Dementia is Part of the Mental Health Conversation

In this Summit Pointe Podcast, we look at how dementia fits within behavioral health, why symptoms deserve a thorough medical workup, and how caregivers can find support and tools that protect dignity and safety. 

Summit Pointe board member Sherii Sherban, founder of Miles for Memories, shares resources, including mentoring and a Safe Return program that brings wanderers home.

Episode Resources
Miles for Memories
Careers at Summit Pointe
Summit Pointe First Step

Summit Pointe Podcast 96 is a Livemic Communications production. 

Summit Pointe, the Behavioral Health Authority in Calhoun County, Michigan, is pioneering Community Mental Health Services by developing innovative ideas and community partnerships that lead to high-quality care and a healthy community.

Transcript

Welcome And Show Overview

Richard Piet 0:07

I'm Richard Piet. Welcome back to the Summit Point Podcast. Summit Point, the Behavioral Health Authority in Calhoun County, Michigan. Our episodes are where you get podcasts. Just type it in, Summit Point Point with an E, and you will find them. And we invite you to subscribe to these. We speak as a result of the progress and vast reach of Summit Point in Calhoun County, Battle Creek, and all around the county, the community mental health in our area. We have done about 100 episodes at this point, so have a look. Whether it is by way of where you get podcasts, or perhaps at summitpoint.org where the episodes await you, along with other useful information. You know, sometimes we look at what Summit Point does and we look at the everyday kinds of life-saving things happening at Summit Point, and we come away with some tremendous stories. This particular one maybe goes a little bit beyond what we might have realized, is at least somewhat connected to the notion of behavioral health or mental health. The idea that as we age, there are other perhaps allied ailments or pathways that have to do with mental health in one way or another. That is certainly the case, perhaps, and maybe we didn't think of it, with the notion of dementia. And generally speaking, aging. Sherii Sherban is back with us this time on the Summit Point podcast. You may have been with us a few episodes ago when we talked with Sherii from the perspective, her perspective of being a member of the board of directors. But also, Sherii has some other perspectives, having been the founder of Calhoun County's Miles for Memories Dementia Education and Programming Organization. She's also an adjunct professor at the University of Olivet, teaching coursework like substance abuse and prevention. Sounds familiar with regard to some of our other subjects. First aid and also aging in America. Interesting perspectives from Sherii Sherban, who's back with us now on the Summit Point podcast. Hi, Sherii.

Sherii Sherban 2:30

Oh hi, Richard. Nice to be with you.

Richard Piet 2:32

Thank you for your return. You know, I think when we think about behavioral health or mental health, whatever, whichever word you choose, we tend to be focused on some of the things that are quite prominent in the discussions about the same, the use of substances, recovery, depression, things of that nature. Would you consider dementia to be some kind of connected thing to what we might call mental health?

Sherii Sherban 3:05

Yeah, I definitely would. So when we think about it, we think about the way that the brain functions. And when we're talking about an individual with dementia, there are challenges now in the way that the brain functions, whether it's memory, whether it is activities, whether it's the way of organizing certain things. And the brain can be impacted from a variety of different perspectives. So somebody with vascular dementia, as an example, has probably experienced some sort of vascular vent, maybe such as stroke or had a heart attack. And so there are some damages to processes and dementia becomes one of those risks. You know, you mentioned depression as an example. And we do know as the adult ages, those risks for depression do indeed increase. We also know that as a person ages, their risks for dementia increase. And as we start to look at some of the ways that the body begins to change with age, it helps us to understand why some of these additional chronic conditions begin to become more prevalent over time because the organs don't function as they did when we were 30 or 40. And so we need to adjust to those changes. So what we do know for sure is that an individual with dementia can have an increased risk and often does. There's a higher percentage of individuals with depression at the same time. We also know that depression, depending on the other conditions that are there with it, can also increase a person's risk for dementia. So there is a connection in either direction. Is it definitive in terms of actual statistical numbers right at the moment? There's a lot of different variables that make that number change. So without getting into the clinician side of all of this, it's just important to know that the older that we get, the higher the risk is, very specifically for both of those.

Richard Piet 5:04

And when you're talking about just the general notion of dementia and some of the uh the ways you look at it from the mouse for memories programming standpoint, the community need standpoint, I presume this comes up somewhat regularly. This isn't to say everyone with dementia is depressed or vice versa, but there's some interrelational aspects.

