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How To Integrate Faith, Medicine And Dementia Into Your Healthcare Experience

Have you ever wondered how your faith can shape your caregiving journey for a loved one with dementia?

In this latest episode of our Christian Dementia Caregiving Podcast, Dr. Nakeisha Rodgers (, a dual board Internist and Geriatrician, best-selling author, and national speaker from the beautiful island of the Bahamas, shares her unique perspective on caring for person living with dementia.

Her journey from the Bahamas to becoming a dedicated doctor is filled with inspiring anecdotes and practical advice.

Faith in Caregiving

One of the most enlightening aspects is the integration of faith in daily medical practice. Our guest emphasizes the importance of prayer and spiritual support. Before meeting patients, she often prays for wisdom and guidance.

This spiritual preparation helps her offer not just medical but also emotional and spiritual support. For caregivers, this means recognizing the power of faith in providing holistic care.

Beyond the Basics: Personalized Care

While many websites offer standard caregiving tips, our guest delves into personalized care strategies. She highlights the importance of understanding the individual histories of dementia patients. This involves not only their medical history but also their personal stories and emotional triggers. Knowing these details can help caregivers provide more empathetic and effective care.

The Role of Family and Community

Another unique insight is the role of family and community in dementia care. Dr. Rodgers stresses the need for caregivers to build a supportive network.

She shares a touching story of how community involvement, such as organizing arts and crafts sessions at a nursing home, can significantly enhance the well-being of dementia patients.

For caregivers, creating a supportive and engaging environment can make a world of difference.

Practical Tools for Caregivers

They also introduce practical tools that many caregivers might not be aware of. One such tool is the "pill map," designed to manage medications efficiently.

This simple yet effective tool can prevent medication errors and reduce the stress of managing multiple prescriptions. Incorporating such innovative solutions can streamline caregiving tasks and improve patient safety.

Teaching Future Caregivers

Dr. Rodgers' commitment to educating future doctors underscores the importance of a compassionate approach in medical training. She encourages her students to see the person behind the patient, fostering a culture of respect and empathy.
For caregivers, this means advocating for compassionate care and ensuring that medical professionals view their loved ones as individuals with unique needs and histories.

Final Thoughts

Caring for a loved one with dementia is challenging, but incorporating faith, personalized care, and practical tools can make the journey more manageable.

Remember, you are not alone. Building a supportive community and continuously learning new strategies can significantly enhance the caregiving experience.

For more insights and practical tips, tune into our podcast and explore the transformative power of compassionate caregiving.

Listen to the Podcast

Listen to the episode on the player above, click here to download the episode and take it with you or listen anywhere you normally listen to podcasts.

a woman smiling with a woman's face | How To Integrate Faith, Medicine And Dementia Into Your Healthcare Experience

[0:02] Welcome to our newly rebranded Christian Dementia Caregiving Podcast. This is episode 147, and I am really excited to have a very special guest, special in a lot of different ways, but a very special guest who is a geriatrician. And it is doubly special because geriatricians are not very commonly out and about in the medical world. And secondly, Nakeisha is a Christian doctor, which means she's navigating the healthcare system from a Christian worldview, which having been in the healthcare system, I know can be extremely challenging. So I want to thank you, Nakeisha, for your willingness to be on my newly rebranded podcast and spending this time together today. It is a sweet, sweet blessing. Thank you. So why don't you start off and tell us a little bit about yourself and tell us why you got into geriatrics, because I know many physicians do not want to be a geriatrician. I know. Well, first of all, Ms. Lizette, thank you so much for having me. I really appreciate this platform that you are using to amplify our voices.

[1:25] So as you stated before, my name is Nakeisha Rogers. I am from the beautiful islands of the Bahamas. Originally, my story really begins with, you know, living there and going back and forth. But I've always had an interest in in biology. I always love living things and so forth. So when I was in primary school, I went to a primary school called Our Ladies. I had this really amazing teacher. Her name was Barbara Mosley. She's still, you know, around. And she was just really someone that I always remember because she always made me believe in myself and believe that the sky was the limit from the age of six. And I still, you know, think about her to this day. And so when I graduated from that school, I went to this high school. They call it the Big Red Machine. So we are a train is our big logo, but it was called St. Augustine's College. And when I went to St. Augustine's College, I had amazing teachers. I remember like my math teacher, I loved all the subjects, but there was just something about science, really biology that I really enjoyed doing. And I had this teacher there, wonderful teachers, but this one, her name was Ms. Edwards. And she would always call me Ms. Rogers.

