History of Dementia Friendly Wyoming

2015–In the Beginning

Dementia Friendly Wyoming’s roots began after the development of Green House Living for Sheridan in 2012, creating a nurturing environment where elders continue their life journey with meaningful engagement and excellent skilled nursing care. 

In 2015 the Green House Board of Directors held as one of their goals to “create a community that focuses on person-centered care for those living with dementia and supports those who care about them through education and advocacy”.   Two board members, Kay Wallick, one of the founders of the Green House, and Wendy Ostlind, Sheridan College nursing instructor, researched national and international initiatives to create dementia friendly communities.  The Center for a Vital Community became involved in moving this initiative forward.  Seven community-wide study groups met over five weeks to assess the need to create a dementia friendly community.  All came together in an Action Forum and identified the following five initiatives to move forward:

  1. Creating a community where people living with dementia feel accepted and understood through county-wide education
  • Front line providers
  • Clubs, churches, organizations
  • Businesses
  • Emergency personnel
  • Medical community
  • Policy makers
  • Law enforcement
  • Neighbors
  1. Planning for Dementia Friendly Physical spaces. 
    Encouraging meaningful activity and social interaction while reducing risks and providing quiet, safe spaces
  • Outdoor facilities
  • Care facilities
  • Businesses
  1. Building a healthcare continuum for dementia needs. Assuring integration of care across health and social services
  • Recruit elder care professionals
  • Provide ongoing education on eldercare and dementia for all healthcare professionals
  • Promote cognitive screenings, especially for early diagnosis
  • Increase and empower CNAs
  • Provide information on dementia prevention
  1. Create support center where those living with dementia and their families can receive initial and ongoing support.
  2. Expanding caregiver support and respite for those caring persons living with dementia
  • Support groups in outlying communities
  • Activities
  • Short break programs
  • Expanded senior companion programs

2016-2020–Grant from Health and Human Services, Administration for Community Living

After six months of working on the initiatives created in the Study Groups through the partnership with Center for a Vital Community, a grant opportunity was presented through Health and Human Services, Administration for Community Living.  A proposal was submitted in the summer of 2016 and awarded in the fall for the Alzheimer’s Disease and Related Dementia Initiative project to expand and significantly strengthen Sheridan County’s dementia capability for individuals living with dementia and their care partners.  This project was called “Dementia Friendly Wyoming” with the intent that successes would spread across Wyoming.

Kay Wallick served as the Program Director for the project for three and one-half years. During this time staff and volunteers increased dementia capability in Sheridan County, Wyoming by improving awareness and decreasing the stigma about dementia; educating and supporting the health care system about the importance of early diagnosis and quality care; and creating services and support for persons living with dementia and their care partners.  The following individuals were an important part of the team making it possible to create a foundation for a sustainable dementia friendly community:

Kay Wallick, Program Director

Heather Comstock, Dementia Care Educator

Jamie Hoeft, Support Center Coordinator

Amanda Lawson, Care Coordinator

Sheree Childers-Cossell, Executive Assistant

Wendy Ostlind, coordinator of Health Care Education

A statewide leadership team and many volunteers also worked to make this possible.

The project began with the hypothesis that the medical and social models work together to develop care plans ensuring persons living with dementia will stay in the community as long as possible.  Meeting this hypothesis depended on the understanding that social, chronic, and mobility issues outside of their dementia diagnosis require referrals to therapists and other outside assistance.   This change in the culture of care is now occurring.  It has far-reaching implications for increasing the life span and quality of life for persons living with dementia as well as the significance of saving state and federal dollars. 

Over 2,000 individuals participated in dementia education targeted to their sector interests. One hundred sixty-one persons living with dementia received service and supports from the social service and health care sectors to help them stay in their community as long as possible.  One hundred sixty-nine care partners received the skills and support to help them care for their loved ones.    We learned that emerging work requires a team of creative and critical thinking individuals with curiosity in place of judgment to evaluate and adjust programs to meet changing community needs.  The development of the Sheridan Community Care Team, with representatives from multiple disciplines, provides guidance and stability for the dementia team, especially during critical transitions.  During the COVID-19 outbreak, the need for mental health support for older adults increased while creating an opportunity for staff to “lean in” to provide additional support and creating unique opportunities for socialization.  The main lesson learned is that it takes time to build community partnerships to change the culture of care for persons living with dementia and their care partners. 

The Sheridan community and the state of Wyoming will continue to benefit from the products developed during this grant.  These include sector educational power points and accompanying information sheets for general and specific education on dementia for continued state and community-wide education:  The health care three-module video training on the importance of  screening and continuum of care provides ongoing training for health care professionals and students.  The Support Center rack cards and the Sheridan Community Care team referral sheet will solidify the referral system throughout Sheridan.   

INTRODUCTION TO FINAL REPORT

The goal of Senior Citizen’s Council d/b/a The Hub on Smith’s Alzheimer’s Disease and Related Dementias (ADRD) Initiative project is to expand and significantly strengthen Sheridan County’s dementia capability for individuals who have ADRD and their caregivers.  This project was called “Dementia Friendly Wyoming” with the intent that successes would spread across Wyoming. 

