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Bravo Zulu Achieveing Excellence in Relationship-Centered Dementia

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Bravo Zulu Achieveing Excellence in Relationship-Centered Dementia Zulu Achieving Excellence in Relationship-Centered Dementia Care Honor the soldier and sailor everywhere who bravely bears his country's cause. Honor, also, the citizen who cares for his brother in the field and serves, as best he can, the same cause. ~ Abraham Lincoln Learner’s Resource – Module 1 Valuing Personhood, Relationships and Culture i Bravo Zulu: Achieving Excellence in Relationship-Centered Dementia Care Acknowledgements This program was developed by: Kat Miller, Colonel (U.S. Army, Retired), Director Wendy Simons, Deputy Director of Health Wellness in partnership with: PERRY and University of Nevada,Reno FOUNDATION Jennifer Carson, PhD, Director, Robert Kidd, President/CEO Dementia Engagement, Education and Research (DEER) Program (*Bravo Zulu Author/Facilitator) This program is being delivered as part of: ' University of Nevada, Reno Im School of Medicin e ~~' '>.!nford Center for Aq,nq ICECAPNEVADA ImprovingCare of Eldersthrough med .unr.edu /aging Communityand Academic Partnerships (775 ) 784 -4774 This training is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $3,315,845 with 0% financed with nongovernmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS or the U.S. Government. ii Bravo Zulu: Achieving Excellence in Relationship-Centered Dementia Care Overview Veterans and Dementia As part of its Veterans-in-Care initiative, the Nevada Department of Veterans Services (NDVS) partnered with the Perry Foundation and Dr. Jennifer Carson, Director, Dementia Engagement, Education and Research Program, University of Nevada, Reno, to create Bravo Zulu: Achieving Excellence in Relationship-Centered Dementia Care, an innovative, comprehensive, 12-hour military cultural competence, dementia and eldercare training program, for three primary reasons: 1. The need to improve military cultural competence/humility among healthcare providers. Nevada is home to at least 218,406 veterans, 47% of whom are over the age of 65. This mirrors the national demographic that approximately half of America’s 20 million veterans are over the age of 65. Increasingly, the majority of formal care and support for older and disabled veterans is provided outside of the VA system by civilian healthcare providers with an overwhelming lack of military cultural competence. Even within the VA system, civilian healthcare providers demonstrate a lack of military cultural competence, which can lead to poor health outcomes. Achieving cultural competence is a hallmark of quality care. Yet, national surveys have indicated low military cultural competence among healthcare providers and limited educational opportunities on military culture in healthcare training programs. While a few military cultural competence training programs exist, none have focused specifically on the care and support of older and disabled veterans. Bravo Zulu meets this need by improving military cultural competence/humility and helping healthcare providers understand the influence and impact of service experiences on the aging process and healthcare needs of older and disabled veterans. iii 2. The need to provide comprehensive dementia care education. Dementia is an umbrella term that describes a wide range of symptoms associated with cognitive impairment. This includes changes in memory, thinking, concentration, judgment, problem solving, and functioning severe enough to reduce a person's ability to perform everyday activities. Alzheimer's disease is the most common type of dementia and accounts for 50 to 75 percent of cases. Other types of dementia include Lewy Body, Frontotemporal and Vascular. Currently affecting an estimated 5.8 million Americans, dementia is a leading cause of morbidity, mortality, disability and institutionalization among individuals aged 65 years and older. There is a dramatic increase in the prevalence of dementia among veterans due to the aging of the veteran population and a high prevalence of dementia risk factors (e.g., traumatic brain injury, post-traumatic stress, depression and substance use). As such, the pathway to providing high-quality care and support to older and disabled veterans requires excellence in dementia care and support. However, there is a lack of current dementia education programs which embrace emerging, evidence-informed innovations. Bravo Zulu meets this need by providing comprehensive and innovative dementia education that exceeds the Nevada State regulation (NRS 449.094) for 8 hours of dementia education for skilled nursing and assisted living providers. CEUs and a Certificate of Completion will be awarded upon completion of all four modules. 