Exercises reveal what it's like to have Alzheimer's

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10:20 AM CST on Tuesday, November 18, 2008
By BOB MOOS / The Dallas Morning News

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Caregiver Sara Villa sets a table as she copes with taped fingers, goggles that narrow her vision and headphones that play static. The exercise simulates what people with Alzheimer’s disease and dementia go through in daily life. Then she went through a staff training exercise at the Arden Courts assisted-living community in Richardson that simulates the effects of Alzheimer’s and other conditions associated with aging.

It was an eye-opener.Like other employees, she donned headphones, goggles and gloves to replicate conditions faced by Alzheimer’s patients. She then headed into a chilly, dimly lit room where she was told to perform everyday tasks such as dressing, writing a note and pouring a glass of water.

"My senses were so disoriented that I couldn’t concentrate on what I was supposed to do," Ms. Fiedler said after completing only half of her tasks. "I felt confused, helpless and frustrated."

Arden Courts, which specializes in the care of people with dementia, recently instituted the training exercise to raise its employees’ understanding of the challenges that residents face.

The assisted-living center’s staff members – everyone from nurses’ aides to kitchen helpers – have taken the hourlong course, and new employees will go through it in their orientation.

"It’s taught our staff to be much more patient," said Arden Courts executive director Michael Knight. "They now realize why someone may need more time to comb her hair or button a blouse in the morning."

Employees who suit up for the exercise may feel as though they’re dressing for a costume party, but each piece of gear is meant to simulate a different aspect of dementia or aging.

A headset creates the buzzing and static that many dementia patients complain they hear, while goggles produce the narrower field of vision that some people experience.

Gloves whose fingers have been taped together mimic a loss of dexterity in the hands, and lentils that have been placed in the shoes simulate poor circulation and a loss of feeling in the feet.

The employees are led into a darkened room with a flashing light where they bump into furniture as they try to do household tasks.

A shock in the mirror

Jane Washington, a nurse’s aide, managed to find a pair of socks but failed at everything else she was supposed to do, such as folding towels, setting a table and putting on a belt.

When she looked in the bathroom mirror, it wasn’t her. "It scared me to death. I didn’t know what to think," she said.

A life-size photo of a stranger had been taped to the mirror because people in the later stages of Alzheimer’s often can’t recognize familiar objects or even themselves, explained Arden Courts training director Tori Moore.

Alzheimer’s Association officials who have taken the course say they’re impressed by the realism of the simulation and the compassion and empathy it creates in caregivers.

"It lets people understand just how devastating this disease can be," said Lisa Brodsky, director of programs and services for the association’s Dallas chapter.

Sufferers to triple

Experts predict that the number of Americans with Alzheimer’s will more than triple by 2050, from 5.2 million to 16 million, as the disease exacts its toll on the huge baby boomer generation.

As Alzheimer’s progresses in a loved one, many families won’t be able to handle the care by themselves and will turn to assisted-living communities that specialize in caring for people with dementia.

Executives in the senior-living industry say that accommodating the rapidly growing population will require recruiting and training far more caregivers over the next decade.

At Arden Courts, Mr. Knight says he places a high priority on employee training because looking after someone with Alzheimer’s demands a special knowledge of the disease and its effects.

For instance, when dementia patients become frustrated by a seemingly simple task, they may get agitated, he said. Skilled caregivers know to redirect patients’ attention to another task to calm them.

Likewise, people with dementia respond better to nonverbal communication, Mr. Knight said, so caregivers know to smile at residents and look them directly in the eye while speaking.

Caring for someone with Alzheimer’s almost demands a sixth sense, said Ms. Moore. "Because our patients can’t tell us how they’re feeling, it’s our job to figure it out ourselves."

The "virtual dementia" exercise at Arden Courts, part of a broader training program, helps staff understand why people with Alzheimer’s act the way they do, she said.

A nonprofit group called Second Wind Dreams developed the exercise, and Arden Courts’ corporate parent, HCR ManorCare, has begun to promote it among the company’s 56 dementia-care operations nationwide.

Friends and family members of Arden Courts residents have also gone through the training exercise to answer some of the nagging questions they have about loved ones’ erratic behavior.

Leo Norman of Richardson, who visits a friend every day at the assisted-living community, said he took the course to help understand the reasons for the good days and the not-so-good ones.

"I’ll never know exactly what my friend is experiencing, but at least this gives me some idea," he said.

Alzheimer’s Association officials say they will continue to monitor Arden Courts’ training exercise and may eventually use it in their own education programs for family members and professional caregivers.

"You can talk all you want about the science of Alzheimer’s, but until you experience the disease with your five senses, you can’t truly know it," said John Gilchrist, executive director of the association’s Dallas chapter.

"If everyone could walk in the shoes of someone with Alzheimer’s, if only for a few moments, imagine how the public’s misunderstanding of the disease would disappear. That’s what this exercise promises."

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