[2:37] I was like, why is this lady calling me Miss Rogers? But I kind of figured out eventually she realized that I had a knack for biology and I was always asking questions. But I mean, to speed up, there was just something about science. And I always question, you know, why are these things connected the way they are? And about that same time, around the ninth or 10th grade, I started to really question my faith, you know, as a believer. And I had these two religion teachers and I would just start asking them questions about the Bible and, you know, why is this, you know, why did God say this? And I just had a desire for God's word. And at the time, I mean, being full transparency, I wasn't really going to church a lot. Um, I would have been like 13, 14. So, um, it wasn't a, I mean, my parents were Christians, but we weren't, they weren't forcing me to go to church, which you shouldn't. Um, but around that 13, 14 age, I started to, uh, go around the corner from my home to a church because it was a walking distance. I'd go like every Sunday, I'd go to service. I started talking to the pastor and I just had a desire. I didn't really understand my Bible per se, but I would get the baby Bibles and like read the stories of obviously David and Goliath and go through the Old Testament. And then eventually...

[3:55] I just kept going to that church. And that was really, really a big part of my growth as a Christian when I was 13 or 14. And then more and more at that church, we started to really work with the children there. And we were able, there was another lady, she was a little older than me. And we put together this kids teaching thing. So this after school program for kids there. But I say that to say like that period, like that formative period around the age of all all the way to the 16th is when I really started to have questions about God and my faith. And I was just more curious. And I realized like God became more definitely like important to me. Like it was even when I would study, I would pray. If I would get, you know, stuck about something, I would just say, God, help me, help me. And I saw him just come through in amazing ways. And as I graduated, I had this decision to make like, would I stay in the Bahamas or leave? leave. But, you know, because I had got, I'd been having my relationship with Christ, I was just starting to get more direction. And he put people in my life. I mean, honestly, it was always someone and when I look back at my life, I'm like, yep, that was the person you put to encourage me or guide me. So the decision, you know, that I made after prayer and my parents and so forth

Nakeisha's Journey to Geriatrics

[5:10] was to stay in the Bahamas after we graduated. And I'm glad I did that because I was I was only 16.

[5:19] And So I was super young. I was like, you're not going anywhere. I'm staying here. So I stayed there for two years and did an associates in biology and chemistry. And again, still kept reading my Bible, still kept going to church and so forth. And then the big decision was, okay, what are you going to do now that it is time to, it was 2000 and it was time to make that decision of where I would go. And I remember just definitely being in prayer and talking to different people. But at the end of the day, there was a lady that visited our college in the Bahamas is now the University of the Bahamas, but she visited at a fair once.

[5:58] And there was just something about her spirit that was just so calming and so reassuring. And she was from Nova Scotia. So she came to show about her university. It was called Acadia. And I just gravitated to the booth. And I started talking to her about, you know, what they offered. And of course, the magic words, biology. You know, she's like, yeah, we do biology, chemistry there. So I left the Bahamas in 2000, went to Acadia University.

[6:23] And again as God would have it while I went to that university we had an opportunity to do different things after hours so you know people would go and you know do sports and so forth but you would find me there was a nursing home that was a little down the way from the university and I don't know how it had to be God because I was just walking one afternoon just exploring Nova Scotia and I was like this is a beautiful building and I just went inside knocked on the door introduced myself. And I quickly figured out it was a nursing facility, but they were so kind to me. There were, and I still have their pictures. There were these two ladies and they did the arts and craft and they said, come in, come on in. And so every Friday after classes, I would go and help them with crafts. I'd help the seniors like color, put the crafts out and so forth. And unbeknownst to me, I was actually seeing the elements of, you know, interdisciplinary care, because I would come in in the afternoons, and I would see the nurses doing their rounds, giving the medications, I'd see the physical therapist, the doctors rounding. And so I didn't have the obviously the formative training as a physician. But God was like showing me like little nudges, little pieces, little pieces, exactly.

