Episode 121

Are Hospitals and Care Homes Failing Those with Dementia?

In today’s episode, Lisa discusses information presented by Dr. Reza Hosseini Ghomi, MD, MSE. Dr. Ghomi is a europsychiatrist, and a 2X Best-Selling Author, who is also an expert on dementia. Having diagnosed over 1000 dementia cases throughout his career, he shares with us what he observed after visiting 47 nursing homes over the past year, and why almost every one of them that he visited, he found to be failing the dementia patients. Listen to this episode to find out the details of what he saw, and why you need to be aware of his findings. Additionally, Lisa also shares recent study information posted by Dr. Ethelle Lord, on LinkedIn, that discloses why hospital-to-home transitions are also failing seniors with dementia and multiple other conditions. The findings in both of these articles are startling!   

Mentioned Resources:

About the Host:

Author Lisa Skinner is a behavioral specialist with expertise in Alzheimer’s disease and related dementia. In her 30+year career working with family members and caregivers, Lisa has taught them how to successfully navigate the many challenges that accompany this heartbreaking disease. Lisa is both a Certified Dementia Practitioner and is also a certified dementia care trainer through the Alzheimer’s Association. She also holds a degree in Human Behavior.

Her latest book, “Truth, Lies & Alzheimer’s – Its Secret Faces” continues Lisa’s quest of working with dementia-related illnesses and teaching families and caregivers how to better understand the daunting challenges of brain disease. Her #1 Best-seller book “Not All Who Wander Need Be Lost,” was written at their urging. As someone who has had eight family members diagnosed with dementia, Lisa Skinner has found her calling in helping others through the struggle so they can have a better-quality relationship with their loved ones through education and through her workshops on counter-intuitive solutions and tools to help people effectively manage the symptoms of brain disease. Lisa Skinner has appeared on many national and regional media broadcasts. Lisa helps explain behaviors caused by dementia, encourages those who feel burdened, and gives practical advice for how to respond.

So many people today are heavily impacted by Alzheimer's disease and related dementia. The Alzheimer's Association and the World Health Organization have projected that the number of people who will develop Alzheimer's disease by the year 2050 worldwide will triple if a treatment or cure is not found. Society is not prepared to care for the projected increase of people who will develop this devastating disease. In her 30 years of working with family members and caregivers who suffer from dementia, Lisa has recognized how little people really understand the complexities of what living with this disease is really like. For Lisa, it starts with knowledge, education, and training.

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Transcript
Lisa Skinner:

Hi everybody. Welcome back to another new

Lisa Skinner:

episode of the truth, lies and Alzheimer's show. I'm Lisa

Lisa Skinner:

Skinner, your host. I've got some pretty profound information

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to share with all of you today, and I think it's really

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important. I always want to be very transparent with what I

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discover out there in the world that's truthful and honest and

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really draws a realistic picture of life out there, especially

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when it involves our loved ones and the people that we care for

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who live with Alzheimer's disease and dementia, we have to

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be their advocates, because due to their cognitive impairment,

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they're no longer able to really do what needs to happen to

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completely protect themselves. It's up to us, so I'm bringing

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you this information today that I think is really, really

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important for everybody to know. And once again, I tripped over

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another article. This is written by Dr Ghomi. He's a

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neuropsychiatrist and engineer. He has been a health tech

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founder four times in his career, and this guy has

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treated, has diagnosed in his careers. Medical career, over

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1000 dementia cases, and he just is continuously staying on top

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of what's current and what's accurate. And there's so much

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misinformation and disinformation out there that

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it's really important to me to filter all of that stuff out and

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bring everybody the truth. So Dr Ghomi has visited 47 nursing

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homes just in the past year, and he found that almost every

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single one of them was failing the dementia patients. This is

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what he found. This is what he saw. And he said, The problem

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starts the moment you walk in. The staff rushing between 30

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plus residents, alarms beeping, constantly confused patients

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calling for help. That's 20 minutes away, but the real

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failures are systematic. What's broken the dementia training is

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virtually non existent. AIDS get as little as one hour training

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total on memory care in some states. I know that the

