Curriculum Maximizing Functional Outcomes for Patients With Dementia

These pre-recorded lectures are on-demand and last only an hour, so you can listen to them whenever time permits!

Comprehensive, Patient-Centered Management of Individuals With Dementia
Ken Brummel-Smith, MD

This session will discuss a holistic, patient-centered approach to caring for people with dementia. Dementia care is too often managed only medically rather than within the context of the patient's relationship with his or her family or caregiver, which can strain all involved. This session will explore a team approach to optimize treatment and ensure quality of life.

After completing this session, you will be able to:

• identify the four main components of patient-centered dementia care
• define the role of various team members in dementia care
• describe the best methods for optimizing family care for patients with dementia

Neurobiology and Types of Dementia
Ken Brummel-Smith, MD

This session will define dementia and identify the clinical presentations associated with Alzheimer's disease and the other major types of dementia to help clinicians distinguish among the types. The session will also discuss the prominent theory—as well as newer thoughts—on the biology of Alzheimer's disease.

After completing this session, you will be able to:

• distinguish mild cognitive impairment from dementia
• describe the major types of dementia
• describe common communication impairments that accompany different types of dementia

A Team Approach to Addressing Hearing Loss in Patients With Dementia
Yvonne Rogalski, PhD, CCC-SLP, and Amy Rominger, AuD, CCC-A

The combined impact of dementia and hearing loss can create huge barriers to a patient's interpersonal communication and engagement. This session will look at the complicated relationship between dementia and hearing loss and explain how to help a person with dementia prior to, during, and after an audiologic examination, including maximizing the care, maintenance, and use of hearing aids. The session will offer strategies for SLPs and audiologists to work in concert with families and caregivers to enhance the patient's quality of life.

After completing this session, you will be able to:

• discuss the current research on dementia and hearing loss
• identify actions to assist a person with dementia before, during, and after audiologic referral
• identify how SLPs and audiologists can facilitate hearing in a person with dementia

Tips for Documenting Skilled Services for Individuals With Dementia
Renee Kinder, MS, CCC-SLP

Navigating regulatory documentation requirements for providing skilled speech-language therapy services can be a significant challenge when working with individuals with dementia. This session will provide guidance on effectively documenting skilled need and care for geriatric Medicare beneficiaries, including how to meet standards for "reasonable and necessary" services per the Medicare Benefit Policy Manual.

After completing this session, you will be able to:

• create individualized treatment plans that are compensatory and restorative in nature based on evaluation findings
• write functional and measureable goals that provide evidence of skilled care

Malnutrition, Dehydration and Dysphagia in Individuals With Dementia
Michelle Tristani, MS, CCC-SLP

Managing nutrition and hydration needs in the presence of oropharyngeal dysphagia in individuals with dementia is a significant and individualized challenge. Eating and swallowing patterns among individuals with dementia have not been studied systematically, and clinicians must also consider how to account for an individual's personal/cultural beliefs and how to modify the dysphagia-dementia treatment plan as the diseases progress. This session will educate and empower clinicians to evaluate swallowing and cognition assessment results; use cognitive-based dysphagia compensatory techniques; and preserve nutrition, hydration, and quality of life in patients with dysphagia in various stages of dementia.

After completing this session, you will be able to:

• identify steps to implement a systematic protocol for dysphagia in individuals with dementia
• describe the rationale for use of the dysphagia–dementia scale
• develop functional, measurable, patient-focused goals for patients with dysphagia and dementia

Differentiating Between Normal Aging and Mild Cognitive Impairment
Valarie B. Fleming, PhD, CCC-SLP

Mild cognitive impairment (MCI), often considered a transitional diagnosis between normal cognitive aging and dementia, is a diagnosis that SLPs need to be familiar with to assist with early identification and management. The often-subtle characteristics of MCI can be difficult to distinguish from healthy cognitive aging. This session will provide an overview of healthy cognitive aging and MCI as well as describe the neurological, cognitive, and cognitive-communication changes associated with both. In addition, assessment and management information will be presented.

After completing this session, you will be able to:

• summarize the neurological, cognitive, and cognitive-communicative changes that occur due to normal cognitive aging and MCI
• list groups that are at greater risk of developing MCI
• explain the role of SLPs in the assessment and management of cognitive-communication abilities related to MCI

Promoting Functional Abilities for People With Dementia
Tammy Hopper, PhD, CCC-SLP

Because most common causes of dementia are associated with progressive decline, limitations and restrictions in communication that result from dementia-related cognitive impairments continue to get worse over time. Developing treatment goals and staging interventions to promote functional abilities can be challenging. This session will explore how to select appropriate treatments to address cognitive and communication limitations, help individuals with dementia and their caregivers in developing treatment goals that address functional abilities, and measure cognitive-communication treatment effects.

