The “WE” in Awakenings is essential. Successfully reducing antipsychotics occurs because care professionals, physician and pharmacy partners, the person with Alzheimer’s or related dementias and their loved ones are sharing and using collective insights, talents and skills to focus on what is best for the person. It is this human collaboration, compassion and creativity that create a new norm in care that empowers and honors people with Alzheimer’s and related dementias. Awakenings includes 4 key parts:
- Health Discovery: A review of medical history informs caregivers’ discussions with the physician and pharmacist. It probes questions such as: What medications are being used and why? What side effects have occurred? Do these medications carry high-risks for older adults? Have other underlying conditions been resolved, such as seasonal allergies? Answers to these and other questions help shape the care plan strategy.
- Personal Discovery: The care team goes beyond the medical chart to form a vivid biographical picture of who this person entrusted in their care is. They seek information on key events in his or her life (good and bad); the person’s recreational, familial, vocational, intellectual, and spiritual passions and interests; and other elements that make up who this person uniquely is.
- Care Strategy: The Awakenings care strategy plan is coordinated with the physician and shaped by the health and personal discovery work, and insights learned from other care experiences. Every member of the care team (including family members and other non-nurses) receives the plan and contributes to it with their observations and interactions as it is implemented.
- Implementation, Observation, Assessment: Implementation includes a parallel integration of medication monitoring/tapering in coordination with the physician and non-pharmaceutical care techniques associated with one or more of a person’s 5 senses. Examples can include but are not limited to storytelling, reminiscing, massage, aromatherapy, music, art, and pet therapy, cooking, and physical exercise. Behavioral symptoms, care responses and observations are logged and tracked to identify patterns, behavioral “triggers,” new insights, and positive or negative responses that help determine changes in the care plan.