Specialty Care Clinic


  In early 2010, the VA Innovation
Initiative, known as VAi2, was   launched to bring fresh thinking
to solve   departmental challenges.   Gathering ideas from VA
employees, entrepreneurs,   and industry, VA has created
a mechanism that brings   private-sector style competition
and agility to public service.   The result is a portfolio
of more   than 120 funded innovations.   One of those is an idea
presented by the Specialty Care   Clinic at the VA hospital
in Wilkes-Barre, Pennsylvania.   As we will see, they created
a whole new environment to help   their very special patients.   – You’ve done this before,
right, Herman?   – Well, this is our
multi sensory environment.   And the multi sensory
environment is made to target   the different senses of people
who have dementia   or Alzheimer’s disease.   What we do is we try to get them
to come into our environment   here.
And it’s a structured area.   We can provide comfort
and safety.   And we’re trying to engage
them back into reality.   – [singing]
And those…   – [both singing]
Caissons go rolling along…   – In 2011, there was an email
sent out asking for different   ideas how to better the VA and
how we can help our veterans.   So I wrote a small little blurb
about how special care units   need to have some more training
and we need to have   multi sensory environments so we
could be helping our veterans   achieve the maximum potential
while they’re living with us.   Fortunately, my idea was chosen
to continue,   and it received funding.   So today, we’re going to do
an activity…   And from this funding, we were
able to have different training   opportunities, to have different
sensitivity training,   and to purchase the equipment
for a multi sensory environment.   Well, when people are diagnosed   with Alzheimer’s-related
dementia,   a lot of the physiological
problems come along with that.   They start to lose their
different levels of   functioning
with their speech maybe   or their ability to walk
or feed themselves.   Depending on what
their functionability is   and what they like to do, we are
able to coordinate a program   with that veteran that’s
specifically geared   towards them.   – I’m an occupational therapist.   I’ve worked at the VA
for approximately 6 years now.   I came prior to that from
pediatrics, and I’m only   stating that because my
specialization before   was autism.   And autism has lent its way
well to transition to dementia,   because a lot of the strategies,
such as this multi sensory room,   are used with both populations.   – When we won the innovation
grant, we were able to contract   with a company called
Dementia Care Specialists.   Dementia Care Specialists
came to our facility, and they   completed a train
the trainer program.   – How would you define function?   – There are seven of us who are
trained to provide education   for the rest of the staff in the
community living center as well   as the hospitals and our
community outreach programs.   – “I am repairing the fence
with a hammer and nails.”   – We go through all of behaviors
that you might see with someone   who has dementia
or Alzheimer’s disease.   The focus of our training is not
what people are losing,   is what abilities still remain.   So we want to always focus
on the positive, what’s still   remaining abilities for the
veterans that we are serving.   Your job is to get her to stand
up, but you have do what’s on   that card before she
can do that.   – Yeah, I was hoping we could go
to the store together and do   a little shopping. You know, we
could buy you a new outfit   or something.   Maybe catch the bus or a taxi   or we could go for a bike ride.   You want to go outside
for a little bit   and get some fresh air
and everything?   – Yes. Yeah!
– All right! Then let’s go…   – What we’re going to do
now is a virtual dementia tour.   We’re going to simulate
what some of the physical   disabilities feel like that
our veterans have every day.   Put the goggles on to simulate
macular degeneration.   So the email goes out,
and anyone who is interested   in this can join and ask
to be part of the training.   – I can’t hear anything
you’re saying.   – What you’re going to do today
is set the table and match   the colored socks.   As they go through
the continuum with dementia,   their visual field will narrow.   It tends to end up being
about a 12- to 18-inch box,   which is sort of
in front of their eyes.   They have a tendency to not
look up and seldom look down.   Not looking down becomes
a hazard when they’re   walking with a walker.   You want to maintain the upward
gaze as long as you can,   so you’re going to try to use
stimulating things   like the bubble tube.   So that’s what the goal
of all of this is, is to   really get, you know, give them
quality of life as we help them   share the end of their journey,
and have this sensory impact   so that they can, you know,
have an enjoyable,   meaningful final days, you know.   It’s not with chemicals
and drugs and medications.   – When they have problems with
their vision–   macular degeneration,
glaucoma, and cataracts–   they have a harder time being
able to see.   We all know that when we were
kids, we enjoyed looking through   kaleidoscopes and seeing
the different colors.   Well, now we’re able to do
that with them again.   Just by touching the screen
and moving your finger along   the screen, it has
a kaleidoscope effect.   – From the sensory perspective,
what a weighted blanket does is   it triggers the proprioceptive
system.   And what that is
is just deep pressure,   but it’s very calming and it’s
also organizing.   So if somebody’s very, like,
feels out of control   this has an organizing effect.   It’s going to let them help calm
down a little bit.   This is a lighted system, where
we can put different colors   onto the wall.   So if someone’s favorite color
is red, blue, green, or yellow   that can be there
and it can help soothe them.   It can also change different
colors as well.   – Wait. one more push.
Perfect!   – Good.   – It’s really neat to see
the people come in and see   their life change when they have
meaning and they’re focused   and you’re accommodating them   and not doing for, you know,   because it’s so easy to put
someone’s shirt on.   It’s so much harder to stand
back and watch them struggle   through it. But that’s the goal.   – I was in World War II.
– I know.   – That was quite something
I’ll never forget.   – That’s the hard part is just
watching them, not necessarily   struggle through it, but be able
to do it and realize a sense of   accomplishment because nobody
wants to be totally dependent.   – Going through things
with the Big Red One,   that was something, when we
actually fought in Europe   and fought the Germans.
And I was part of that.   – We love you, Daniel.   – Thanks.   – To learn more or submit your
own innovative idea to VAi2,   please visit the website
on your screen.    

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