Sterling HeightsSeptember 10, 2012
Firefighters delve into world of dementia
By Cortney Casey
C & G Staff Writer
Imagine everyday activities like cleaning, preparing a meal, doing laundry, jotting notes, communicating with family members, giving and receiving directions.
Now imagine tackling those same tasks while grappling with physical and cognitive impairments like pain, loss of dexterity, discomfort, distraction and disorientation.
Welcome to the life of an elderly patient with Alzheimer’s disease or dementia.
Sterling Heights firefighters recently spent a few minutes enduring what such patients deal with around the clock during a sensitivity and awareness training conducted by firefighter/paramedic Vinnie Schwartz.
“Most of our runs that we do are medical in nature, and most of those runs are geriatric in nature. To respond to the elderly people on medical runs is a common occurrence for us,” said interim Fire Chief Chris Martin. “You kind of have to keep reminding the guys that dealing with people as they get older is really tricky, because all of their senses change. This training gives them the perspective from the elder point of view. It tries to put the firefighter in the position of being the elderly patient, so they get the realization of how they should be treating them.”
Schwartz became intrigued by the topic after his father-in-law was diagnosed with dementia and Alzheimer’s two years ago. He chose it as his research subject during a recent Macomb Community College class on EMS instruction and subsequently became one of only 10 people nationwide selected annually to complete the Virtual Dementia Tour certification course in Georgia.
Last month, he began administering a class to his Sterling colleagues that pairs the Virtual Dementia Tour with a presentation he developed himself. Schwartz’s addendum is specifically geared toward first responders, extrapolating lessons learned during the first-hand tour portion for better care delivery in the field.
During the tour Schwartz employs props, such as special goggles, headphones and gloves, to interfere with participants’ senses — including visual, auditory, tactile and ambulatory abilities — while manipulating information flow to simulate cognitive impairment.
The students are turned loose, alone and in pairs, to perform seemingly simple tasks in a cramped room. Schwartz observes from the corner, taking notes as the usually able-bodied participants struggle mightily under their constraints.
Afterward, they’re debriefed on their performances and discuss how the challenges they experienced translate to behaviors exhibited by real-life dementia patients.
When understood as coping mechanisms, some of those actions seem much more comprehensible, said Schwartz. For instance, patients may closely shadow a relative because they’re trying to figure out what they’re supposed to be doing; they may talk to themselves because they’re trying to focus their attention, he said.
The program’s goal is to connect with students at all three levels of learning: psychomotor, cognitive thinking and — the most difficult — affective/emotion, said Schwartz.
Also, paramedics who are more aware of the general physical challenges the majority of elderly patients face daily may be better able to narrow down conditions that exhibit similar symptoms, he added.
EMS workers “are the eyes and ears out in the field,” the people who see patients’ surroundings, observe their behavior briefly at home and often speak to caretakers on the scene prior to hospital transport, said Schwartz.
Geriatrics is an especially critical field, considering the aging population and the prevalence of Alzheimer’s and dementia, which affects one in eight people, said Schwartz.
For firefighter/paramedic Ryan Sears, who went through Schwartz’s training, said the onslaught of so many simultaneous physical and mental hurdles was eye opening.
He found the simulation of garbled hearing the most difficult to overcome and said it drove home the necessity of speaking clearly when trying to communicate with older patients.
“It really makes your focus go away,” said Sears. “It makes us, as a provider, be more attentive and speak up. To do something like this and actually open your eyes and see what it’s like from their point of view — I think the care can only get better.”
For more information on the training, contact Schwartz at (586) 405-2158 or email email@example.com.
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