[7:39] And I just remembered enjoying I love I look forward to Fridays, like, where are you going to nursing home? And I was like, yes, the nursing home. You were an odd little duck girl. Very much so. But it was so much fun. I remember one Easter, I took a friend of mine, because he was a really good singer. He still is. And we still laugh about this. But I took him and two friends to sing for them for Easter. And I was like, oh, my God. And we went around to different rooms and then the arts and craft people let me bring them and sing to the seniors for Easter. But when I look back, I could see God's hand in everything. It was a little bit of this and a little bit of that and all of that.

[8:16] Isn't it amazing that when you know what God's providence really is, you can look back on your life. You cannot see it right in the moment that you're living it. But when you look back, you can say, oh, this was for my good and his glory. And we kind of segue into dementia and dementia caregiving related to that because I think a lot of people forget God's providence in dementia and dementia caregiving. And they feel like it might be a, you know, a punishment or a, you know, they don't necessarily see God's goodness despite dementia. And, you know, that's one of the big things that I'm trying to change for people, because when you come when when somebody is through this whole dementia caregiving journey. Yeah, absolutely.

[9:21] It's been for their sanctification. And you can still see God's providence in dementia. And so, you know, I think your story just reminds me so much that God is in the details. Yes. In all of the details of our life, even though we don't feel it necessarily at that time. Yes. But I love how you could pull out the pieces and the people who were put in your path. Yes. a specific time in a specific place to get you to be a doctor. Yeah. Definitely. Definitely. Yeah. What a culture change going from the Bahamas to Nova Scotia, by the way. I know I was, there were days Miss Lizette when I would walk home from the cafeteria because it was on a hill and I mean, in the snow and I'm like, why here? Why? Why? You know, but, but eventually I enjoyed it. I really enjoyed it. So it was a really good time in my life. But I do note you are not living in. No.

[10:24] It's like enough of the snow. It's good to look at, but it was enough. So after that, tell us a little bit about what you're doing now and how you can incorporate your faith into being a doctor in the medical world. Because I'll use this as an example. I worked in a small hospital in Greenwood, South Carolina. We live in Greenville now, but I was working in Greenwood and there was a Christian physician on staff and I loved working with him and what he would do, you know, in the acute care hospital, he would ask his patients if he could pray with them. And that was how he incorporated his faith. Most people didn't say no. I agree. I would have to agree. So right now I'm in Florida, just a stone's throw away from the Bahamas.

[11:18] But I do the same thing. So I think for me, I think you mentioned that you have a prayer journal. So I keep one as well. And so when I get up in the morning, you know, I definitely have my time set aside where I, you know, I read my scriptures and then I go on my journal and I write down and I'm like, okay, God, you know, this is, this is what my plan is. but, you know, help me to be cognizant of your plan throughout my day.

[11:40] And, you know, before I even go in the rooms, sometimes, you know, before I knock on that door and go in the room, like, okay, God, I need you. Give me the wisdom. I agree with what you said about that doctor. I do ask people, you know, is it okay? And nine times out of 10, I don't think I've ever had anyone say no. Obviously, you know, we don't force it on people, but you listen to the spirits prompting, you know, And sometimes you'll see where somebody is going through something and you've come up with this amazing plan of take this medication, do this, do that, eat this, eat that. But you could see someone's really weighed down. I remember just recently I had someone that came to me. This person just came and said, you know, I lost my son. And, you know, we were just traumatized because she was so excited to come and move here to be with her son. And I think the son died in a car crash. And when she showed up to the to our clinic, she was just really you could just see it. And in my spirit, I sensed it like this. She needs someone, you know, we everybody was giving condolences. But before she left, I asked the nurses, the nurses stepped out. So she and I were left in the room. And I just said I extended my hands. Is it OK if I spend some time praying with you?

[12:50] And she just wept and she just wept. And I could feel the load lifted. And the obedience is so important. Like when the spirit tells you to do it, it's really important to be obedient. The worst they could say is no.

