A photo taken in 1977 shows a nurse cradling a badly-burned infant, Amanda Scarpinati, at an Albany, New York, hospital. The patient recovered and spent years searching for her mystery caretaker. Scarpinati and nurse Sue Berger were reunited Tuesday. Michelle Miller reports.
An emergency call comes into dispatch from a grocery store manager that requests police assistance during a shoplifting incident in which a woman fills her purse with items from their shelves before attempting to leave without paying.
A terrified mother and son dial 911 to report a home invasion in progress and hide in an upstairs closet until Law Enforcement responds moments later with guns drawn to find a confused senior insisting that the officers “get out” of his home.
A frantic young female worker at a local donut shop reports a potential sexual predator engaged in indecent exposure when she notices a man in their parking lot wearing only underwear and shoes under his coat asking their exiting patrons to give him a ride home.
What these three calls have in common is that they all involve persons with dementia. Persons who, due to cognitive impairment, may have been seemingly engaged in criminal behavior but were by no means criminals.
We’ve all heard the statistics and they are staggering. Per the Alzheimer’s Association, EVERY 67 SECONDS someone in the United States develops the disease. What you may not have considered is the impact this growing number of persons living with dementia is having on the Law Enforcement community and vice versa.
The number of encounters between persons with dementia and Law Enforcement/First Responders is rapidly rising, and with the Silver Tsunami bringing with it a tidal wave of citizens with Alzheimer’s or dementia the need to ensure that First Responders and Law Enforcement Officers are prepared to respond to calls in a way that best supports positive outcomes for all involved is reaching a critical point.
The Alzheimer’s Association notes that the Law Enforcement calls involving persons with dementia most typically include: wandering, shoplifting, erratic driving, auto accidents, indecent exposure, false reports and most tragically suicide and even homicide.
I first became painfully aware of the potential for negative outcomes for both persons living with dementia and the officers responding to these calls during a conversation with my younger brother, a Law Enforcement Officer in Colorado..
“Look, Gandhi,” he began using a term of semi-endearment he often kids me with because he thinks my three decade career working with seniors has made me a little too open, too trusting and too affectionate with everyone I meet, “you and I have been trained to see the same situation very differently.”
“When you see a disoriented person, you’re looking for what their unmet need might be. Trying to assess their cognitive ability and determine what might be the reason behind their behavior – which you view as their primary communication tool.” I momentarily pause to think with pride how much he’s learned having also grown up serving seniors. He further explained, “Though I might want and have the opportunity to do those same things eventually, when I arrive on scene, I have to run through a whole different set of scenarios often in a fraction of second. I’m trying to determine if this person’s armed, or has immediate access to something that can be used as a weapon, if they pose an imminent threat to themselves or others, if they are potentially under the influence, how best to take control of the situation in a way that has the best chance of ensuring the safest outcome for all parties, and do all of this as quickly as possible.”
What my little brother taught me in that call about the differences in our training and thought process and the increased incidents in Silver Alerts has stayed with me, a gnawing ache that would painfully resurface when I would see news report of injuries and even deaths from persons with dementia who wandered.
As our grandfather coped with the advancing Alzheimer’s symptoms that would eventually claim his life, I saw an always humble, gentle and mild-mannered man occasionally erupt in angry outbursts and adopt a physical stance that an untrained observer might consider threatening in the wrong situation. Fortunately for us, the kind of situations that can give rise to a 911 call never occurred for him like it does for hundreds of other families who encounter law enforcement during their journey as caregivers.
Still, I wanted to help officers like my brother be better prepared to respond to calls that involved persons with dementia like my Grandfather.
