The changes came on gradually. A forgotten name here and there, confusion over details from longstanding family stories, failing to remember simple tasks that were once second nature. “My dad has always been the pillar of the family – the strong one,” said the daughter of a 76 year-old man in the middle stages of his dementia journey. “It’s difficult seeing the deterioration in a person you love,” she said. “Where he used to be sharp as a tack and the one we leaned on for answers, he is now easily agitated and often confused. It’s a new normal.”
As people age, cognitive decline may seem as commonplace as bad knees and gray hair, but it is not part of normal aging. Aging individuals generally have a wide swath of both mental and physical needs that are unique and require specialized attention from loved ones and caregivers alike.
Thanks to generous donor support to the Kootenai Health Foundation, Kootenai Health has been able to spearhead a program dedicated to providing tools and education for staff to ensure the best possible experience for geriatric patients and their families.
A year and a half ago Kootenai Health adopted the Institute for Health Care Improvement (IHI) 4Ms framework as a model to improve care. The 4Ms are defined as:
- What Matters – Identify what matters most to our patients
- Mobility – Improve strength and balance (mobility)
- Mentation – Check for signs of depression or dementia (mentation), and
- Medication safety
Its framework is designed to work across all settings of care. Kootenai Health has proven progress toward this goal and in August 2021 was recognized as an Age-friendly Health Systems Participant. According to IHI, the hospitals and health care practices recognized by IHI as Age-Friendly have shown exemplary alignment with the elements of the 4Ms framework, have formally committed to putting the 4Ms into practice and received a review of their plans by the IHI.
Dementia and elder care training
Additionally, the generosity of Kootenai Health Foundation donors enabled Kootenai Health to purchase a membership to Nurses Improving Care for Hospitalized Elders (NICHE) which provides free training for nurses who interact with geriatric patients. Kootenai Health has a goal to provide dementia care training to all bedside staff by the end of 2022.
“Our region has a significant population of aging individuals and our hospital sees many every day,” said Linda Henrich, DNP, RN and geriatric nurse practice specialist who spearheads Kootenai Health’s geriatric care initiative. “When any person comes into the hospital, they are usually stressed, anxious, scared and in pain. These emotions can be stressful to anyone, but are particularly exacerbated in those patients who are suffering from cognitive and/or physical decline. Knowing how to effectively communicate with them and their families is essential to providing them the best possible care,” Linda said. “The 4M framework and NICHE are valuable tools enabling our staff to target the best course of care for our older patients. We have to pattern how we talk to and care for our geriatric population in a way that caters to their unique cognitive and physical needs.”
‘Still the person they once were’
Many symptoms experienced by an older person can be categorized as “normal aging”. Kootenai Health’s geriatric program focuses on the patient’s life goals and health care goals to provide more personalized treatment plans.
“Things such as pain, depression and memory problems can all be managed so that person has a better quality of life which is ultimate goal,” said Linda. “Additionally, as a person ages, so do their vital organs. Medications are not broken down as effectively, the more medications taken the higher the risk for harmful reactions and muscle mass decreases. Even short periods of inactivity can be harmful. Many people are also unaware that untreated depression can mimic symptoms of dementia. We’re really proud of the advancements our care team has made, and continues to make, to focus on the overall needs of our geriatric patients.”
This program would not be possible without the generosity of our community. “We are very proud of the geriatric care initiative and the tireless efforts of Linda and her team. The goal of this investment is to continue to improve upon the resources we provide our care team which will translate to a better experience for our geriatric patients and their families,” said Kootenai Health Foundation President, Julie Holt.
Linda best summarized the intent of the geriatric care initiative when she said “they’re still the person they once were, they’re just different. It’s important for us to remember that.”
Have a passion for supporting geriatric care initiatives? Visit kh.org/foundation or call (208) 625-4438.