[13:02] And, you know, I just let her weep. And I just prayed over her. And I said, you know, I pray that God would bless you with his strength and letting your family know that he's going to be with you and your family and the grandkids. And she just, she ended up, you know, giving that strength back to me. And she just said, thank you. And we just, it was amazing. But to see God get the glory in that moment, I was really, really good. I think that was better than any pill or medicine we could have given her. Absolutely. You know, because bottom line is, you're a doctor. We know this. None of us are going to make it out of here alive, right? So talking to her about her specific spiritual need right at that moment was way more important than her physical need.

The Power of Prayer in Healthcare

[13:48] Exactly. Yeah. What a blessing that was. Oh, awesome. I wish I had more doctors like you working with me in the hospital. So you mentioned the clinic. Do you work in the hospital or do you mostly work in the clinic? I work mostly in the clinic, but there are times when I'm on the floors as well. And there is definitely when you see people really, really receptive to prayer, because I mean, obviously, it's more acute. There are things that they're going through, sometimes they have no one to visit them. And then there's times when people, you know, they may act out or they may seem frustrated with staff or they may lash out. And if you go in that in your own flesh, you know, you're willing to lash back. But I mean, what will that accomplish? So it's really important to remember, like, you know, I don't know what this person is going through. I'm not a bad laying here sick and I can't move. So imagine that. So when you go in that room with Lord, just make me a servant. Help me to put myself in their shoes. It just kind of it gives them they could feel the love. People get people can tell. You can't. Absolutely. One of the I don't know if you're familiar with Dave Ramsey. So Dave Ramsey has this thing when somebody asks you how are you doing that you answer better than I deserve and as a occupational therapist when I was working with.

[15:06] Patients, when they would ask me how I'm doing, I would always, always answer better than I deserve. And what I found very early on in using that it was a very easy screening tool for me to see where the person's heart was, as to which way the conversations would ultimately go. And what I found fascinating, you know, this is subjective, it's not data driven. But when I had good experiences, and you know, the person really benefited, I'm not saying unbelievers didn't benefit from what I did, and worked with them on, but there was a different connection with true believers. And in the home health arena, when I started working in home health, it would not take me more than 10 minutes of being in somebody's home yeah where their heart is yes and you can see the evidence i mean you can oh absolutely i'll see you in the home and so forth so and it just changes the dynamic i think people receive the treatment better they trust you because you have a common

Teaching Future Physicians

[16:14] ground yeah for sure for sure so um i know one of the things that you do is you teach. I do. And I love that. That was one of the biggest things why that's part of the reason I have the platform I'm building is because I can multiply myself.

[16:32] Yes. By using a larger platform. And that was why I taught OT students because, you know, I can only see one person at at a time. So my sense is that that's one of the reasons why you teach. Tell us a little bit about what it is that you're trying to accomplish through investing a lot of time and effort into upcoming physicians.

[17:00] Yeah, I think with them, it's, you see, when they come in, they come in so excited, and they come in, you know, oh, my gosh, I want to go see patients, I want to do that. And the thing is the system and different things can change you with time. With time, people can go from that amazing experience to just a number. I've seen it happen. I've seen it happen at colleagues. I've seen burnt out. I've seen it. I get it. So my job is just to keep that excitement for them to realize that this is an honor. This is a privilege. You don't take this for granted. You know, you didn't have to come here, but, you know, God made a way for you to be selected to get into a program. And there's thousands of people that don't get selected every, every March when we do our process. I think for me, they're different faiths, of course. So, and they could see, I mean, I don't have to go around preaching, but I think just showing them how to love on people and just trying to treat everybody with respect you know I try to tell them to not get into that that system where we make um we marginalize people in our comments there it's easy for them to hear you know and I'll just be transparent like sometimes people that have been around longer in the system will make certain comments about certain nationalities or for sure I'll say oh this person is always a bounce back this person is a frequent flyer and And I'm like, boomerang patient.

