Importance of belonging and fun Susan Gilster PhD

Educational Mission 1986-HCP lacked knowledge of dementia Impact of AD found in the “experience” Established Alois educational mission Content of Affiliation Agreement Defining roles and responsibilities Creating environment for success Benefits-residents, families, staff, students Promoting positive student experience Facilitating mutually beneficial research Susan Gilster PhD

Alois Alzheimer Center 25 years later-affiliated with several universities in the region-University of Cincinnati Educational setting for students 150-200 students year-national and international Physicians, pharmacists, nurses, architectural students, allied health Research Clinical-what can we do to improve care Drug research-experimental and symptom Susan Gilster PhD

Alois-Non Traditional LTC Founders not LTC Established Center under a service model Service oriented-resident, family, staff, students, community Individualized care Students experience service, importance of respect, team work, families and fun Susan Gilster PhD

S.E.R.V.I.C.E Model S=Service-Serving others-why we exist-to serve E=Orientation, job preparation, ongoing education, expectations for performance R=Respect as a foundation for all V=Vision-shared, a destination, direction I=Inclusion-all have a voice in the organization C=Communication, routine, open, ongoing E=Enrichment-self awareness, growing, learning, caring and nurturing of all Susan Gilster PhD

Student Experience:Residential normal living environments Susan Gilster PhD

Students experience: Therapeutic nature of outdoor gardens – designed for specific population Susan Gilster PhD

Students experience: The importance of activities, events, outtings and the inclusion of families on quality of life Susan Gilster PhD

Students experience: Welcoming environment-all have preceptor Normal living environments 5 households differ Individualized - ”person-centered” Outdoor environments differ Impact of atmosphere and stimulation on behavior Normal, fun activities 185 trips out each year Integration of families Impact of consistent staffing Importance of training and support Susan Gilster PhD

Student evaluations Physicians: Exposure to real life experience of patients with different types of dementia Interdisciplinary approach to care-best care Face to face interactions with the residents and staff Discussions with families-more insight Impact of educated and supported staff in all departments So much you could do Susan Gilster PhD

Student evaluations • Pharmacists, nurses and others: • Interdisciplinary interactionscentered on improving the life for the patient • First hand experience, face to face w patients • Team approach best interest of the patient • Helped me learn more about AD and needs • Staff explained everything-individual patient needs, disease process and family needs • Patients were delightfuland made me want to extend my work in this field Susan Gilster PhD

Students experience: Effectiveness of multidisciplinary approach How to minimize hospitalization: Alois rate 3 years <1-5% Medication is not the only answer: ‘ Alois per resident half of national average Impact of consistent, nurtured staff: Alois high staff retention – 90% How to impact family satisfaction: Alois satisfaction 3.94 out of perfect 4.0 Susan Gilster PhD

Conclusion Evaluations reinforce that physicians, nurses, pharmacists, even those with extensive training are not fully in touch with the impact of AD until they actually experience it Offers greater sensitivity and ability to work effectively with persons with AD and families - their own practice Understand much can be done to improve the daily life of residents and manage challenges Experience the impact of a vision and service oriented experienced, trained and consistent staff Susan Gilster PhD

The Physician and Pharmacist as Teachers in an Alzheimer's Facility