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requirement is, in California is much more than that, I think

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it's at least eight hours, but I'm also aware that it's as

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little as one hour training total in some states. So this is

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very consistent with what I'm aware of, that most of the staff

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don't understand behavioral symptoms that show up as a

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result of the damage being done to the brains. That's consistent

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with what I have come to realize that agitation gets treated with

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restraints, not based on the root causes, like what triggers

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the agitation? Uh, Number two, what he discovered and observed

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was that the way medication is managed in these institutional

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settings is dangerous. Patients on 15 plus medications with

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absolutely no review. Anticholinergic burden is

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ignored completely. The behavioral issues are resolved

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by giving more pills, not less pills that the environments are

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designed for efficiency and not brain impairment. Fluorescent

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lighting disrupts the sleep cycles. Noise levels trigger

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anxiety and confusion. The layout of these neighborhoods,

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of these communities create more wanderings and falls. They're

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not designed properly, that the families are kept in the dark.

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No communication is transmitted about cognitive changes that are

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observed and recorded between the residents, the patients or

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in the family members. Care plans are written and then

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forgotten. The quality of the metrics focused on paperwork and

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not the outcomes. And the saddest part that he met

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incredible individual caregivers doing their best in broken

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systems. One aide knew every resident's favorite song, a

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nurse spent her break painting nails with a woman who'd

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forgotten her own name. But the longer than short here, the

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bottom line is that heroic individuals who do work within

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these organizations can't fix these systemic failures. What

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needs to change these are the main things better, staffing

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ratios, dementia specific, training, environmental designs

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that support Brain Health Reimbursement, systems that

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reward quality of life and that are not just keeping people

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alive. He's adamant, and I feel as strongly about this as he

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does our loved ones with dementia deserve better than

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just institutional survival. And he completes this article by

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saying, the average hairstylist gets 1500 hours of training, the

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average nursing aide caring for dementia patients as little as

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one hour. I'm left speechless with these current findings. So

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I think it's important for everybody to be aware of these

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things. So if you are looking at an institutional environment for

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your loved one living with dementia or skilled nursing, at

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least, these are things to be aware of so you can vet the

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choice that you're considering this other doctor named Dr Lord,

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also recently published information about hospital to

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home transitions, and this is what she has revealed, hospital

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to home, transitions fail, seniors with dementia and

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multiple condition according to this study that she is talking

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about, This is very consistent with what Dr GOMI just

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published. So this is just supporting they're supporting

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each other in their findings. Hospital to home transitions for

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older adults with dementia and multiple chronic conditions face

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major challenges due to systemic health care gaps.

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Dr Ghomi just said that, according to a comprehensive

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review published in BMC geriatrics, The study analyzed

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70 documents to understand how these critical transitions work

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for patients and multiple long term conditions and dementia.

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Health care professionals, including geriatric specialists,

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frequently lack adequate dementia training, and this is

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what this research revealed. According to the review, this

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knowledge gap affects providers ability to identify and diagnose

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dementia, which the review links to poor discharge planning and

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higher readmission risk. The review found that limited

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dimensional. Knowledge made it difficult for many providers to

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create a hospital to home care plan or manage coexisting

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conditions that these patients may have. The analysis found no

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standardized approach for documenting or sharing dementia

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diagnosis information between health care providers different

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electronic health record systems and non standardized terminology

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create these barriers with health care professionals

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working outside of Geriatric Care, often unaware of patients

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dementia diagnosis, and this has been revealed, according to the

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findings. Also, the findings revealed that family caregivers

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face significant challenges during these transitions. The

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research actually showed that 82% of unpaid caregivers suffer

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mental health challenges. They often assume medical

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responsibilities, such as administering treatments,

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monitoring blood sugars, giving insulin injections without

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receiving the proper training. The study associated this

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situation with increased emotional distress for these

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caregivers and a higher risk of hospital readmission for the

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patients when care needs went unmet. According to the

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findings, hospital admission and discharge procedures often

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prioritize the primary diagnosis and overlook dementia symptoms

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such as cognitive decline and behavioral issues. The found