[18:24] Exactly. None. You want to know what my, my compliant, right? Compliant. Exactly. And, and obviously I get it, but if we, if we keep doing that, then we, we treat people differently for no reason. And we don't know people's stories. You don't know what that person has to go through when they leave. They may not have any food. That's why they're coming to the emergency room. So I tell them, I try to teach them like, you're the, this, this person's coming to you for something, whether that be, you know, medicine treatment, but you can give them hope and you can do it in a dignified way. And I try to teach them like, what if that were your mom? Like if, if they don't return a phone call for someone's medications, they may think, oh, it was just, I'll do it tomorrow. And I'm like, no, what if that was your mom calling your 70 year old mother or your grandmother calling for that blood pressure medication?

[19:10] And they like, oh, that's true. I would want my grandmother to get it. So I've always trying to teach them. You're like, Like as the Bible says,

Understanding Challenging Behaviors in Dementia

[19:16] do to others as you'd want them done to you or your family members. So what I really find fascinating about what you just said is you are actually using a lot of the techniques to communicate with your students that family caregivers need to effectively communicate with a person with dementia. Dementia because when people come you know and and your patients when somebody's going to the emergency room yes it's not always an emergency no there are there aren't like you said i'm i'm hungry i'm cold this is a safe haven yeah teaching those students to to look at the bigger picture exactly and how to communicate with another human like one of my biggest pet peeves in the dementia a caregiving economy system is the words challenging behaviors. And I always use the inverted commas, challenging behaviors, because that's the medical model. That's what, what.

[20:21] The medical model in society and so on have used to classify. And I, I understand why, because we need a word to describe what we're seeing. But those challenging behaviors are always challenging to whom? Exactly. It's challenging to me, the person who's dealing with the behavior, right? But in essence, these are just normal human behaviors that are magnified. I like to think of them as just the unmet needs. They're trying to communicate with you. Exactly. You know, and there is a reality that certain of these things that happen are absolutely 100% direct results of the change in the brain. I get it. Yeah hallucinations is one of those definitely you know there's there's there's certain things that it's just because of the physical change in the brain but for the most part it is because i can't let you know what i need anymore yeah that's hard that's it is both sides.

[21:36] There's there's a um a movie many many years ago and i forgot the name of the movie Of course, now I'm not going to remember it, but in essence, it happened in France. I don't know if you've ever heard the story. He was an editor to a big magazine. I want to say Vogue. And he was driving with his 14 or 13 year old son or daughter when he had a massive stroke. And the child was able to get the car off of the side of the road. But the gentleman had the type of stroke that caused locked in syndrome oh gosh okay and he wrote this book oh it's um the diving bell and the butterfly okay you need to go look it up it's a fascinating book he wrote a book using eye blinks with a speech language pathologist yeah who who came up with a system of frequency of letters yeah not the alphabet but the frequency of letters And she would just run through the frequency. And when it was the right letter, he would blink. And letter by letter, they wrote it down. And it's a very powerful book to read. But he also lost the ability to communicate with people.

[22:53] You know, and so cognitively, he was 100% intact. Yeah. He had no physical ability to move anymore. Right. Yeah. And so the reason for the book, The Diving Bell and the Butterfly was when when the weight of the world was on him, he was in the diving bell, you know, all of the weight was pushing on him. But then he used his imagination to be the butterfly. Yeah. And to leave. So if you haven't ever read the book or watched the movie, it's actually a very powerful as a healthcare provider, it was a very powerful book to read, because he could tell us what he was feeling. You know, a person with dementia cannot tell us what they're experiencing.

[23:38] It's a really good analogy. Yeah, it is. It's very, very good.

Free Workshop Announcement: Avoiding Challenging Behaviors

[23:43] Did you know that caring for a person with dementia doesn't have to be this hard? If you are struggling and you would like to join our next free workshop, the topic of the workshop is three tips how to avoid challenging dementia behaviors without stress, anxiety, or burnout. out. I invite you to walk away with science-backed dementia caregiving skills that many professionals don't even know after attending this free workshop on Saturday. If you'd like to register, sister, message me the word workshop on Instagram or check out the link in the show notes below.

[24:41] So tell people a little bit about how you serve family caregivers, because you're a super busy woman because you work in a hospital. You take care of training up new doctors, obviously taking care of yourself.