Recognition of the power vested in the uniform; an understanding that the first responder can rescue, protect, incarcerate, hospitalize, take into custody/transport at will; the trust that comes with the title as a member of the public safety team; the knowledge that first responders have citizens’ best interests at heart; and the understanding of their ability to use force to deter potential physical aggression or restraint to prevent danger to self or others… So many of these tools that Law Enforcement Officers rely upon to end their shifts safely each day are often rendered useless when communicating with a person with cognitive impairment. Likewise, the uses of multi-step instructions to de-escalate a situation are also ineffective. The directive to “Step away from the door and put your hands up” can be met with little comprehension or compliance from someone with later stage dementia.
The good news is that there are a new and incredibly effective set of tools out there to support the best possible outcomes during these types of encounters.
Project Lifesaver International is a non-profit organization made up of retired Law Enforcement and First Responders. They’ve developed the technology and training to help achieve a record 3,000 safe returns of persons with cognitive impairment in cooperation with over 1400 police, sheriff, fire, public safety departments and other emergency responders in 48 states, Canada and Australia. I sat down with them over a year ago to create something that we both felt was desperately needed but not previously available.
We co-created the manual and certification course “Alzheimer’s / Dementia Emergency Response” specifically for Law Enforcement and First Responders. What makes this different than any other tools previously available is that it combines for the first time not only information about dementia, best practices for communication with cognitively impaired persons, and non-threatening ways to de-escalate situations but it is also written in “cop-speak.” Working hand in hand, these resources were developed based upon input from law enforcement officers and first responders, using their real world situations and incorporating their most widely agreed upon successful techniques for supporting safe outcomes that we could mine from both the Alzheimer’s and Law Enforcement communities.
These tools have the potential to better equip persons living with dementia, their caregivers and the first responders that are ever more likely to encounter one another in increasing numbers with the best chance of peaceful and safe outcome. If you think your local police or fire department may find this information helpful, please share this article online in your social media circles and print a copy for your local public safety office. You can also visit Project Lifesaver’s website to learn more at www.projectlifesaver.org.
Better health care for your patients involves much more than simply finding the right diagnosis and treatment. Great health happens when patients feel empowered, knowledgeable, and supported by their practitioners. Strong health literacy skills are at the heart of this approach.
How do you foster this kind of healthy partnership between healthcare practitioner and patient?
Here are four ways to improve patient experience and nurture a trusting partnership between you and your patients.
1. Sit down and remove barriers.
One of the first ways to gain trust from a patient is by truly being present. This means sitting down with that patient and removing any distractions between you. Set your laptop, cell phone, and medical equipment aside for a moment, make eye contact, and listen. If patients have physical or language barriers, be sure to resolve those concerns right away.
2. Use a narrative model rather than the more traditional Q & A model.
Allow your patient to tell the story of his or her illness or state of health. Though there are often important questions that you may need answered, let these be follow-up questions. Making time for your patient to speak uninterrupted will send the message that you are listening and taking into account the pieces of the situation that the patient feels are important. There are not only many clues to the diagnosis in this narrative, but this style allows patients to feel heard and valued.
3. Clearly explain your reasoning.
As you offer ideas for a diagnosis, future testing, prescriptions, or for improving your patient’s health, it is important to be as clear as you can. You may use diagrams or images as needed. And it is always helpful to offer clearly written information to reinforce your verbal discussion.
4. Encourage questions.
At any point in your interaction with your patient, stop and ask if he or she has questions. Be sure to tell your patients that they can interrupt at any point if you are not being clear. You can also offer an email and telephone number for patients to use if they have questions that come up after their visit. Direct patients to websites such as the National Patient Safety Foundation, which designed the patient education program, “Ask Me 3®,” and the Agency for Healthcare Research and Quality, which launched the “Questions are the Answer” campaign. These resources will help your patients determine the most important questions to ask in any healthcare setting.
Garnering trust in your patients is paramount to patient engagement and improved health outcomes. Take some time to incorporate these steps into your daily routine and take note of the positive changes that result.
Lessons Are All Around Us
Leadership lesson are all around us if we look for them. In my case, my wife is one who has shown me a lot—by simply managing her own life!
