Helping patients with dementia realize their potential

What do puzzles, therapeutic pets, and card games have in common?

Scarborough Health Network’s (SHN) Annette Harris, for one!

As a Behavioural Support Ontario (BSO) Acute Care Registered Nurse, these are just some of the tools and activities Annette counts on to address responsive behaviours in patients with dementia or neurocognitive conditions.

BSO care providers have supported patients in community settings since 2010, when the Ministry of Health and Long-Term Care dedicated $40 Million of funding toward the development of an evidence and experience-based framework to enhance the availability of supports and services to persons living with responsive behaviours – but the role is quite new within an acute hospital setting, and was introduced to SHN in February 2019.

It’s a Friday afternoon and Annette has been on her feet all day following SHN’s Seniors Health Fair. But she is bubbling with energy and passion for this work, and her warm, compassionate personality makes it easy to see why she’s a natural fit for this role.

In a nutshell, it’s Annette’s job to observe a person’s responsive behaviour(s), work with their family and care providers to understand potential triggers for the behaviour, and develop care plans that focus on quality of care and quality of life, while teaching families and caregivers to care for their loved ones in a safe and meaningful way.

Responsive behaviours and their triggers vary by individual: loneliness, boredom, or simply the need to use a bathroom might evoke a physical, emotional, or social response from a person struggling to communicate their needs.

“Once I understand the details of a person’s life – their background, passions, careers, and hobbies – I can help problem-solve to minimize the stress of being in the hospital,” says Annette.

“This often involves being creative with the patient’s preferred routines and practices, and recommending comforting techniques and tools that improve comfort, coping, and satisfaction of the patient and their family, as well as staff and physicians.”

For example, Annette says music therapy brought comfort to a gentleman who was lonely, while completing math sheets was invaluable for a retired teacher who was bored. Other tools may include adult colouring, doll therapy, therapeutic pets, books, and handheld games.

Sometimes, the simplest things can make the biggest difference, and the tactics become part of a patient’s care plan, written in the voice of the patient:

  • “I enjoy music, especially soft rock. The iPod is in the medication room with my own earphones.”
  • “I like to solve math problems and complete word searches.”
  • “Caring for dolls helps satisfy my nurturing personality.”

Care plans are transferrable making hospital-to-home or hospital-to-long-term-care smoother and more predictable.

“When a person has dementia, it doesn’t mean they don’t still have a range of abilities,” says Annette. “Working with our patients to help them celebrate what they can do and realize their own potential is incredible. It’s heartwarming to see the transformation that occurs when people are equipped with the right tools.”

Annette moved into the behavioural support role after a 31-year nursing career in surgery at Centenary hospital. She became interested in caring for patients with dementia and neurocognitive conditions on the surgical floor, after seeing many of these patients suffering from pain or the effects of medications while in the hospital and being unable to effectively express their needs.

As a nurse educator, an Alzheimer Society of Toronto volunteer, and as a caregiver, Annette is well-equipped to improve lives through exceptional care, by sharing her expertise with staff at all SHN hospitals through education and collaboration.

For more information on Seniors’ Health services at SHN visit https://www.shn.ca/seniors-health/.

For more information on Behavioural Support Ontario visit http://behaviouralsupportsontario.ca/.

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