This next week I get to present my project for AD awareness month.
For those who do not know, I am an RN and work in the field of EMS education. Teaching EMTs, Paramedics and ER nurses. And developing special curricula for other instructors to teach. When my wife was Dxed I was surprised at how much I did not know. Being familiar with EMS curricula I know that dementia is not covered anywhere.
Long story short, on Thursday I am giving a two hour(!) presentation on "Dementia for EMS providers". There are practicing EMTs & PMs who are scheduled to attend, but the bigger catch is that there many current EMS educators & program directors that are coming too :-)
Many of the tips & information about Emergency medicine and dementia came from you folks on this board and I thank you heartily. It will take a while but my goal is to make dementia a regular part of basic EMS education.
The one thing I am vacillating on is whether I should bring my wife to the presentation . . . . Hummmmmm . . . The chance for people to experience a "real" AD person is tempting but I do intend to be very blunt and realistic about the many symptoms and behaviors. We are both very open about her (middle stage) situation but I wonder if she would become too anxious . . . Hummmm. . . .
I wouldn't bring your dw to the presentation. It is all about the disease. If she can be at home and have a "break" from the disease, it would be a good thing. Is there someone who can spend some time with her?
I would say not to do this. You cannot be sure how she would react in such a situation. It might be quite stressful for her and upsetting. You don't need to contend with that during a presentation. There are documentaries that can be used to demonstrate the effects of this disease. Speaking only for myself, if I had this disease, I would not want to be used to demonstrate this disease in a show and tell situation..
This is a time when Having your wife along very likely could/would not work to your goal. I can see wheree iy might appeal, but the potential for her to become stressed and have difficulties would at minimum distract your focus and could, even worse, damage your goal.This is a time when, forthe goodofyour goals, she needs to stay home.
such a good idea to b ring this to the attention of the EMS personnell. good for you. i hope it catches on as a requirement in the future. agree with the others. dedicate the time to the essential curriculum and leave DW at home where she is comfortable.
What makes it all more interesting is that my wife was a nurse and she knows/knew more than a few of the folks who will be there. In fact as a director of a major Emergency department she actually hired several of them years ago and started their careers . . . I now work in the same office with them and they do ask about her.
In the end you are probably right. I will leave her home. Maybe bringing her in to see them again on a social basis.
I do plan to play segments from the HBO project so I will have those examples to show.
That sounds so interesting. Is anyone going to be taping your presentation?? It might be something others would like to purchase to give to or at least have to show to day helpers, etc.
No it will not be taped at this time. My goal is to get the material into the basic teaching of EMTs & Paramedics.
The govt agency I work for regulates ambulance and pre-hospital care. I/we write all kinds of material that becomes part of EMS training. (Policies, skills, drug and treatment information, etc) Although all of our work officially applies only to LA County a lot of it is 'adopted' by other counties and even states.
My goal has always been to put this 'unknown' material into EMS education, but it has hit some uphill battles as you can imagine. I am hoping this presentation will be a real ice breaker and eye opener.
BTW- if anyone has had any issues, problems or good experiences when your AD/dementia situation interacted with EMTs, Paramedics, ambulances or Emergency Departments please post them or write me through my profile. I always want to bring attention to real situations and not teach just abstract concepts.
m-mman, a few weeks ago I wanted to have my wife join me for a glass of ice-tea on our balcony and enjoy the beautiful weather. She got onto the balcony and then panicked, sinking down to the floor, holding on to the rail. She kept saying "I'm scared, please help me". I couldn't get her up by myself, so called for a couple of nurses from the Assisted Living part of our Inn. They couldn't get her up so we called the ambulance squad. Although we told them that we only needed help getting her up, they brought all their equipment. After getting her up and into the apartment, they checked her BP - it was OK - and her blood sugar - a little high, but not unusual. Then they wanted to take her to the hospital to see "why she fell". I told them she did not fall, just sat down due to panic. I tried to explain about her Alzheimer's. They were almost ready to make me sign "against medical advice" to keep her from the hospital. Finally they gave in and left her home.
Marsh, m-mman might correct me on this, but I believe the EMTs are required by law to follow certain procedures. They cannot rely on the callers to accurately assess the situation or dictate the care they provide. Perhaps if you had an out-of-hospital DNR to show them they might have been more easily persuaded.
Weejun you are correct in every EMS system there are procedures to be followed. This is because the minimum EMT training is only 160 hours. Minimum Paramedic training is only 1050 hours.
It sounds like the EMTs were (correctly) concerned about trauma from a fall (broken bones?) a heart arrhythmia or a possible new stroke. However sometimes it is very necessary to look at the big situation. Especially concerning older folks.
It seems like they did a full assessment (look for broken bones, look at the EKG, neuro check for stroke symptoms, etc.) Then if there are no new onset symptoms AND the family is explaining the situation ("There was no fall") there is no need to transport to a hospital. Remembering that the patient is in an assisted living situation. It would be different if she were living alone.
In Los Angeles county EMS folks respond all the time to put people 'back in bed'. It is referred to as a "Public Assist". Their desire to have Marsh sign out AMA was an attempt to avoid liability on their part. However if they checked and documented everything as they should have, there would be no problem.
Working with older folks in general (geriatrics) is another thing I teach ;-) Something the 20 y/o EMTs do not want to hear about, but I remind them that in LA, people over age 65 represent 30% of all the EMS runs. (children less that 14 are only 7% of all runs)