Over the years, I have observed my wife balance many competing priorities. She has managed a career with her own business, raised our children, developed friendships and run a household all while being a great wife and partner. As we progress through life together, I have noticed leadership traits that she naturally employs as an effective, successful businesswoman, mother, friend and wife.
Sometimes we get very theoretical or philosophical in describing leadership talent. We go to seminars, read books or take courses, but I have found some of the most effective lessons are very practical and are demonstrated through the actions of those around us. My wife doesn’t talk about or preach leadership—she just naturally has the qualities. It just took me a while to catch on…
Here is a brief list of the effective leadership lessons that I have observed from her in action:
- Give careful attention to the individual.
- Empathy creates loyal followers.
- Genuine listening gets to the heart of the matter and builds relationships.
- You do not always need to have the answer. Listening to others will help everyone get better answers.
- Forgiving mistakes builds trust and loyalty.
- First impressions are not always right.
- Look beyond someone’s behavior for real issues.
- Holding grudges is detrimental and unproductive.
- Writing down negative thoughts and feelings is a healthy way to release them.
- Acts of kindness create trust and an appreciative atmosphere.
- It is fine to feel emotion, but do not let it lead to bad decisions and regretful actions.
- Nurturing creates an atmosphere for others to comfortably grow and learn.
- Being a pleaser, trying to satisfy everyone, does not work and drains your energy.
- Setting boundaries holds people accountable.
- Holding people accountable creates positive culture and helps people grow.
- Know when to let someone else take control.
- Getting others involved builds buy-in and reduce stress.
- Sometimes it is best to let others go first—it makes them feel important, appreciated and taps into their energy.
- Understand the other person’s perspective to create a better outcome.
- Give people an “out” to help them take measured risks.
- Take action on small things to reduce stress and create a decisive culture.
- Organization and advanced planning enables everyone to accomplish a lot while reducing stress.
- To-Do lists are essential for leaders to accomplish broad and varied agendas.
- Helping others to feel and show passion creates energy.
- Perfection is good for some things, but not everything.
- Decisiveness reduces stress and churn for everyone, even if changes are needed later.
- Better decisions result when you allow people to talk about options, alternatives and choices without forcing quick conclusions.
- Advanced “negotiation” develops choices, gets buy-in from others and prevents tantrums.
- Talking about feelings is good for culture—it is not always about decisions, actions and performance.
- Teaching people to be self-aware and to control impulses strengthens character.
These simple strategies can keep you energized both on and off the job.
Here’s a column that I guarantee will make you more more successful in both your professional and personal lives.
Here are 14 quick strategies to get and keep yourself motivated:
1. Condition your mind. Train yourself to think positive thoughts while avoiding negative thoughts.
2. Condition your body. It takes physical energy to take action. Get your food and exercise budget in place and follow it like a business plan.
3. Avoid negative people. They drain your energy and waste your time, so hanging with them is like shooting yourself in the foot.
4. Seek out the similarly motivated. Their positive energy will rub off on you and you can imitate their success strategies.
5. Have goals–but remain flexible. No plan should be cast in concrete, lest it become more important than achieving the goal.
6. Act with a higher purpose. Any activity or action that doesn’t serve your higher goal is wasted effort–and should be avoided.
7. Take responsibility for your own results. If you blame (or credit) luck, fate or divine intervention, you’ll always have an excuse.
8. Stretch past your limits on a daily basis. Walking the old, familiar paths is how you grow old. Stretching makes you grow and evolve.
9. Don’t wait for perfection; do it now! Perfectionists are the losers in the game of life. Strive for excellence rather than the unachievable.
10. Celebrate your failures. Your most important lessons in life will come from what you don’t achieve. Take time to understand where you fell short.
11. Don’t take success too seriously. Success can breed tomorrow’s failure if you use it as an excuse to become complacent.
12. Avoid weak goals. Goals are the soul of achievement, so never begin them with “I’ll try …” Always start with “I will” or “I must.”