Supporting Family Caregivers

[24:55] But I also know that you work with family caregivers.

[24:58] So tell people a little bit about what that looks like. Sure. So my parents are in their 80s, very sassy still. And so I have we did a book in 2022 called the secrets of sassy savvy seniors like say that really fast and so based on the the way that book turned out I turned that book into a course and so that course is an online five module course that we do with caregivers and basically my goal is really to help caregivers get the tools they need to you know decide if they need if they need someone like me. And if they don't decide to get a geriatrician, I try to teach families how to spot the right doctor for them. There's, I give you the tools that I use to pick my parents' doctors, because as doctors, there's things that we look for. So I teach them, you know, what to look for in the, to see if you're a good fit, like what should your doctor be doing? Then we also in the second module go over once you've selected the right doctor, how to make that visit count. because you know, you only have like 20 minutes on a good day, 30 minutes. And so I find the patients and the families who really are prepared, and they know what to ask, they know how to really use and maximize that time efficiently. I have one patient, she's so trained right now with the system that you know, she knows she has her notebook, and we have the questions pre prepped. And that saves the doctor a lot of time and allow questions to be answered. And then, you.

[26:25] Once we go over, you know, pick the right doctor for you, how to maximize the time, then we figure out what is normal aging, because a lot of people are embarking on careers in dealing with people over 65. But sometimes we tend to, it goes vice versa, we'll tend to think a symptom is a part of getting older, or likewise, we'll think that something that is really dangerous is supposed to be happening. And it's like, you have to know the difference. So we go over like what's normal aging and then what's like, no, mom shouldn't be doing this or my uncle shouldn't be doing that. And then once we've done that, my favorite is everybody's favorite. We love to be in the comfort of our homes. So my parents are like, my father is a homebody, loves to be home. He was just over here for a while. I got to get back to the Bahamas. But our goal is to keep people out of the emergency room. I came down here I worked in Virginia and that was a big a big force of what we did trying to innovate think of creative ways what are what are we doing that is landing this patient back into the emergency room so we go over with families the things to look out for how to spot an emergency what to do how to have your plan together how your doctor and the staff can help you get keep that person home in the comfort of their home because sometimes a lot of people didn't know oh I could have called, I could have done this, I could have done that when they were traveling, I should have had a plan. So we go over all those different scenarios.

[27:51] And then I just like I said, I love teaching, I love hearing from people. So the goal is to get through the modules, we do live sessions, and we kind of we do scenarios as well. So that's what we're doing for caregivers. That is wonderful. You've mentioned so many things that I want to touch on. I did an interview overview earlier this year. It was episode 80. Okay. And it's called for people who want to go back and listen. It's called how one tool prevented medication errors in dementia caregiving. Her name is Kimber Westmore. And she started a product called pill map.

[28:26] Ah, have you ever heard of it, Nakeisha? I've heard of it briefly. Can you tell me a little bit more about it? So what it is, in essence, it's word with bubbles in, you can close and you can put the person's pill actually Oh, yeah. But it's specifically designed for you to be able to keep, take to the doctor. Yeah. Put them in like... For a person to know and be able to identify their medication. Yeah. Also have all of their emergency contacts on go to the, if you go to the ER, you can instead of grabbing a bag full of medication, you can grab this one sheet that has everything on it. It's a really, really good product. I will link you up with Kimber because I think for sure, you know, it's less than 15 bucks and it can significantly cut back on people's time and effort. You know, when you go to the doctor and you carry a bag full of medication, which is what you're supposed to do.

[29:24] You're supposed to do that. But how many people do that? You know, that would be an opportunity. But I love the mission of trying to keep people out of the emergency room. Yeah. Yeah, definitely. Because I tell my students all the time to like, this is a war zone. So I have them going in there when they go and do those ward rounds. Like, listen, our goal is to, you know, obviously, most, you know, hospitalizations will be justified. But even once that person is admitted, they know when they work with Dr. Rogers, yep, she's going to have us we physically are getting people out of the beds. Because I'm saying we're not waiting to wait. They're like, you know, we can wait for the physical therapist. this to a new, so they're, the seniors don't know.