The Hub on Smith lies in the center of Sheridan County, a rural, neighborly community with individuals and organizations dedicated to supporting each other.  The county, with a population of over 30,000, is quickly growing as a popular retirement community and has a larger older adult population than many locations throughout the State.  Individuals using the Hub’s services and supports increased from 2,800 in 2016 at the beginning of the grant period to over 4,800 last year.  The cause of this increase is due partly to the growing Baby Boomer population as well as the greater awareness and expansion of supportive services built through the Dementia Friendly Wyoming project.  The planning process to support persons living with dementia and their families began a few years before applying for the Administration for Community Living grant.  Working closely with the coordinated leadership of the Center for a Vital Community at Sheridan College, over 100 residents came together to create an action plan.  This plan formed the basis of the ADRD Initiative.  After receipt of the grant, further planning in partnership with Dementia Friendly America initiated interviews with representatives of 11 sectors of the community, completing the planning process.  Partnerships to develop and oversee the project formed with leaders from around the state representing Alzheimer’s Association Wyoming, Wyoming AARP, Wyoming Department of Health Aging Division, Sheridan Veteran’s Affairs Medical System, Wyoming Institute for Disabilities, and Wyoming Center on Aging.

Over the last three and one-half years, the Hub on Smith increased dementia capability by improving awareness, early diagnosis, access to services, and improved quality of care.  The project also focused on screening and support for those with Intellectual Developmental Disabilities (IDD) who are at higher risk of ADRD. 

The first objective was to develop and sustain the foundation for management and oversight, including community assessment, program development, sustainability, and evaluation.  The greatest impact in the community is changing the culture and attitudes of individuals and organizations supporting persons living with dementia and their care partners.  A survey at the end of the grant period of those involved from multiple sectors endorsed this goal.   Eighty-one percent of the respondents implemented dementia-friendly practices, 90% felt more equipped to interact effectively, 96% felt more empathy, and 94% believe Sheridan is friendlier for people with dementia.  Two statewide conferences highlighted services and support for persons living with dementia and their care partners.  Communities around the state are beginning to provide education and are interested in launching other initiatives from Dementia Friendly Wyoming.  However, due to COVID-19 it will take time.  Sustainability for all of the efforts will be essential for the increased population of older adults, along with the increased isolation.   The Hub will work closely with the state and private funders to assure the future of these supports.

The second objective was to provide dementia awareness and education to create a supportive community for those living with dementia and their care partners.  Education for all the sectors (business, civic, legal, financial, first responders and faith) created the foundation for building a dementia capable community in Sheridan.  The 852 individuals receiving this education felt that they had a better understanding of dementia, the ability to begin to recognize the signs and they learned new skills in communicating effectively and had more empathy for families.

The third objective was to provide behavioral symptom management training and support to family and community care partners.  The project’s Dementia Care Educator received certifications in Validation and Positive Approach to Care training, coaching, consulting and engagement.  She provided behavioral symptom management training to 327 family, community, and professional care partners. The impact of behavioral symptom management training through many unique approaches offered family, community, and professional care partners multiple layers of perspectives and built empathy into their roles as care partners. Learning directly from persons living with dementia created a healthier position of understanding. 

The fourth objective was to empower health care providers and care coordinators to use evidence-based diagnostic tools and systems to support individuals at risk of ADRD.  Training was provided to 48 health care providers on the importance of early detection/diagnosis and creating a continuum of care.  One hundred twenty-seven participated in care coordinator training on “Dementia Screening and Care.”  Sixty-one public health nurses attended a Zoom training to learn how to use the Mini-Cog, and they are now using this tool in their LT101 assessments statewide.  Dementia training provided to 116 Sheridan and Gillette College nursing students is now a part of the curriculum for nursing students.  Sheridan Memorial Hospital Internal Medicine incorporated the administration of the Min-Cog into the annual Medicare wellness exam and created a system on the Electronic Medical Record to record the results.  Training on utilizing the NTG-EDSD for screening Persons with Intellectual Developmental Disabilities was provided to 61 Developmental Disabilities providers. 

The fifth and final objective was to create an ADRD support center that provides community outreach, assessments, support, navigation, and supplemental volunteer services for individuals living with ADRD and their care partners.  Eleven couples (persons living with dementia and their care partners) completed the five-week sessions to identify their values and preferences, learn more about the disease, and develop a care plan.  Sixty-four care partners participate in the Benjamin Rose Institute on Aging Care Consultation initiative.  The purpose was to receive ongoing consultation and coaching to support the care partner through their caregiving experience.  Care coordination for persons living alone was provided to 43 individuals over the grant period, ranging from a few meetings to set up services to 2-1/2 years of intensive support.  Ongoing advocacy and coordination of services assured that clients could remain in their homes as long as possible.  Six-month assessments showed that the trajectories for persons living alone with dementia decreased the number of risks over time.   The Friendly Visitor program is one of the greatest assets for persons living alone, providing socialization and connections to the community.  The project created the Sheridan Community Care Team to develop a community-wide assessment and referral process for clients, encouraging referrals to The Hub Support Center.  The Team meets monthly to assist staff with client challenges.  The team includes representatives from the medical, social service, legal, mental health, emergency and financial sectors, creating a forum for the social and medical models of care for persons living with dementia to begin to integrate philosophies and create a holistic approach.   The Support Center has now successfully transitioned to The Hub and is significantly impacting Sheridan, creating a community of support for those living with dementia and their care partners utilizing best practices.