‘Dementia link to sudden low blood pressure and dizziness’
October 13, 2024
When Diana Adams first walked into the hospital room of a frail 88-year-old a month ago, she caught him in the midst of climbing off his stretcher. The distressed man had severe dementia, had been in the emergency room for four hours and was saying he wanted to go home.
But by the time Ms. Adams had helped him sit back and set up her materials, he was calm, focused and engaged in the task before him; clipping coloured clothespins to plastic buckets.
“He was engaged with this for 40 minutes,” she said. “After I left, he didn’t pull his ECG lines, he didn’t try to pull out his IV. He was calm.”
Activities like this are part of a new study Ms. Adams, a geriatric emergency management nurse, is leading at North York General Hospital through funding from the hospital’s Exploration Fund. Her research is looking at how Montessori Methods for Dementia, which uses a person-centred approach and multisensory activities, can calm and reassure an ER patient, preserve their abilities and improve their overall experience.
A visit to the ER can be overwhelming enough for someone without cognitive impairment, but for someone with dementia or Alzheimer’s, the visit can be especially challenging.
“Imagine somebody you love and they’re in an emergency department and they’re in a stretcher screaming, they’re trying to climb off. It’s so heartbreaking,” said Ms. Adams after she exited the main ER area, where sick patients waited in the hallway on stretchers and nurses addressed concerns of anxious relatives.
“It’s a recipe for disaster. They don’t know where they are and it’s very frightening,” she said. Sometimes patients have to be sedated or restrained.
Patient distress can also make the already chaotic environment more stressful for staff, she said.
The method Ms. Adams uses is simple. She or one of her team members will sit down with a patient for 30 minutes or so, set up materials and allow the patient to interact with the items. There is no right or wrong way of engaging; pink clothespins can be clipped on blue buckets, or on top of other clips.
Her materials include plastic buckets and clothespins, sorting cards and a laminated book showing scenes the patient might encounter — a nurse in scrubs with a mask on her face or ECG wires on someone’s chest — and large print describing what each scene means.
The Montessori philosophy was first developed in the early 1900s by Italian educator Maria Montessori and was geared toward helping children learn through discovery, encouraging them to follow their interests. In the 1990s, American psychologist Cameron Camp adapted these methods when he discovered it could preserve ability in people with dementia. Later, now-retired McMaster University gerontologist Gail Elliot created Montessori Methods for Dementia. This approach looks at an individual’s needs, skills and abilities and then matches them with purposeful, stimulating activities.
Source National Post