[30:08] They go and they open those blinds. We get people up, you know, we're, as we're talking to them, we're, you know, helping them get their, their food. We're feeding them. I'm like, no, that tray, if that tray's there, she won't remember to drink from that tray. So at least while we're doing the rounds, you know, feed her, help her. And so do these little nuanced things. And the students are like, that's true, Dr. Rogers. I didn't think about that. I'm like, there's things that we have to, we have to think outside of the model to provide the seniors with the care they deserve. And, you know, you and I would have worked so well together in the hospital. Oh, I have driven you nuts.

[30:46] I would have been the one coming to saying, Dr. Rogers, this person has this, this, and this, and this. Doctors like that were always a joy to work with. There are two types of doctors. Yeah. Doctors like you who see the world in a different lens and recognize and see the role of all of the players. Yes. In the system. You can't do everything. Oh, wow. And then the doctors that believe that because just based on title and education, they know more than you have never done significantly well with the latter. I'll never forget one day. Doctors used to scare me. They don't anymore. But one day when I was a young and dumb therapist, you know, they used to scare me. But then when one day I'm like, you know what? Yeah. I'm like legitimately, I'm old enough to be your parent.

[31:47] And you just said something really dumb. It would go through, you know, goes through my mind. I had a doctor one day tell me the patient had balanced deficits and that's why they're falling. And I looked at the doctor. I'm like, they're falling because they have cognitive deficits. And he's like, but how does that relate? I'm like, he's making stupid decisions and trying to sit down on a chair that's 10 feet away. Yeah.

[32:16] He had no balance deficits. It wasn't balance. It was cognition. And the doctor never saw it. I'm like, you will one day, but it's teamwork, like you said. And I think one of the things we try to teach, I try to teach the students also is to everybody's valuable, you know, in the clinic, you guys won't get patients. And if you, if you don't learn how the front desk works, you won't have any patients to learn from. So everybody in the team brings something to the table. you're the one that's like the quarterback. So you're going to coordinate everything, but you need all your players helping you. Right. And ultimately, it is up to the doctor to make that final decision related to a diagnosis.

[32:58] Yeah, they're not open to hearing from the family or the therapist or the sibling of the person. If they're not open to hearing that information, they're never going to be a

Cognitive Assessments in Dementia Diagnosis

[33:12] truly effective care provider for the person who is living with dementia. So totally curious out of, this is now professional curiosity, but in your practice, what cognitive assessments do you use to help diagnose or at least start to narrow the gap related to dementia and dementia caregiving? Oh, sure. So I mean, the simple screen that we'll do is just your basic mini cog. And I have to a lot of the patients like, yeah, Dr. Rogers, I know that's coming. So I have to switch it up a little bit. But we the first thing I do is always, you know, take a collateral history. So before we do any screens, it's important to talk to the family, look at the time period that we're dealing with, you know, if you're thinking something that's happening a change in like eight weeks or less, you're thinking more of like an encephalitis or another differential. So one of the things I always do is get a timeline, do a proper history. So before we do any screens, the history is key. And we look at different questions, you know, family history. Have you played sports in high school? Were you in any car accidents?

[34:22] What's your literacy level like? What age did you, you know, finish high school? So those are the basic things we'll do in the history. We also look for risk factors in that history. So, you know, I'm looking for my person that has the uncontrolled diabetes or we're looking for, you know, vitamin deficiencies like B12 and symptoms of that. So the history is where we definitely start off. And also speaking to the family. I can't tell you how many times, you know, a lot of times people with cognitive challenges may be blissfully unaware and they can fool you. You know, I've had students come back and say, no, Dr. Rogers, no, there's no way she's she looks she's talking to me. I'm like, yeah, but dig deeper, sit in there deeper and speak to the family. And when they call the daughter, oh, yeah, mom has been doing this for like months. You know, she's been, you know, misplacing those keys. And I had to take the keys from her because the car is scratched up. And so they're like, oh, my gosh, it's like two different stories, as I told you.