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care plans been prioritized the admission diagnosis and failed

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to integrate dementia with the management of other chronic

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conditions. The study emphasizes that successful transitions

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require system level changes, including standardized reporting

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single points of contact for care, coordination, dementia,

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specific training for health care professionals and tailored

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interventions addressing both patient and caregiver needs. The

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source for this information is being credited to Donna Schreier

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of McKnight long term news, and the source is HTTPS l i, n,

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k.in, for LinkedIn, forward slash, G as in girl eight, 3f,

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as in Frank, P as in Paul, M as in Mary, R, R. And as all of you

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know, I have been working in the elder care industry. I've been

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exposed to it. I've been in the weeds of it for 30 years now.

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And these are things that I have personally observed over the

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many decades that I have been involved. These are recent

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findings, the publications, the studies, and it doesn't look

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like to me that things really have changed all that much, and

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this is a very sad state of affairs, as far as I'm

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concerned. And that's the one thing that I realized a long

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time ago, and why I'm bringing this information to all of you,

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is these very things that these two doctors have revealed to us

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in these posts, in these articles, and to remind

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everybody that, based on the World Health Organization and

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all of these Alzheimer's organizations, that by the year

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2050 that's 25 years From now, it's going to be here before we

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blink our eyes, the number of people who are expected to

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develop Alzheimer's disease by that date, by 2050, or between

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now and then, is expected to triple if a cure or treatment is

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not found. Out, does it sound like we're prepared for the

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number of people who will be living with Alzheimer's disease

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and the other 200 known brain diseases that cause dementia?

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Don't forget, these are terminal illnesses. Something has got to

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change. It's increasing awareness and educating people

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that I know, but it's not happening fast enough. So

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hopefully any of you listening to this show, the truth lies and

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Alzheimer's show, will be a little more prepared than people

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who don't have access to this information, and that's what I

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really want. That's what I've dedicated my life to. I don't

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want families to have to be caught completely unprepared for

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a dementia diagnosis. Nobody signs up for that. So being

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prepared, being educated, being well informed, is going to end

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up being giving you a huge leg up to people who are completely

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blindsided and caught off guard by a dementia diagnosis, or for

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those of you who care for people who are living with dementia, as

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you heard me say in these two articles by two different

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doctors, that the findings are that most people lack serious

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training in how to care for people Living with a brain

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disease. So there you have it, and this will conclude today's

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episode for the truth, lies and Alzheimer's show. I'm Lisa

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Skinner, your host. Keep tuning in, because I'm going to be

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continuing to bring you this information week after week

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after week and keep you up to date on the honest truth and the

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the updated most recent findings, so we all can stay

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informed and be more prepared if it strikes our families. So have

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a great rest of your week. Stay safe, stay healthy. Thanks again

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for spending part of your day here with me, and I look forward

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to you coming back and sharing another episode with more

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information next week. Take care. Bye, bye.

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About the Podcast

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Truth, Lies & Alzheimer's

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About your host

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Lisa Skinner, CDP, CDT

Author Lisa Skinner is a behavioral specialist with expertise in Alzheimer’s disease and related dementia. In her 30+year career working with family members and caregivers, Lisa has taught them how to successfully navigate the many challenges that accompany this heartbreaking disease. Lisa is both a Certified Dementia Practitioner and is also a certified dementia care trainer through the Alzheimer’s Association. She also holds a degree in Human Behavior.
Her latest book, “Truth, Lies & Alzheimer’s – Its Secret Faces” continues Skinner’s quest of working with dementia-related illnesses and teaching families and caregivers how to better understand the daunting challenges of brain disease. Her #1 Best-seller book “Not All Who Wander Need Be Lost,” was written at their urging. As someone who has had eight family members diagnosed with dementia, Lisa Skinner has found her calling in helping others through the struggle they can have a better-quality relationship with their loved ones through education and offering workshops on counter-intuitive solutions and tools to help people effectively manage the symptoms of brain disease. Lisa Skinner has appeared on many national and regional media broadcasts. Lisa helps explain behaviors caused by dementia, encourages those who feel burdened, and gives practical advice for how to respond.