13. Treat inaction as the only real failure. If you don’t take action, you fail by default and can’t even learn from the experience.
14. Think before you speak. Keep silent rather than express something that doesn’t serve your purpose.
In this video, Dr. Goodall encourages individuals around the globe to participate in the United Nations International Day of Peace which is celebrated on September 21 each year. This year, an especially auspicious one with the UN’s celebration its 70th anniversary, will have the theme of, “Partnerships for Peace – Dignity for All.” Click here to learn more about Dr. Goodall’s role as a UN Messenger of Peace and how you can participate in celebrating in the annual Day of Peace.
Visit our website at http://www.janegoodall.org/
Since I saw The View’s so-called “apology” clip on social media, I’ve given this post a tremendous amount of thought. My first instinct and knee-jerk reaction was to sit down with my laptop and blast them with full force…unload my anger and outrage onto the page…err…computer screen…so I could purge it and get all of that negativity out of my system. I’ll admit, I even got about a quarter of the way through that piece, when I stopped to re-read it. It was a scathing, searing diatribe that quite frankly, made me ashamed of myself. It sounded like something that the View Crew would say…it was petty, spiteful, angry and distasteful. That’s not who I am as a person, a writer or more specifically, a nurse. Quite frequently, I end my blog posts with a sentence urging my readers to be kind to each other. I am a tireless advocate for tolerance, peaceful coexistence and doing unto others, as the old saying goes. Those beliefs were always as much a part of my nursing practice as my clinical skills. Blasting the women of The View with insults and anger will only fuel the fire of their ignorant misconceptions regarding the nursing profession, and that ultimately serves no truly useful purpose.
That being said, I have no intention of just simply allowing my profession and all of my many colleagues to be repeatedly insulted and NOT speak out. I hear my Mother’s voice in my head…you can be assertive without being aggressive….you can be direct without being demeaning…and lastly, her old standard: when all else fails, give them a taste of some Irish Diplomacy and tell them to go to hell in such a way it will make them look forward to the trip. (She was quite a character!) I have decided there is only one way to go about accomplishing this.
An Open Letter to Whoopi Goldberg:
I am very disappointed in you. I wrongly expected more of you than to look directly into the camera and tell an entire profession of educated, degreed professionals that we need to listen and pay attention. I can assure you, we were listening, very closely indeed. However, I felt the need to let you know that while I was listening and paying attention, I realized I have much for which to thank you.
Thank you for reminding me how very fortunate I am to share a profession with some of the kindest souls on the planet. I am no longer a nurse at the bedside, but when I was, my coworkers were the best of the best. I have had the distinct honor and privilege to work alongside some of the most amazing, intelligent, highly skilled, and riotously funny people… my sisters and brothers of my nurse family…and for that I will be forever grateful. I hope that someday, you will be able to say the same.
Thank you for reminding our profession that solidarity is not something we will ever lack. It has been refreshing to watch nurses supporting Kelly Johnson, and each other. I have to admit, this recent uprising of nurses in support of one another has been long overdue. It confirms what we have always known but have been too busy in recent times to recognize…We are many, yet we stand as one. The callous, thoughtless remarks on your show may have been aimed at one beauty pageant contestant, but 3 million nurses in the US felt the sting for her and with her. I guess you could say, that’s just how we roll. And it’s wonderful that you reminded us of that fact.
I cannot thank you enough for solidifying the entire medical community. It is no secret, or big surprise that in our high-stress careers nurses, doctors, and members of ancillary staff have been known to “butt heads” on occasion. It is simply the nature of the beast that is healthcare. However, as a direct result of the comments made this week on The View, I’ve come to realize that not only do nurses have each other’s backs, there are many others who have rushed to our defense as well. I personally, because of one blog post I’ve written regarding your comments, have heard from MDs, DOs, nursing assistants, veterinarians, respiratory therapists, physical therapists, occupational therapists, veterinary assistants, lab techs, radiology techs, hospital administrators, pathologists, social workers, hospital housekeeping staff, maintenance staff, professors, EMTs, paramedics, firefighters, a couple of cafeteria workers and even a CFO of a large hospital in California all standing united in support of nurses around the world. The outpouring of support has been overwhelming, touching and quite humbling. Nurses don’t ask for much, and therefore we don’t frequently get a lot of credit. It is heartwarming to know that people recognize and appreciate all that nurses do, and we have you, the women of The View, to thank for that.