[35:19] So a quick last couple of questions. Have you ever used the brief cognitive assessment test? I use I start off with the basic mini cog. We'll use the slums from St. Louis University. We'll do that.

[35:34] And then sometimes we have an 88 of Alzheimer's, dementia, eight rating scale, a screening scale that we'll use as well. Once we've done those basic assessments, we'll get our scores. And then we also make sure that we offer a PHQ-9 because we want depression to be, you know, masking is that. Sure. And then for a lot of my older ones, I'll also use my GDS, my geriatric depression screen because I don't want the influence of you know physical factors we do the screens for the cognition we do the screens for the mood and anxiety and then once we've done those screens we'll do a battery of basic tests we'll check people's electrolyte levels their levels their thyroid make sure there's nothing physically going on exactly Exactly. Exactly. And then we'll do some sort of imaging of the brain, typically CAT scan or an MRI of the brain at the very least. Now I tell my kids, they hate when I call them, my kids are like, we're adults, but you're my kids. They're your kids. They'll always be your kids. Yeah. So I tell them, cause we've had, you know, I can think of a guy that was an IT engineer and obviously would come through those screens with flying colors. So for someone like that, would they get neuropsych testing? And so they'll come and spend the entire day. And that's a little bit more. We could get more. Yeah, for sure. But what I really wanted the family caregivers to hear is understanding.

[37:01] Your thought processes of where to start, because a lot of people will go to their doctor and the doctor will tell them it's normal aging. So what I want family caregivers to hear from our conversation today is if their scientific part of their body, in other words, their gut, yeah, them something is wrong. Yeah, something is wrong. And they need to follow up. And if If their physician is not doing it, you need to find another doctor. Hence the module that I told you, choosing the right doctor for you. And then my sister is an amazing advocate. And I find, again, the patients that do well are the patients who are advocates or they have those caregivers. And there's a way to advocate. So you don't want to ruffle too many feathers and so forth. But there's a way to respectfully voice your opinion. opinion and typically the the doctor that's really you know like me I'm excited when you know patients bring me or their families bring me information I'm like definitely I didn't consider that let me look into that well bottom line is it cuts down your work really definitely definitely and so when they're involved and they're you know bringing things to the forefront that I may have missed that's a that's a gem you're looking for family members like that that's a gem so Nakeisha , if somebody wanted to actually get your course, because I'm very excited about your course, where do they go to find that?

Discovering Secrets of Sassy Savvy Caregivers

[38:29] Oh, yeah. So on any of our social media platforms, LinkedIn, Facebook, Instagram and so forth, we normally have a barcode you're able to click on and it'll take you to the secrets of Sassy Savvy Caregivers. Oh, I love it. I'm going to go check it out. Any last final words before we close off today?

[38:51] First of all, I just want to say thank you for what you're doing. I think that a lot of people are going to be blessed by giving a voice to our faith. I think so many times, especially right now in the society we live in, we tend to have to feel like we have to dim our faith or we have to be careful in what we say and so forth. But I think we have to you have to be an ambassador. And if people if we don't speak up, then other people speak louder than us. So I think, you know, just given a platform that you're using to let people know that there is a beauty in bringing your faith to the care of dementia, I think is amazing. Thank you for having me. Thank you so much. I really, really appreciate your time today. And I look forward to seeing you again in the future. Yes, definitely. Thank you so much.

Lizette as a family caregiver

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About the author

“Think Different” Dementia’s owner, Lizette Cloete, OTR/L graduated as an Occupational Therapist from the University of Pretoria in South Africa in 1992. Lizette has almost 30 years of experience as an Occupational Therapist in a variety of settings, the latest being in the home health environment. She enjoys teaching on the topic of dementia, most recently presenting at a national conference on the topic “Dementia Made Simple”.

Disclaimer: These blogs, videos and any work done by Lizette Cloete OT, as a Member of Think Different Dementia, LLC, is given only as educational content and consulting work. This does not create an Occupational Therapist-Patient Relationship. The educational content and consulting work performed should not be considered medical treatment as an Occupational Therapist. The consulting work does not take the place of medical work normally performed by a licensed Occupational Therapist. Please consult a licensed Occupational Therapist for medical advice.

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