After seeing his daughter, he wept, but after seeing the video message from his son, he laughed.
Either way, it was a gentle reaction from a patient whose severe dementia normally made him prone to aggressive behavior. The man was in the habit of ordering people around and getting upset when his wishes weren’t followed.
The videos are part of a new therapy being used as part of the geriatric behavioral health services offered at Novant Health Thomasville Medical Center.
Each morning, inpatient dementia patients are greeted by the friendly face of their loved one. “We don’t want patients waking up wondering where they are,” said Ben Palombo, a psychiatric mental health nurse practitioner in the unit. “What we want is for the patient to experience less agitation and to administer less medication to patients to keep them calm.”
Palombo came up with the idea after reading about a similar experiment at a New York nursing home. “The videos help reorient the patient with the family,” he said.
Here’s how it works. Family members are given a loose script to follow. It starts with a greeting. The loved one tells the patient where they are, what year it is and what time of year. The patient is told that that the family knows they are at the hospital and that they are being cared for. The loved one tells the patient when they will next be visiting and reminds them that they love him or her.
All the information is recorded on an iPad by team members at the behavioral health unit so that the video can be played to the patient each morning of their stay.
Palombo likens the process to what happens in the movie “50 First Dates,” the 2004 romantic comedy featuring Adam Sandler and Drew Barrymore. In the film, Barrymore develops amnesia following a car accident. As a result, she wakes up each morning returning to the day of the accident. Sandler decides to record a video that she can play each morning, reminding her of the accident and their relationship so she can readjust and resume her day.
The videos help give patients better stays at the facility, and they may actually help reduce the duration of the hospitalization, according to Palombo.
Families of patients have been extremely supportive of the project. “Normally when a patient is admitted to a behavioral health unit, the family is often at the end of their rope, frustrated and stressed,” said Melissa Colón, director of the geriatric behavioral health program at Novant Health Thomasville Medical Center.
“The family wants to be involved in the care of the patient, and this gives them another avenue,” she said.
Patients from all over the state stay at the 45-bed facility, so in some cases families may have to travel four to five hours to visit someone being treated in the behavioral health unit, according to Colón. The video can provide patients with the comfort of a known voice when being there in person may not be possible.
As the disease advances, dementia patients can progress through a series of attitudes, including depression, confusion and aggression, Colón said, and the videos can help at each stage. “Instead of giving them medication, we have this alternative therapy.”
The program started about three months ago. Initially, it began as music therapy using the iPads to play songs of a particular era. Dr. Beverly Jones, medical director of the geriatric program at Thomasville Medical Center, suggested using the devices to play music to match patients’ preferences.
“It’s amazing,” Colón said. “Patients may not know their names, but they know every word of an Elvis Presley song. They can go back in the recess of the mind and you can see the joy it brings them.”
Colón said they are in the process of evaluating these alternative therapies, measuring the patient’s state before and after seeing the videos and hearing music. The plan is to gather the data and release it quarterly.