Today's Challenge: Walk a Mile in Someone Else's Shoes

Recently, I visited a friend who works in a facility which acts as a nursing home and rehabilitation center. My friend, "Gertrude" mentioned that several of the Certified Nursing Assistants (CNAs) struggled in caring for clients with dementia. Gertrude asked if I could offer the CNAs any advice.... Oh yeah! I love an opportunity to educate almost as much as I love an opportunity to talk!!

Of course, "Gertrude" knew that I had a father-in-law who passed away due to complications of dementia, I had worked at the Alzheimer's Association and am a gerontologist. Indeed, I had much that I could share with these people. Interacting with these frustrated individuals reminded me how important it is to take the other person's perspective into consideration. We spent time discussing their frustration so that I could understand their perspective about their work. This discussion made it was clear that they were unable to see things from the patients' perspective.

We spent over an hour together. Comparing pictures of healthy brains to pictures of brains impacted by Alzheimer's initiated an understanding of their patients' disease. I must admit that utilizing a head of cauliflower and silly string to illustrate what neurons and synapses are, and the impact dementia has on them probably helped a bit too.

Knowing the physical characteristics of dementia was important, but understanding and respecting the particular place in time these precious vulnerable patients are at were essential too. A "mindful" exploration of how these employees would interact with the world if it were they who had the dementia revealed the reality that individuals with dementia deserve respect, patience and compassion.

We role played. The first situation involved entering the room to assist a patient. I was the patient with dementia. I indicated that I had been in the nursing home for approximately two years. "Henry", who volunteered showed me how he addresses his long term patients. I reminded him about the disease progression detailed in the creative cauliflower activity. With very little coaching, this CNA came to the realization that he needed to:

• walk into the room more slowly
• position himself to be face to face with his patient
• greet the individual and introduce himself
• offer assistance articulately and respectfully

Initially, there was surprise that I suggested this routine be done each time there is interaction with this patient; however, reminding the CNAs of that clever cauliflower activity hit the point home. "Henry's" eyes lit up when he made the connection. We role played several scenarios. Each scenario driving home the need to:

• understand & appreciate where the patient is at THIS moment
• interact respectfully and compassionately
• make a personal connection with the patient

I teased the CNAs about wanting their jobs to be easier. They laughed and admitted that this was true. I reminded them of the old adage, "You kill more flies with honey than you do with vinegar." Compassionate interaction will improve the mood of the patients, enabling them to be more cooperative. This will improve the mood of the employee, which in turn brings greater job satisfaction. I look forward to checking in with "Gertrude" in a few weeks to see how "walking a mile in the patients' shoes" has impacted the CNA/patient relationship.