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Dr Laura Hanson
Laura Hanson, MD

More than one million Americans have late-stage dementia. Sadly, they suffer significantly from physical pain, neuropsychiatric distress symptoms, and medical complications. On top of that, these people also often deal with hospital and emergency room visits.

Dr. Laura Hanson (UNC Geriatrics, UNC Palliative Care Program) says, “Their family caregivers provide direct daily care for years, and face financial and personal health effects. Over half of these families desire comfort-focused dementia care once dementia is moderate or severe. Yet many struggle to find nursing home staff who can provide it.”

As a result, Dr. Hanson has worked alongside Dr. Sheryl Zimmerman (UNC School of Social Work) and Dr. Mark Toles (UNC School of Nursing) to develop Comfort First. The team also collaborated with the developers of Comfort Matters at the Beatitudes in Phoenix, Arizona, and the North Carolina Friends of Residents in Long-term Care.

“Caring for people with dementia is challenging for their families, and for the clinicians who work to meet their needs in outpatient, long-term care, and acute care settings…Comfort First is an approach to dementia care that uses the goal of comfort to guide the care plan and daily care for people with dementia.” – Dementia Comfort

Developing Comfort First

The team based the Comfort First program on another well-known dementia care program called Comfort Matters. Developed at the Beatitudes nursing center in Phoenix, AZ, Comfort Matters is, “the nation’s leading evidence-based model of comfort-focused dementia care.” However, accessing this training is difficult. Dr. Hanson says, “Using videos of the care practices at Beatitudes, we created a web-based training program called Comfort First. After that, we evaluated it in two North Carolina nursing homes.”

Funded by a grant from the Centers for Medicare and Medicaid Services (CMS) Civil Money Penalty fund, Comfort First resources are intended for clinicians and staff who provide dementia care in long-term care settings (nursing homes, assisted living). Specifically, this includes nurses, nursing aides, advance practice providers, physicians, social workers, activity staff, and even administrative staff – everyone who interacts with people with dementia or supports their care.

In partnership with the UNC Center for Aging and Health, the training, evaluation, and implementation materials are available on the Greensboro AHEC site. In this six-module training program, participants learn to understand people with dementia, address their experience of pain or emotional distress, and learn effective ways to prevent or reduce these distressing symptoms of the condition. And by prioritizing comfort, long-term care staff or other caregivers can reframe the care plan for those living with dementia.

Learn More

To set up a training and ensure continuing education credit, visit the Carolina Geriatric Workforce Enhancement Program’s training options. For additional details about Comfort First, visit the Dementia Comfort website:

Comfort First website screenshot