Learning by Doing Students from three disciplines work together to help people with dementia with their communication and physical challenges. Academic Edge
Free
Academic Edge  |   November 01, 2016
Learning by Doing
Author Notes
  • Brenda Everett Mitchell, PhD, CCC-SLP, is the associate chair for student services and AHEC operations in the Department of Allied Health Sciences, and associate professor of speech-language pathology at the University of North Carolina at Chapel Hill. brenda_mitchell@med.unc.edu
    Brenda Everett Mitchell, PhD, CCC-SLP, is the associate chair for student services and AHEC operations in the Department of Allied Health Sciences, and associate professor of speech-language pathology at the University of North Carolina at Chapel Hill. brenda_mitchell@med.unc.edu×
  • Tyson G. Harmon, MS, CCC-SLP, is a doctoral student and research assistant in the Division of Speech and Hearing Sciences at the University of North Carolina at Chapel Hill. tyson_harmon@med.unc.edu
    Tyson G. Harmon, MS, CCC-SLP, is a doctoral student and research assistant in the Division of Speech and Hearing Sciences at the University of North Carolina at Chapel Hill. tyson_harmon@med.unc.edu×
  • Anna Weinberg, MS, CF-SLP, is a clinical fellow in speech-language pathology at UNC Hospital. annamweinberg@gmail.com
    Anna Weinberg, MS, CF-SLP, is a clinical fellow in speech-language pathology at UNC Hospital. annamweinberg@gmail.com×
Article Information
Special Populations / Older Adults & Aging / Attention, Memory & Executive Functions / Academic Edge
Academic Edge   |   November 01, 2016
Learning by Doing
The ASHA Leader, November 2016, Vol. 21, 36-37. doi:10.1044/leader.AE.21112016.36
The ASHA Leader, November 2016, Vol. 21, 36-37. doi:10.1044/leader.AE.21112016.36
What happens when you get four graduate students from different professions to work together to help people with dementia? At one program, the result was a hands-on experience in interprofessional collaboration for the students, and enhanced services for people with dementia.
That’s what happened when the Department of Allied Health at the University of North Carolina School of Medicine challenged four students to design and implement an interprofessional education (IPE) summer clinical assignment. The graduate students—from occupational therapy, physical therapy and speech-language pathology—participated in an assignment uniquely designed to give students an IPE experience while meeting discipline-specific requirements.
The IPE project took place at a rural PACE (Program of All-inclusive Care for the Elderly) facility. PACE is a Medicare/Medicaid program that provides community-based services, with the goal of preventing the need for nursing home or other facility care. The students’ tasks were to determine some of the unmet needs of the participants and to develop a project to help meet those needs. The goal was to design a project that the PACE staff would view as valuable and choose to continue after the students’ assignment was over.
Preparation
To prepare for the assignment, students researched the demographics of the PACE participants. Next, students visited the PACE facility, participated in a staff meeting, and asked facility staff about current activities, the expected amount of physical engagement of the participants, perceived obstacles that might affect participant involvement, and what activities might be most helpful for staff and participants. From this initial staff survey, the students learned that a large percentage of PACE participants had some degree of cognitive decline.
Finally, students conducted informal interviews with a few participants who shared what they enjoy doing, any changes they were looking for, and obstacles that might prevent them from full participation.
Based upon input from PACE staff, student supervisors and participants themselves, the students decided to focus on the patient-centered needs of participants with dementia. They designed a project that emphasized three main components: dementia groups, participant interviews and deliverables.

Each student engaged participants in therapeutic activities related to their own discipline. For example, the speech-language pathology student worked on conversation skills and memory strategies within the context of the physical activity.

Dementia groups
The students led small group activities for participants with cognitive decline. The groups focused on sensory stimulation, storytelling, music with movement, physical activity and current events. Initially, the groups were scheduled daily so participants would more easily adapt to the routine.
The physical therapy student led the physical activities group, taking advantage of unscheduled time in the afternoon when PACE participants waited for their rides home. During this time, student clinicians involved participants in physical activity (kicking or throwing a ball, for example, or hitting a balloon in the air). At the same time, each student engaged participants in therapeutic activities related to their own discipline. For example, the speech-language pathology student worked on conversation skills and memory strategies within the context of the physical activity.
The current events group, co-led by the speech-language and occupational therapy students, took place during Monday coffee time in the dining hall. The students used the weekend newspaper to talk about current events while engaging participants in conversation and orientation tasks.
During their final weeks at PACE, the students identified participants and staff who could continue to lead the groups and worked to transition the group operation. In a follow-up survey, 43 percent of the PACE staff completing the survey reported that they continued using strategies, groups or programs initiated by the student team.
Participant interviews
A memory wall at the facility displays photographs of PACE participants, with information that staff gleaned from interviews with them. But it soon became apparent that no one had interviewed participants with dementia, so the students obtained personal stories from 20 participants who had dementia or who were receiving palliative care. They recorded the interviews and gave a copy to the participants or their families.
The sessions also allowed the speech-language pathology student to strengthen communication support as needed. For example, the student recognized that a participant with severe dysarthria needed an improved communication board and that staff needed training to support conversations using it. In a video-recorded conversation with the participant, the student modeled effective use of the improved board. The students used the video during an in-service they provided.
Deliverables
The student team produced three concrete deliverables.
  • Dementia handbook. The students developed a resource book for the PACE facility that included family-focused information about dementia and therapeutic strategies and activities.

  • Communication book. Students also compiled a binder of communication boards to support communication for people with dementia and other communication disorders. This book was placed in the clinical area for staff to easily access. The SLP provided training to key staff members on how to use the book to support communication.

  • Resources for future students. The students gathered materials to help other students learn to care for participants with dementia and to promote continued interprofessional collaboration.

Meeting and overcoming obstacles along the way improved students’ confidence in contributing meaningfully to interdisciplinary care for dementia.

IPE lessons
The interdisciplinary experience at PACE was successful—but also challenging. It was not always easy, for example, to coordinate schedules and individual interests. However, meeting and overcoming obstacles along the way improved students’ confidence in contributing meaningfully to interdisciplinary care for dementia. More broadly, the team learned to facilitate interprofessional experiences that motivate and inspire future clinicians.
0 Comments
Submit a Comment
Submit A Comment
Name
Comment Title
Comment


This feature is available to Subscribers Only
Sign In or Create an Account ×
FROM THIS ISSUE
November 2016
Volume 21, Issue 11