3. The need to serve and support people, including older and disabled veterans, like VIPS! Achieving excellence in eldercare and support requires that healthcare providers honor personhood, relationships and culture, and provide care and support that is tailored, yet flexible, to each unique individual’s strengths, preferences and needs. It also requires that healthcare providers try to see the world from the perspective of each person, and provide a positive and supportive social environment in addition to excellent care. Unfortunately, after decades of nursing home reform and efforts to change the culture of eldercare communities, the overwhelming majority still fail to provide care that is reflective of person- and relationship- centered values and practices. Bravo Zulu meets this need by teaching healthcare providers how to serve and support people, including older and disabled veterans, like VIPS! iv • V = Valuing Personhood, Relationships and Culture • I = Treating People as Unique Individuals • P = Looking at the World from the Perspective of the Person • S = Providing a Positive and Supportive Social Environment (VIPS framework adapted from Brooker, 2007) Getting to Bravo Zulu Bravo Zulu, also referred to as "BZ," originated as a naval signal, typically conveyed by flag-hoist or radio, meaning "Well done!" Since its origin, Bravo Zulu has been used by senior U.S. Navy, U.S. Marine Corps and U.S. Coast Guard officers in command and senior supervisory positions to congratulate or compliment contemporaries or juniors, including their subordinate crews or commands, for outstanding performance! This program explores what it takes to get to Bravo Zulu within the context of eldercare, including skilled nursing, dementia care, and assisted living communities. The content can also serve to improve home-based care and support. Care partners get to Bravo Zulu when they honor personhood, relationships and culture, and provide care and support that is tailored, yet flexible, to each unique individual’s strengths, preferences and needs. It also requires that care partners try to see the world from the perspective of each person, and provide a positive and supportive social environment while providing excellent care. Bravo Zulu consists of four 3-hour modules. Each module explores the principles and practices associated with a particular component of the VIPS framework, always using veterans as the central example. While originally developed with older and disabled veterans in mind, due to its focus on dementia and relationship-centered approaches, Bravo Zulu can serve to improve the care and support of all elders. v Bravo Zulu: Achieving Excellence in Relationship-Centered Dementia Care Creating a Safe Space Speedy Introductions Before we begin the content for Module 1, it is important that we have a chance to get to know each other and warm the group for engagement. Let’s take turns sharing our answers to the statements below. Please take a moment now to consider your response. Each person will have 20 seconds. • My name is… • My role as a care partner is supporting… • If I were a kitchen utensil, I’d be a… because I… Group Guidelines When people have the power to be active collaborators and decision-makers in their own learning, they are likely to experience real and lasting development. As such, Bravo Zulu has been designed to reflect the principles and practices of Dialogue Education (Vella, 2007). In order to ensure the success of this online learning opportunity, let’s create some guidelines to help set the stage for sharing, critical reflection and collaboration, while also honoring the agenda provided. As a group, we agree to the following safe space guidelines: • Honor the confidentiality of any story that is shared. • Turn our video cameras on, if possible, and mute our sound unless we wish to speak. • Remove distractions. • Respect each other’s opinions, especially when they differ from our own. vi Bravo Zulu: Achieving Excellence in Relationship-Centered Dementia Care Table of Contents Module 1: Valuing Personhood, Relationships and Culture…………………… 1 1.1 Valuing Personhood…………………………………………………………………….. 2 1.2 Valuing Relationships…………………………………………………………………… 8 1.3 Valuing Culture……….……………………………………………………………………. 16 Summary of Valuing Module………………………………………………………………….. 21 vii Bravo Zulu: Achieving Excellence in Relationship-Centered Dementia Care Module 1: Valuing Personhood, Relationships and Culture This module recognizes that each elder and those who support him or her (e.g., family members, care partners, volunteers and other friends) are all valuable human beings deserving of dignity and respect. In order to support each person in achieving his or her highest potential, both in terms of
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