UNI house offers a better understanding of dementia


CEDAR FALLS, Iowa (AP) — Five minutes is plenty of time for those trying to live with dementia.

Once-familiar carpeted hallways turn into an unresolved maze. Locating a coffee cup, a feather duster or a book lying around the house seems tedious; remembering what you planned to do with those items is worse.

By altering sight, hearing, and touch, the University of Northern Iowa’s “dementia simulation house” sends people into this world with a higher purpose.

“What we’re trying to do is educate people in the community, so that when people with dementia seek their services, they’ll be a little more understanding,” said UNI professor of gerontology Elaine Eshbaugh. . “Our goal is really to keep people with dementia in the community a little longer.”

The simulation house is operated as part of UNI’s gerontology programme. The field of study attracts an average of 12 students per year who plan to make a career out of working with people much older than them.

Anyone can register online for the free simulation in a three-bedroom Cedar Falls home, complete with family photos on the wall and coffee in the closet. The setting sets it apart from other dementia simulations, in Iowa or elsewhere, which are often smaller in scale and portable.

But the framework is also useful: four out of five people with dementia live in a house, not in an assisted living facility. And the population, which numbers 6.5 million people with Alzheimer’s disease in the United States alone, could more than double by 2050, according to some projections, due to the aging of the baby boomer generation.

Eshbaugh wants the simulation to attract more than people who work in assisted living facilities. Her hope is to educate members of the public who regularly encounter people with dementia, such as those who work at the local dentist’s office or hair salon.

She says that while the average person has 100 “emotional pennies” to spend throughout the day, a person with dementia has 12. And those pennies are spent quickly when a person with dementia is put in a situation – often involuntary – which causes guilt, confusion or physical disturbances. discomfort.


Eshbaugh and other UNI educators want to develop strategies that keep more money in people’s pockets.

So far, they say, it’s working. Before the simulation house soft-opened in February, Eshbaugh wondered if anyone would come.

“And (now) we are just full. All the time,” she said.

Upon entering the house at 8712 University Ave., participants are invited to complete activities they might encounter in everyday life.

Most forget what they were supposed to do. UNI staff stand by, ready to give reminders. But they also give a warning: they will answer as if they have already been questioned dozens of times.

Often, those who undergo the simulation end up walking around the house looking confused in their glasses, headphones, and gloves.

“I think the most important thing I’ve learned is just the importance of giving people grace,” UNI social work major Hannah Kelley said after a simulation recently. “You don’t know what’s going on in their head or with them physically. You can only see what you can see from another person.

Much of the 40-minute simulation is spent sitting on patterned living room couches, debriefing. If it’s confusing for people in the simulation to walk around the house, Eshbaugh pointed out, imagine having dementia and trying to carry on a conversation.

When explaining the memory loss, she said to imagine there’s an older man who keeps packing a bag of clothes, saying he and his wife are going to Nebraska.

But he can’t drive and his wife died 10 years ago. One option is to tell him the truth. But it will rekindle the pain of that reality, only to be forgotten minutes later.

A better option is what Eshbaugh calls “lying therapy,” more commonly known as “validation therapy.” The respondent will play along and redirect the conversation. Something like, “Oh fuck, we forgot to tell you your car is in the store. Could we reschedule for a week?

To have that conversation with anyone with dementia, Eshbaugh said she would start 6 feet away and introduce herself by name. Once recognized, it would move 3 feet.

This is because dementia impairs spatial awareness. Entering someone’s personal space too quickly or indirectly can be shocking; someone’s face may appear to be broken into pieces, like a puzzle that is difficult to put together.

Even a touch on the shoulder in greeting can be alarming, as a brain with dementia struggles to interpret physical touch and texture as it once could.

That’s why a flu shot can feel like a stab in the arm, or nothing at all. The Iowa winter could feel mild against bare skin. Hot tub water may feel lukewarm. A gooey brownie might feel like sandpaper, and a cotton sweatshirt might be constricted and itchy.

Many participants are surprised to learn how much dementia goes beyond memory loss, said Carly Spies, one of the UNI students helping run the simulation.

The 22-year-old, who is pursuing a double major in communication disorders and gerontology, said there is a lot of life to be had after a diagnosis, especially with the right knowledge.

“I think that’s what’s really cool is that people are walking away (from home) with more confidence to help people with dementia,” Spies said.

‘It’s hard to make those years great’: Program prepares young people to care for older generations

UNI senior Olivia Clark said it’s not always easy to watch people experience the simulation. Often, she sees caregivers realizing that they should change their behavior.

“It can be difficult,” Clark, 22, said. “But for the most part, even these difficult conversations are uplifting in a way, because they come together and understand something they didn’t understand before.”

Clark once planned to major in graphic design. Then his grandfather, suffering from Alzheimer’s disease, died last summer.

“My mum has a lot of siblings, and watching a family of seven sail was a bit difficult for me. And that’s when I realized the lack of resources available for the aging population,” she said.

She is now heading into long-term care administration, one of UNI’s gerontology majors. She said it’s hard to listen to people talk about how old they think they are ‘old’ or afraid to spend their final years in assisted living.

“I would like to be part of this change; solve these problems,” she said. “As a society, because we see it that way, it’s hard to make those years great.”

Eshbaugh runs the gerontology program with this in mind. She wants to see the culture move from the “servitude” of the elderly to belonging to a community.

“Because when we just say, ‘You’re here and we’re taking care of you,’ it takes away their sense of purpose and their sense of meaning,” Eshbaugh said.

Much of that culture change must come from training staff who work directly with older populations, she said. Lack of proper education does a disservice to staff – they are unprepared to thrive in their jobs, resulting in staff turnover – as well as to the people they care for.

“If you see different faces inside and out, especially if you have dementia, it’s traumatic and confusing,” she said.

UNI’s gerontology program has awarded 120 majors from 2011 to 2021.

“I’m not focusing on whether my future nursing home administrators can name each part of the brain and how it’s affected by Alzheimer’s disease,” Eshbaugh said. “But they need to know how to interact with someone who has Alzheimer’s disease.”

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