“The class was The Psychology of Dementia Care, and this was where I learned about ‘person-centered care'”, she explained, “and it made me look at the subject of dementia care in a completely different light.”
The subject resonated with her, and Mehlman decided she wanted to continue studying it when she returned to Bowdoin. This meant teaming up with Assistant Professor of Psychology Hannah Reese to devise her own curriculum. “As a small department in a small college, we don’t have the same range of formal courses that larger universities have,” said Reese. “But independent studies are a wonderful means of allowing a student to explore their own interests in more depth, and in this instance it allowed Julia to integrate a rigorous exploration of the literature on person-centered care with hands-on experience in a person-centered residential care facility.”
The residential home where Julia Mehlman got experience was the Vicarage By The Sea, a long-term dementia care facility in Harpswell, where she began volunteering up to six hours a week in September 2015. The aim of person-centered care, said Mehlman, is to focus on the individual and not the disease. “Instead of using labels, we deal with behaviors that we see,” she said. “It’s really about focusing on the personhood of the person living with dementia, on what they’ve retained rather than what they’ve lost, treating them as individuals and creating a positive social environment.” This approach differs from what she described as the “bio-medical model,” where the focus is on managing behaviors through medication.
Mehlman encountered a range of progression at the Vicarage, and admitted that communicating with the more advanced dementia cases could be a challenge. “Some people are still able to walk around and have conversations, but there are others who are almost non-verbal.” In these cases, she said, you learn to communicate through behaviors rather than words. “Physical touch is huge, hugs, hand-holding, and even people that don’t quite have words will still say things: maybe it’s not totally understandable, but engaging with them and repeating various words is a way to have meaningful interactions.”
Shakespearean analogies notwithstanding, Mehlman balks a little at the notion that caring for advanced dementia sufferers is akin to caring for an infant. “You get that comparison a lot, and on one level it’s understandable. But you should also take a step back and realize that although they have a disease these people have lived entire lives and are not infants.” She also rejected the idea that a dementia diagnosis is almost akin to a death sentence. “The idea that relatives should say goodbye to the person they once knew is so awful; that person may be changing but they’re still a person.”
Mehlman will be hosting a public event, at 1.30 p.m., May 7, at the Curtis Memorial Library in Brunswick, to educate members of the community about person-centered care and how it can be implemented at home.
