Research shows that apathy is a significant challenge for people living with dementia. They lose the ability to take initiative, which has an enormous effect on their emotional and physical wellbeing. This makes the disorder much harder to treat.

THE PROBLEM

Andrus on Hudson, based in Hastings-on-Hudson, New York, serves and cares for individuals ("residents," to reflect the environment in which they receive care) who have various types of dementia. One of the primary challenges caregivers and residents face are negative behaviors that occur when there are downtimes during the day and/or the sundown window.

These negative behaviors include agitation and wandering. While AOH uses best practices to provide care to these residents, such as responding to those negative behaviors, it's important for caregivers to expand the "tool kit" for this special population, said Andruette "Kerry" Beckford, RN, director of nursing at AOH.

"In addition to robust recreational therapy programming, tools within the tool kit are effective, but should be used in moderation, such as having residents watch TV or similar approaches to help reduce negative behavior," she explained. "However, these do not always fully engage the resident."

PROPOSAL

To help with the challenge, AOH turned to Netherlands-based Tover, a healthcare technology company that focuses on people facing cognitive challenges that include dementia and intellectual disabilities. Tover markets the Tovertafel, a gaming table for individuals with cognitive disabilities.

"The technology also has helped with states of apathy, which negatively influences physical, cognitive and emotional wellbeing."

Andruette "Kerry" Beckford, RN, Andrus on Hudson

"When the Tovertafel came to our attention, there was a positive perception from the care team," Beckford recalled. "As such, they wanted to see it in action to gauge its true effectiveness and the practicality of using it with residents on a regular basis."

MEETING THE CHALLENGE

AOH set up the Tovertafel on its memory care floor to expand the toolkit of resources for caregivers. The setup was relatively easy and the rollout of the technology for the IT and maintenance team was streamlined with few challenges, Beckford reported.

"This helped to ensure the Tovertafel was implemented in a thoughtful manner and geared toward those residents who we believed would benefit most from the technology," she said.

"There were scheduled times for residents to experience the Tovertafel with the care team – and from the very beginning the technology was a success," she continued. "The residents using it were engaged and participating in positive ways that the care team did not anticipate."

Some residents who were less inclined to be engaged were participating using their hands and providing positive verbal feedback. Perhaps most important, some of the residents clearly displayed lower levels of agitation at times when they were more likely to, as they remained immersed in the programs.

Over time, AOH has expanded its use of Tover to other non-memory care floors and has experienced similar positive feedback in terms of engagement and depth of immersion in the programs.

RESULTS

It still is early for quantitative data on the health outcomes, but Beckford offers a synopsis of the technology's impact on her residents.

"We initially ordered one Tovertafel for our memory care floor, but quickly realized all our residents would enjoy and benefit from the games," she recalled. "Therefore, we purchased a Tovertafel for each floor, bringing this to four in total.

"The technology also has helped with states of apathy, which negatively influences physical, cognitive and emotional wellbeing," she concluded. "Our residents are moving more when sitting at the table, able to stretch further than they typically would or believed they could, and report feeling more social and happy and less fearful and sad during the day."

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