A big thank you to your colleague Joy Behar for making it so abundantly clear through her “stupid and inattentive” statements, that as women, there quite obviously needs to be more education and awareness of how we speak to, and about, one another. We’re doing better, but Ms. Behar made us realize that we still have so very far to go. A young woman stood on a stage at a beauty pageant dressed in scrubs and was ridiculed, not supported in the least. She was blasted for wearing a “nurse costume” instead of a cleavage-baring evening gown or skimpy outfit. Not a word was spoken about her ability to be an articulate and well-composed public speaker. Not a word was mentioned that she was obviously an intelligent professional, proud of her chosen career. Not a single syllable was uttered about the content of her monologue (which was, by the way, caring for an Alzheimer’s patient named Joe, and NOT just simply reading her emails out loud). Ms. Behar’s mean-spirited knee-jerk reaction and then subsequent act of playing dumb, I-didn’t-know-what-was-going-on routine (which NOBODY is buying) makes me grateful that the amazing women I worked with, and the incredible women I have in my life as friends, have the insight and class to think before they speak…to be supportive before they judge…to feel empathy toward other women and make the conscious choice to build them up, instead of tearing them down.
I would like to thank Michelle Collins for the unexpected gift of immense gratitude for my unimportant, non-celebrity life, because wow. Does she ever grow tired of chewing on that foot that is constantly in her mouth? I know that being a celebrity and having everything you do and say picked apart must get tiring and infinitely frustrating. But when you issue a supposed apology to an entire profession and then send out tweets (and I’m not certain if these were immediately before, or immediately after the taping of the non-apology) that are highly insulting to that same profession, you either a) just really do not care, b) really honestly suffer from delusions of grandeur or c) both are correct. The Tweets in question are as follows: “I mean it is a little funny the hidden anger you nurses possess. I never knew.” “I’m not taking an anti-nurse platform haha. Like everyone prescribe yourselves a Valium and let’s just all relax.” I was at a loss for words. Wow. Just wow. And you honestly want us to believe that you do not understand WHY this is offensive?
See, Ms. Goldberg? We DO pay attention. I understand that this is supposed humor, but I also understand that 3 million nurses in the US and millions more worldwide, the physicians we work beside and the rest of the healthcare community are most assuredly not laughing.
And in closing, I want to thank your assistant’s-assistant’s-assistant’s-assistant to whatever assistant producer for maybe reading this thank you note from one of the “little people.” All I ask is that you keep this one thing in mind…we are not famous…we may not be wealthy…but we are many and we stand as ONE. Two of your corporate sponsors have already pulled out…kudos to Johnson & Johnson and Egglands’ Best!! We thank these companies from the bottom of our hearts!…..and others are right at this moment, considering following their lead. Funny, isn’t it?
And in closing, I want to assure you and all the women of your panel that when the need arises, and you look up with tear-filled eyes, full of panic, full of fear…into the eyes of the nurse standing at your bedside, you will find that all of your disrespectful comments in that moment, will be forgotten. Because nurses don’t see celebrities…or CEO’s…or homeless bums…or junkies…we only see patients. And time and time again, we put our hearts on the line for every single one of you. Like I said before, that’s just how we roll. I can assure you, our hearts are much bigger than your egos. And for helping me and millions of my sisters, brothers, comrades and colleagues around the world realize that, I thank you.
Becky, RN, BSN, CCRN, CHN, CLNC, CLNI