Occupational therapist Teepa Snow has made it her mission to show dementia in a positive light. “Dementia is a syndrome, not a single condition,” Teepa says. “It can be a primary or secondary issue, can happen at any age, and has many causes and forms.”
On Friday, January 7, 2022, UNC Geriatrics welcomed Teepa to their weekly Division meeting. In this session, she discussed the question: What do you prescribe after a dementia diagnosis?
Dementia, an evolving condition
“According to estimates, 75% of all dementias are only identified after the person is 5-8 years into functional brain changes,” Teepa says. These dementia-related changes include things like:
- Complex chemical changes
- Structural changes in the brain
- Shrinking/dying brain cells
Since dementia isn’t static, Teepa advocates for care models based on dementia as an evolving condition.
We need a paradigm shift to see dementia as a changing disability status rather than a death sentence with no working treatment.
Dementia, incurable YET treatable
Teepa compares dementia to diabetes, for which there is currently no cure. Yet despite not yet being curable, there are ways to treat and manage diabetes. In general, clinicians prescribe lifestyle changes, support, care plans, and other things that help diabetes sufferers live their lives. Similarly, even though dementia is not yet curable, it can be treated and manged.
Developing an essential dementia prescription
Currently, there are more and better ways to recognize and diagnose dementia than ever before. Yet, Teepa believes clinicians need more screening to formulate an effective care plan to meet individual needs. According to her, a typical prescription for a dementia diagnosis consists of:
- Meds to deal with dementia-related symptoms and other related conditions
- Recommendations for the individual to get their affairs in order and select a durable healthcare Power of Attorney
- Better nutrition and more exercise
- Recommendations to stop working and stop driving
In contrast, Teepa suggests an improved dementia prescription that includes:
- A return visit approximately one week after the diagnosis to process what was heard and said at the initial evaluation
- Pharmacy consult to evaluate all meds
- Initial referrals to peer support and education along with connections to knowledgeable and skillful people and/or organizations
- Ongoing follow ups on the above (support, growth in knowledge, and connections to skillful people)
- Focusing on retained use ability, not on what the person has lost
- Encouraging volunteer and purposeful engagement opportunities
- Circadian rhythm evaluation
- Assistance from technology
- Physical activity recommendations
Willing and equipped
For clinicians, a willingness to help dementia patients isn’t the same as being equipped to help. In this session, Teepa encouraged and challenged UNC Geriatrics clinicians: “When it comes to dementia, we need to use all of our skills to assist an individual: observation, compassion, understanding, and other skills.”
Learn more about Teepa Snow and her Positive Approach to Care®. This nuanced approach flows out of her forty-plus years of both academic and clinical experience. Designed to help everyone better understand dementia’s progression, PAC approach offers positive, constructive strategies for caring for those with dementia sufferers.