9/23/2019 Crisis Conference Presentation Laurie Kohler, LCSW Waukesha County APS Dinah LaCaze, APSW Milwaukee County Elder Abuse Chad Stiles, BS, RN, CCEMT-P, EMT-T 1 Learning Objectives: • Learn about how the New State Plan for Alzheimer’s Disease and Related Dementias will address Statewide Response to Persons with Dementia. • Learn about the development of training tools for law enforcement personnel, including the development of an Advanced CIT for Dementia Crisis Response. • Learn about various training tools for crisis personnel and others providing care and services to persons with Dementia. 2 • Status Across State • Who serves this population Dementia in • Statement of problems…. As related to WI crisis intervention • Goal of Responding to a Person with Dementia in Crisis 3 1
9/23/2019 Brief History of Dementia Related Initiatives Handcuffed Report Helen EF Decision Dementia Care Survey in 2017 Dementia State Plan Redesign (first 5 (current) 2010 2012 years) Outcomes 4 HISTORY OF DEMENTIA CARE SYSTEM REDESIGN 2013 Summit | Two-year Plan | Implementation and Accomplishments 5 Accomplishments... From the First State Plan • Dementia Friendly Communities – Dementia Cafes • Dementia Care Specialist Program (ADRCs) 26 Counties, 3 tribes • Early Identification and Screening (community based screening) • Outreach and Training Initiatives • Music and Memory Programs • Crisis Innovation Grants 6 2
9/23/2019 7 NINE GOALS AND 38 STRATEGIES CARE IN THE COMMUNITY HEALTH CARE FACILITY-BASED CARE CRISIS RESPONSE FOR PEOPLE WITH DEMENTIA 8 CARE IN THE COMMUNITY GOALS 1–2 | Wisconsin Dementia State Plan Goals and Strategies| 2019–2023 9 3
9/23/2019 INCREASE UNDERSTANDING AND REDUCE STIGMA • Tools and materials • Public awareness campaign • Dementia-friendly communities • Brain health education 10 IMPROVE CAREGIVER SUPPORT AND EDUCATION • Caregiver focus groups • Support groups and peer mentoring • Respite care • Aging and disability resource center dementia care specialists • Employers 11 HEALTH CARE GOALS 3–4 | Wisconsin Dementia State Plan Goals and Strategies | 2019–2023 12 4
9/23/2019 TIMELY AND ACCURATE DIAGNOSIS • Clinical training and educational materials on diagnosis and management • Incentives for diagnosis • Education across health care workforce • Materials and access to resources for patients 9 13 DEMENTIA-CAPABLE HEALTH SYSTEMS • Value of dementia capability • Role-specific tools • Competence of health care professionals • Incentives for best practices 10 14 FACILITY-BASED CARE GOALS 7–9 | Wisconsin Dementia State Plan Goals and Strategies| 2019–2023 15 15 5
9/23/2019 CONSISTENT, HIGH-QUALITY, APPROPRIATE CARE • Standards of practice • Training and support • Consumer information for informed decisions • Wisconsin Coalition for Collaborative Excellence in Assisted Living 16 16 WORKFORCE • Health care charter schools • Middle and high school career options • Secondary education • Coordination for long-term care career development 17 17 REIMBURSEMENT • Reimbursement models to include dementia-related costs • Reimburse for quality (standards and expertise) • Bed holds for continuity • Program screening and rates reflect dementia 18 18 6
9/23/2019 CRISIS RESPONSE FOR PEOPLE WITH DEMENTIA GOALS 5–6 | Wisconsin Dementia State Plan Goals and Strategies| 2019–2023 12 19 KNOWLEDGE AND COMPETENCY OF CRISIS RESPONSE • Educational materials, protocols, tools • Law enforcement and first responders • Local resource database and referral system • County adult protective services and crisis teams 13 20 UNIFORM SYSTEM OF DEMENTIA CRISIS RESPONSE • Statutory and regulatory clarification or changes • Best practices • Protocols • Infrastructure 14 21 7
9/23/2019 Current Wisconsin Dementia State Plan Steering Communication Leadership Committee Workgroup workgroups Provides: • Website • Sub-groups • Structure • Communication • Four Focus Flow Areas • Oversight • Direction 22 Group Work 1. How are you serving people with dementia in crisis successfully in your community? 2. What are the biggest challenges to the success you identified? 3. What resources are you currently using? 4. What additional resources would be beneficial to improving the system of care? 23 • Crisis Intervention Team (CIT) is a community initiative designed to improve the outcomes of police interactions with people living with mental illness. • Crisis Intervention Partner (CIP)training initiatives are partnerships between law enforcement, mental health providers, local NAMI and other community stakeholders. 24 8
