Patients living with dementia and Alzheimer’s disease experience a number of cognitive problems which can affect their reactions to different places and settings—including a traditional physician’s office.
Jeffrey Schlaudecker, MD, assistant professor in the office of geriatrics, which is housed in the department of family and community medicine, says a construction project brought about a huge realization that has led to better patient and family satisfaction in the clinic for patients living with these conditions.
"The dementia consultation clinic within Maple Knoll Village, which is where the UC clinical geriatric program is housed and where UC geriatric fellows are trained, was recently reallocated for another use,” says Schlaudecker, adding that he and the various trainees had seen patients in this space for seven years. "My office was relocated to an unoccupied, independent living two-bedroom condominium within Maple Knoll Village, and this provided a chance to think about and really experience how the setting of care powerfully impacts patients.”
Schlaudecker says that in the clinical setting, he often had problems with patients trying to wander away while he spoke to families about the care of their loved ones.
"My patients, who had varying degrees of cognitive impairment, were not comfortable in my medical office waiting room, although it was a nice, traditional waiting room,” he says. "However, something about this space made these patients feel restless and uncomfortable, and they were powerfully motivated to leave.”
This stopped when the office made the move to a more "homey” setting.
"Our new office home is truly a home, complete with a front porch and screen door, a fireplace and hearth in the living room, soft lamps and indirect lighting and large windows,” says Schlaudecker. "It turned out that a more welcoming, comfortable and familiar atmosphere is the perfect environment for my patients with cognitive impairment. They no longer wait anxiously, making it easier for me to talk in the bedroom-turned-consultation room with their family caregivers while they relax in the living room.”
Schlaudecker, who has submitted this assessment to academic journals, says the care team, made up of UC geriatricians, fellows, residents, students and pharmacists, now sees patients in a setting that is matched to their needs.
"This has proven to be a great experience for patients, reducing their agitation and creating a comfortable setting for them, and it’s been a great learning experience for our students, residents and fellows,” he says. "Geriatricians know that care must be individualized for each person and their family. Patient- and family-centered care is a care philosophy between providers, patients and families emphasizing a dignified, mutually beneficial partnership. Facilities that improve the dignity of our patients with cognitive impairment can improve care, and now is the time for geriatricians to form these meaningful partnerships.”