Notes from Dr. Gelber



My work with individuals and families suffering from Alzheimer’s disease has convinced me that the greatest need for improved care is to enhance our focus on Person Centered Care (PCC).  Specifically, Person Centered Care uses an alliance of the person with Alzheimer’s, his/her family, professionals, and the residence of the person with Alzheimer’s, to provide the most direct personalized care.  Each facet of a loved one’s care is discussed with a plan which utilizes the person’s desires, abilities, limitations, support system, therapies, medical needs and other pertinent information which will create and optimize potential.  This is not an easy task. It requires time, effort, involvement, cooperation and, most importantly, a reorganized thinking of how we relate to people with Alzheimer’s disease.

We all know the immediate presenting signs which alert a person and loved ones to the possibility of this disease. In the earlier times of the disease, a loved one remains functional, alert, independent and capable of an enjoyable life style. As the disease progresses, a person loses abilities which limits independent functioning with increased dependence from other sources. A person begins to lose a sense of self-identity. They question their decisions, doubt and misjudge their abilities, forget how to accomplish tasks and enjoy themselves. Groups homes, assisted living facilities, skilled nursing facilities are all institutions providing group care. That is, personalized care is secondary to the care of the group or unit of people being cared for.  There are group music programs, gardening, drawing, sing-a-longs and other time occupying events for a general group who are in the ‘Alzheimer’s Unit’.  This is not ‘bad’. The general needs of the individuals are accommodated; it is efficient care and peoples’ routine needs are accounted for. What we are not addressing are the individual needs that separate one from another.  Do we know that Ralph likes the same music as Gloria or that Simone likes being read to while Raul would spend time sitting outside near the bird feeders?

When we generalize and say everyone with Alzheimer’s disease is satisfied with similar wants and likes and have the same limitations, we are cheating them of their individuality. We are giving in to the all-or-none thinking which can permeate response to illness; “it’s all downhill from here”.  

There are numerous studies now showing that individualizing treatment for people with Alzheimer’s disease can slow disease process and more importantly have people with this dreadful disease enjoy each day more fully with activities and social interactions that they like and smile about. Isn’t that what it’s really all about?

In my follow-up blog, I will write more about Person Centered Care; setting specific plans and ways we are beginning to institute PCC in local facilities. I will provide links to articles or journals for more information.

If you have forgotten about yesterday, enjoy today at its fullest and think about a wonderful tomorrow!

Until we think again…

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