Don’t Fear It, Seek Diagnosis

Sherii Sherban 5:29

Yeah, there are definitely some comorbidities, things that are going on at the same time. So one of the things that becomes really important as part of what we do with mouse for memories is that movement matters, right? Movement matters in a lot of different things we do. Movement matters in terms of reducing our risks. Movement matters in terms of being able to continue, obviously moving, right? And working through a variety of different chronic conditions. But over and above that is when we start to recognize that symptoms seem to be jumping up as it relates to memory and where it's going and the concerns that suddenly a person is now starting to experience. Rather than fear that that might be what it is, we instead, with Mouth for Memories, would encourage you to take the next step towards diagnosis. It could very well be that the symptoms that a person is seeing have absolutely nothing to do with dementia in the first place. It could have a whole lot of other causes. So it could be the use of drugs, it could be diabetes, it could be dehydration, it could be that emotional connection that we're just talking about right now, depression. There's a lot of metabolic situations, malnutrition would be another one that jumps up, sensitivities in terms of what we use as our way of sensing what's happening in the world, such as our vision and or hearing. So challenges with those could cause additional risks. Um, even a tumor would might be one of those things that could be a problem identifying symptoms, making someone feel as if dementia is at the forefront when in reality there is another medical cause. So rather than fearing that it might be dementia, I would encourage you to move forward and find the right diagnosis. Because if it's really a medication interaction, there's a way to change the medications so that those symptoms will be alleviated. It is different than ultimately being diagnosed with some type of dementia. But if a person is, there are other steps that we can take to try to slow down that progression. There are medications we can take that can be supported for a period of time. So don't let fear be the reason why we choose not to take that step.

Richard Piet 7:45

So, what does Miles for Memories do when a community member becomes involved and they're seeking information or some kind of pathway if they fear dementia? This could be one of the first things you talk about as, well, are you sure? Because it may not be. But there are other resources that you try to make available for folks if it is, and they can they can do that. And that's a a resource in the community maybe some of them don't know about.

Miles For Memories Resources

Sherii Sherban 8:16

Right. So there are a couple of different things. We do have a great little booklet that you can get from the website for Mouse for Memories, but on there, in that booklet, it starts to describe several of the different types of tests that they do out there in the world. Sometimes it's a little less scary when you know what it is they're doing and why. And there's even a couple of them where certain parts of it can be done from home. So you can sort of experiment your way through it and go, ooh, I did well on that. And maybe I should be a little less fearful about now moving forward with seeking out medical attention. Other situations, we're going to be looking at the caregiver from their perspective, asking them a variety of different questions to be able to go forward into the next steps. And then more importantly, uh, one of the things that's currently now moving to the next phase of development is the caregiver program in terms of how we help that caregiver now manage what steps need to be taken next.

Richard Piet 9:13

This is a huge part of it because that caregiver family, whomever it is, is along for this ride, and they are feeling a tremendous sense of responsibility for the care of this person whom they love. And this is something that Miles for Memories has recognized. And you've been emphasizing this in some of the programming that you're doing.

Caregivers’ Burden And Support

Sherii Sherban 9:40

Right. Not only that, but it has now started to make others in the community recognize that there is a resource that they can go to when they just need somebody to talk to. All right. I am a strong advocate for support groups, and folks should take advantage of those support groups because it helps to interact with others that are experiencing similar but not necessarily the same kinds of things. But when we get into the development of the mentor program, you have someone who's been a longtime caregiver with someone who's brand new trying to figure their way through that and making the connection between those two individuals is like a light bulb that goes off in terms of there is a path that I can look at now. I there is a sea of hope out there to really follow that through from the caregiver's perspective, you know, not just for the person who is experiencing and living with dementia, but that caregiver needs just as much support in this process as well.

Richard Piet 10:38

Well, and we presume too that that caregiver, the person on whom the responsibility may at least initially fall, we don't presume they have a clean slate, right? I mean, they might be dealing with their own challenges in one way or another. Maybe depression is something for them.

Sherii Sherban 10:55

Yeah.

Richard Piet 10:55

Yeah, we're talking about more things now that complicated a bit.

Sherii Sherban 10:59

And what makes it even more complicating is that the caregiver begins to neglect their own personal needs. So if depression was one of those needs and seeing their physician or clinician on a regular basis was important in that process and appropriate medications for whatever conditions that they're dealing with may subside because they're not taking the time to leave the person that they're caring for in order to also care for themselves.

Richard Piet 11:26

So you've recognized the root causes of, I was about to say, lack of diligence on their own health, but you see why they might want to do it. They feel obligated that this other person's health is more important than theirs, I venture to say.

Sherii Sherban 11:43

Well, they need them.

Richard Piet 11:44

Yes.

Sherii Sherban 11:44

They have made it very clear that they need them in order to really make sure that they're safe, that they get what they need. Somebody needs to be there for them. And, you know, when we start looking at what the caregiver needs happen to be, let's recognize that the caregiver who became the caregiver didn't get any training for this job, right? They didn't go to school for eight years to get a degree to say this is the best way I need to interact with mom or dad because I know this because I learned it. They learned it through that school of living, that school of life, to say, I know that dad won't eat his carrots unless I cook them, or I know that mom won't eat mushed carrots. You know, they don't talk about that in our education degrees, right? Uh, those are living parts of how we care for, how we show love for somebody that matters to us.

Richard Piet 12:35

Well, so this is part of the discussion that may be more resonant for someone listening to the Summit Point podcast. They're here because they may feel an obligation to someone whom they love to see after them in this case of dementia. But maybe depression's for part of it. Maybe they're dealing with their other things. This kind of resource is out there in Calhoun County. Milster Memories has been established in Calhoun County for a number of years. What other things do you do and have you recognized as a key in providing resources?