9/23/2019 CIT Video Clip • https://youtu.be/-net9xEotXc • https://www.youtube.com/watch?v=- lYCwQ88-LE 25 Source: NAMIWisconsin.org/Cit-Cip 26 Crisis Intervention Team Training (CIT) Required Major Mental Illness Overview- can include medications or have as a separate topic Special Populations Topics such as: Veterans and PTSD, Adolescents and Youth, Elderly including Dementia, Developmental Disabilities and Autism Spectrum CIT & CIP Core Excited Delirium and Medical Emergencies Lived Experience/Family Panel Agenda Topics Site visits/Ride Alongs or Interactive Agency Panel Hearing Voices Stimulation Trauma Informed Care (including ACE) Taking Care of Our Own presentation (Chris Prohut) De-escalation Overview and Techniques 27 9
9/23/2019 History of CIT Suicide Preventions-QPR or other course Legal Update/ED/Policy and Procedures Police Perspective of CIT Cultural Competency (stigma, race, LGBTQ) Recommended Local NAMI Affiliate Overview Community Resources and Additional Mental Health Services in Wisconsin Topics to Stigmatizing Behaviors and Language Include Community Treatment Alternatives Procedures/Alternatives to bed shortage The topics listed above are modeled after the recognized best practices of the Memphis Model and follow the Wisconsin state standards of CIT trainings overseen by the WI CIT Advisory Committee. Please note, the subject matter is intended to be taught by community partners and professionals who specialize in these specific topic areas. 28 Sample CIT Training Agenda 29 Required: Major Mental Illness Overview- can include medications or have as a separate topic Special Populations Topics such as: Veterans and PTSD, Crisis Adolescents and Youth, Elderly including Dementia, Developmental Disabilities and Autism Spectrum Intervention Excited Delirium and Medical Emergencies Partner Training Lived Experience/Family Panel Hearing Voices Simulation (CIP) Trauma Informed Care (Including ACE) De-escalation Overview and Techniques 30 10
9/23/2019 History of CIT/CIP Case Studies/De-escalation Scenario Videos Suicide Preventions-QPR or other course Cultural Competency (stigma, race, LGBTQ) Recommended Local NAMI Affiliate Overview Community Resources and Additional Mental Health Services in Wisconsin Topics to Stigmatizing Behaviors and Language Community Treatment and Alternatives Include The topics listed above are modeled after the recognized best practices of the Memphis Model and follow the Wisconsin state standards of CIT trainings overseen by the WI CIT Advisory Committee. Please note, the subject matter is intended to be taught by community partners and professionals who specialize in these specific topic areas. 31 CIT for Responding to persons with Dementia Why is it Why is it being needed? considered? 32 Proposed Advanced Curricula for CIT What is Dementia Building Community Partnerships Other Helpful Topics Stages of Dementia ADRC – Dementia Care Specialists (DCS) Information on the Ombudsman program Virtual Dementia Tour (VDT) APS / Elder Abuse • A description of the requirements under Olmstead Challenging Behaviors Crisis • Discussing how to deal with the mandatory Types of Dementia Long Term Care (MCO’s), IRIS arrest requirement in domestic violence Dementia and Driving Others situations Risk/Safety • Understanding the Silver Alert program and how to make a referral • Using alerts or flags within the 911 system • Potential uses of technology • Importance of role playing the similarities and differences in officer interactions with persons with schizophrenia and those with dementia 33 11
9/23/2019 Milwaukee Dementia Training for LEO https://www.youtube.com/channel/UC3abR5Sue6 snc6BaOdkDoIg https://county.milwaukee.gov/files/county/depart ment-on-aging/PDF/FacilitatorGuide- https://www.youtube.com/watch?v=h51Obxf-5QI ThroughtheEyesofaPersonwithDementia.pdf 34 Aging and Disability Resource Centers (ADRC’s) • Information and Assistance • Elder Abuse / Adult Protective Services Dementia Dementia Care Specialists (DCS) Resources to • Dementia Friendly Communities • Dementia Capable Businesses • Training and Education on Dementia Consider • Dementia Resources Alzheimer’s Association Wisconsin Alzheimer’s Institute 35 Additional Dementia Training Resources UNIVERSITY OF ALZHEIMER’S VIRTUAL DEMENTIA WI CRISIS INNOVATION TEEPA SNOW WISCONSIN GREEN BAY ASSOCIATION TOUR TRAINING – DEMENTIA CARE TRAINING PARTNERSHIP VIDEOS 36 12
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