susan gilster phd the physician and pharmacist as teachers in a specialized alzheimer’s facility:...

Susan Gilster PhD

The Physician and The Physician and Pharmacist as Teachers Pharmacist as Teachers

in a Specialized in a Specialized Alzheimer’s Facility: Alzheimer’s Facility: 25 Years of Experience25 Years of Experience

Susan Gilster PhDSusan Gilster PhDSusang@hcmg.com

susang@careleadership.comwww.alois.com

www.careleadership.com513-673-1239513-673-1239

Susan Gilster PhD

Susan Gilster PhD

Alois Alzheimer CenterAlois Alzheimer Center May 1987, first AD facility in the US May 1987, first AD facility in the US Continuum of care (Assisted-Nursing)Continuum of care (Assisted-Nursing) Day and respite-to support care in Day and respite-to support care in

homehome 5 self contained households/units5 self contained households/units Gardens-designed for stage of diseaseGardens-designed for stage of disease Redefined success-they would not get Redefined success-they would not get

better and go homebetter and go home Importance of belonging and funImportance of belonging and fun

Susan Gilster PhD

Susan Gilster PhD

Susan Gilster PhD

Susan Gilster PhD

Susan Gilster PhD

Educational MissionEducational Mission 1986-HCP lacked knowledge of 1986-HCP lacked knowledge of

dementiadementia Impact of AD found in the “experience”Impact of AD found in the “experience” Established Alois educational mission Established Alois educational mission Content of Affiliation AgreementContent of Affiliation Agreement Defining roles and responsibilitiesDefining roles and responsibilities Creating environment for successCreating environment for success Benefits-residents, families, staff, studentsBenefits-residents, families, staff, students Promoting positive student experiencePromoting positive student experience Facilitating mutually beneficial researchFacilitating mutually beneficial research

Susan Gilster PhD

Alois Alzheimer CenterAlois Alzheimer Center 25 years later-affiliated with several 25 years later-affiliated with several

universities in the region-University of universities in the region-University of CincinnatiCincinnati

Educational setting for studentsEducational setting for students 150-200 students year-national and 150-200 students year-national and

internationalinternational Physicians, pharmacists, nurses, Physicians, pharmacists, nurses,

architectural students, allied healtharchitectural students, allied health ResearchResearch

Clinical-what can we do to improve careClinical-what can we do to improve care Drug research-experimental and symptom Drug research-experimental and symptom

Susan Gilster PhD

Alois-Non Traditional Alois-Non Traditional LTCLTC

Founders not LTC Founders not LTC Established Center Established Center

under a service modelunder a service model Service oriented-Service oriented-

resident, family, staff, resident, family, staff, students, communitystudents, community

Individualized careIndividualized care Students experience Students experience

service, importance of service, importance of respect, team work, respect, team work, families and funfamilies and fun

Susan Gilster PhD

S.E.R.V.I.C.E ModelS.E.R.V.I.C.E Model

SS=Service-Serving others-why we exist-to =Service-Serving others-why we exist-to serveserve

EE=Orientation, job preparation, ongoing =Orientation, job preparation, ongoing education, expectations for performanceeducation, expectations for performance

RR=Respect as a foundation for all =Respect as a foundation for all VV=Vision-shared, a destination, direction=Vision-shared, a destination, direction II=Inclusion-all have a voice in the organization =Inclusion-all have a voice in the organization CC=Communication, routine, open, ongoing=Communication, routine, open, ongoing EE=Enrichment-self awareness, growing, =Enrichment-self awareness, growing,

learning, caring and nurturing of all learning, caring and nurturing of all

Susan Gilster PhD

Susan Gilster PhD

Student Student Experience:Experience:

Residential Residential normal living normal living environmentsenvironments

Susan Gilster PhD

Susan Gilster PhD

Susan Gilster PhD

Susan Gilster PhD

Susan Gilster PhD

Students Students experience: experience: Therapeutic Therapeutic

nature of outdoor nature of outdoor gardens – gardens –

designed for designed for specific specific

populationpopulation

Susan Gilster PhD

Susan Gilster PhD

Susan Gilster PhD

Susan Gilster PhD

Students Students experience: The experience: The

importance of importance of activities, events, activities, events, outtings and the outtings and the

inclusion of inclusion of families families

on quality of life on quality of life

Susan Gilster PhD

Susan Gilster PhD

Susan Gilster PhD

Susan Gilster PhD

Susan Gilster PhD

Students Students experienceexperience:: Welcoming environment-Welcoming environment-all have preceptorall have preceptor

Normal living Normal living environmentsenvironments

5 households differ 5 households differ

Individualized - ”person-Individualized - ”person-centered”centered”

Outdoor environments Outdoor environments differdiffer

Impact of atmosphere and Impact of atmosphere and

stimulation on behaviorstimulation on behavior

Normal, fun activitiesNormal, fun activities

185 trips out each year185 trips out each year

Integration of familiesIntegration of families

Impact of consistent Impact of consistent staffingstaffing

Importance of training Importance of training and supportand support

Susan Gilster PhD

Student evaluationsStudent evaluations

Physicians:Physicians: Exposure to real lifeExposure to real life experience of patients experience of patients

with different types of dementiawith different types of dementia Interdisciplinary approach Interdisciplinary approach to care-best careto care-best care Face to face interactions with the residents Face to face interactions with the residents

and staffand staff Discussions with families-more insightDiscussions with families-more insight Impact of educated and supported staffImpact of educated and supported staff in in

all departmentsall departments So much you could doSo much you could do

Susan Gilster PhD

Susan Gilster PhD

Student evaluationsStudent evaluations Pharmacists, nurses and others: Pharmacists, nurses and others:

Interdisciplinary interactionsInterdisciplinary interactions centered centered on improving the life for the patienton improving the life for the patient

First hand experience, face to face w First hand experience, face to face w patientspatients

Team approach best interest of the patientTeam approach best interest of the patient Helped me learn more about AD and needsHelped me learn more about AD and needs Staff explained everything-individual patient Staff explained everything-individual patient

needs, disease process and family needsneeds, disease process and family needs Patients were delightfulPatients were delightful and made me and made me

want to extend my work in this fieldwant to extend my work in this field

Susan Gilster PhD

Students experience:Students experience: Effectiveness of multidisciplinary Effectiveness of multidisciplinary

approachapproach How to minimize hospitalization: How to minimize hospitalization:

Alois rate 3 years <1-5%Alois rate 3 years <1-5% Medication is not the only answer: ‘Medication is not the only answer: ‘

Alois per resident half of national averageAlois per resident half of national average Impact of consistent, nurtured staff: Impact of consistent, nurtured staff:

Alois high staff retention – 90%Alois high staff retention – 90% How to impact family satisfaction:How to impact family satisfaction:

Alois satisfaction 3.94 out of perfect 4.0Alois satisfaction 3.94 out of perfect 4.0

Susan Gilster PhD

ConclusionConclusion Evaluations reinforce that physicians, nurses, Evaluations reinforce that physicians, nurses,

pharmacists, even those with extensive training pharmacists, even those with extensive training are not fully in touch with the impact of AD until are not fully in touch with the impact of AD until they actually experience itthey actually experience it

Offers greater sensitivity and ability to work Offers greater sensitivity and ability to work effectively with persons with AD and families - effectively with persons with AD and families - their own practicetheir own practice

Understand much can be done to improve the Understand much can be done to improve the daily life of residents and manage challengesdaily life of residents and manage challenges

Experience the impact of a vision and service Experience the impact of a vision and service oriented experienced, trained and consistent oriented experienced, trained and consistent staffstaff