After completing this session, you will be able to:

• utilize specific treatments (e.g., spaced-retrieval training, errorless learning, method of vanishing cues, and written and graphic cues) to help people with dementia address memory and communication limitations and perform everyday tasks
• write person-centered, functional goals based on the International Classification of Functioning, Disability and Health for clients with dementia
• evaluate the effects of communication treatment programs for individuals with dementia

Promoting Social Interaction for People With Dementia
Tammy Hopper, PhD, CCC-SLP

Developing treatment goals and staging interventions to promote social interaction for individuals with dementia can be challenging, particularly due to the progressive decline in cognitive and communicative abilities associated with most common causes of dementia. This session will discuss how to facilitate social interaction at various stages of dementia through the use of evidence-based interventions that are focused on the contextual environmental variables that act as barriers or facilitators to communication and well-being.

After completing this session, you will be able to:

• describe the effects of social isolation on overall health and well-being of older adults in general and specifically those with dementia
• utilize specific treatments (written and graphic cues in the form of memory books, reminiscence therapy, and environmental modifications) to help people with dementia and their communication partners have more satisfying interactions
• write person-centered goals based on the International Classification of Functioning, Disability and Health for clients with dementia

Person-Centered Interventions for Primary Progressive Aphasia
Becky Khayum, MS, CCC-SLP, and Emily Rogalski, PhD

Language impairment is the defining feature of primary progressive aphasia (PPA) and a common symptom of other clinical dementia syndromes. There is currently no cure for PPA, but speech-language therapy may improve patients' quality of life. But many interventions that are used with individuals who have stroke-induced aphasia are not effective for dementia patients (e.g., those with PPA). This session will define PPA and outline the diagnostic process. The session will present an evidence-based review of pharmacological and nonpharmacological interventions for individuals with PPA and discuss person-centered assessment and interventions for individuals with PPA using the life participation approach.

After completing this session, you will be able to:

• describe the diagnosis of PPA, differentiate it from other clinical dementia syndromes, and explain the diagnostic process
• create meaningful person-centered plans of treatment and education for individuals with a diagnosis of PPA

Caregiver Counseling and Training
Michelle S. Bourgeois, PhD, CCC-SLP

Caregivers of people with dementia range from family members trying to cope with the increasing demands of a degenerative disease trajectory to professional caregivers in long-term care settings. Clinicians need to be familiar with the education, training, and support needs of different types of caregivers as well as the range of caregiver characteristics, training and counseling options available, and evidence and outcomes for different caregiver approaches. This session will discuss the types of resources available to caregivers with various needs to ensure improved quality-of-life outcomes for individuals with dementia and their caregivers.

After completing this session, you will be able to:

• describe the range of caregiver characteristics—including relationship, culture, ethnicity, education, and setting—and the different needs of various types of caregivers
• describe the range of caregiver interventions—including education, skills training, counseling, and support groups—available and the predicted benefits of each type for various types of caregivers

Functional Assessment of People With Dementia
Michelle S. Bourgeois, PhD, CCC-SLP

A wide range of diverse assessment tools are available for individuals with dementia, but SLPs have limited time to conduct full diagnostic batteries. Thus it is important to know what tools will provide functional assessment data to facilitate intervention planning for individuals with dementia. This session will describe procedures for conducting a functional evaluation that will provide information necessary for developing meaningful goals and therapeutic activities for persons with dementia in long-term care settings.

After completing this session, you will be able to:

• determine the strengths, interests, and abilities of a person with dementia
• develop person-centered, individualized, meaningful, and functional goals for a person with dementia
• identify environmental and social barriers that prevent a person with dementia from engaging in meaningful activities and recommend solutions for overcoming these barriers

The Care Pathway Model: Interdisciplinary Care for People With Dementia and Their Families
Becky Khayum, MS, CCC-SLP, and Darby Morhardt, PhD, LCSW

An interdisciplinary approach to care for people with dementia is essential to their health and quality of life and requires continuous communication among the individual, family members, and all health care professionals involved in the person's care—including the primary care physician, neurologist, neuropsychologist, psychiatrist, social worker, nurse, nursing assistant, SLP, occupational therapist, physical therapist, and recreational therapist. But there are many barriers to working as part of an interdisciplinary team. This session will describe the interdisciplinary Care Pathway Model for diagnosing and treating dementia syndromes and provide examples of how the model may be applied across various health care settings.

After completing this session, you will be able to:

• describe the Care Pathway Model and how an interdisciplinary approach to dementia care may be applied in your health care setting
• describe the importance of psychosocial interventions for individuals and families coping with a dementia diagnosis and how you may increase coordination of care with a social worker in your health care setting
• explain how you might educate other health care professionals about the SLP's role in dementia care

Ethical Issues and End-of-Life Considerations in Dementia Management
Lynne Brady Wagner, MA, CCC-SLP

Individuals with dementia and their loved ones face many challenges, including functional decline, loss of independence, and decisions related to end-of-life medical and social interventions, among others. This session will review key principles and medical-legal precedents related to the ethical issues that SLPs might encounter when working with individuals with dementia, focusing on changes in communication, decision-making capacity, and ability to sustain nutrition and hydration.

After completing this session, you will be able to:

• identify how to discern an ethical dilemma from a clinical one
• describe practical problem-solving approaches used to manage ethical dilemmas in clinical practice
• apply ethical problem-solving strategies to individual clients’ situations