Mentor And Support Group Model

Sherii Sherban 13:17

Well, one of the greatest concerns that a caregiver has is peace of mind and knowing that their loved one happens to be safe. So one of the first programs that we developed was our safe return program, where the individual with dementia, as well as the caregiver, can wear a bracelet that can identify who the wearer is in an emergent situation. They can not only identify who that person is, once it's scanned, it will also send a notification to the loved one that will tell them what the GPS locations are for them and how they can get to them. This particular device has been successful in returning well over 450 individuals since we began this. So it's not 450 every year, but 450 total. But when you start to think about those 450 individuals didn't get on an ambulance and they didn't have to go to the ER, they didn't have to take up space in the waiting line where someone who is responding to a heart attack may need to have that most emergent care, right? It was really very helpful during the times of COVID when we were trying to keep the folks that were in the emergency rooms, those that really needed that type of care. And if we could identify this person and get them home instead of taking them to the hospital, not only did it keep the workflow easier at the hospital, but it also eliminated costs that didn't need to incur. So we didn't pay for the hospital visit, we didn't pay for all the tests, we didn't pay for the trip on the ambulance. What we did was take them home.

Richard Piet 14:48

And when that was the most necessary thing.

Sherii Sherban 14:50

Right.

Richard Piet 14:51

Yeah, but you can understand this. If someone encounters someone in this position, this is what the normal course of action would have been. They end up at the ER, and that normal course of action is to perform an evaluation. We don't know what's happening with this person.

Sherii Sherban 15:07

Yeah, you do need to figure that all out. You know, there are certain situations where that person may really need medical attention. That's a little bit different. So maybe they eloped when they weren't adequately dressed for the weather, like today, as an example. Exposure to the cold for an extended period of time is a real problem, and they need to make sure that everything's going to be okay.

Safety And The Safe Return Program

Richard Piet 15:26

Yeah, we happen to be talking on a day where it's been single digits, so uh just barely above zero. You can imagine the complication that brings in a scenario you've described. But the technology is incredible. I'm always amazed. This is not the first time you and I have talked about these things, and I'm reminded about them and amazed about them. You heard that right. Technology that actually helps return a person who may have wandered back where they belong without the diversion of a costly visit to the ER. Well, this has been, I think, insightful in terms of understanding the overlap between behavioral health and dementia. And that's important to know. I would also point out at the beginning of the program, we talked about the idea that one of the coursework that you're involved with at the University of Alabas Aging in America, as it relates to Summit Point. You actually are part of the education that goes on with the CIT and educating law enforcement in this program. You're talking to them about aging. What are you focused on there?

Sherii Sherban 16:35

Well, a couple of things. Uh, one of the things we get into are the percentages of aging adults. We talk about some of the conditions that they may come across with an aging adult. We talk about how to approach an aging adult if we're witnessing any of the conditions that we are concerned about. We talk about when it's appropriate to wait for an answer, because that's really important too. You know, you don't want to sneak up from behind them, at least it seems like you're sneaking up. You really want to approach them from the front so that you can have that conversation with them. And by all means, just frankly being patient is so important in this whole process. You know, law enforcement need to understand that adults can also be very curious. And when they start being curious, if you are dealing with someone with dementia, they may not only take time to respond, but they might see the weapon and reach for the weapon because they're curious, not because they're trying to cause problems, as an example. Or they could be fearful of a uniform that might be walking in their direction. It just sort of depends on what they experience when they were younger. So we kind of look at it from all sorts of different directions. The other thing we look at is when we have time, is to do an empathy exercise and look at it from the other side and get a better understanding of why and how that person responds the way that they do. The empathy exercise is always very moving. I no matter what group I'm working with, it could be teenagers and it could be law enforcement. It doesn't matter.

Richard Piet 18:11

Boy, by the way, CIT stands for crisis intervention team. We've done episodes about CIT, a few of them. Invite you to go to summitpoint.org and the CIT page. Those episodes will be there, and you can hear more about that. That's incredible. And you know, sometimes you feel like just a little bit of understanding changes the dynamic of so many things. That's what we're talking about here. And we're talking about it too, with the notion of behavioral health and dementia. Understanding.

Sherii Sherban 18:41

Right? Very much so.

Richard Piet 18:42

Well, I think we've scratched the surface of this at least. And uh, if you're interested certainly in learning more about some of the resources that Sherii mentioned are part of the Miles for Memories universe, do that. In fact, check it out. We'll put the link to uh Miles for Memories in the show notes for this episode so that you're able to click through and learn more. Very insightful, Sherii. Thank you.

Sherii Sherban 19:05

Thank you.

Richard Piet 19:06

Sherii Sherban, member of the Board of Directors at Summit Point and founder of Miles for Memories in Calhoun County, here with us on the Summit Point podcast. Working at Summit Point means you're not just part of a team, you're joining a mission. We make a meaningful difference every day in the lives of those we serve. If you're looking for a workplace where your voice is valued, your growth is supported, and your work has purpose, you've found the right place. Check out the Careers page on the Summit Point website. The link is in the show notes.