The journey with dementia: Understanding behavior changes and challenges (podcast transcript)

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Jessica Whittemore's podcast episode graphic for The Journey with Dementia: Understand Behavior Changes and ChallengesDementia patients have a deep impact not only on those who are diagnosed but also on the people who are closest to them. Family members have to take on different responsibilities when a relative is diagnosed with dementia. As the disease progresses, you or others in your family may find the changing roles tough to accept. It may become harder when roles change in some ways, but not in others. When this happens, it can lead to some confusion about how to act. It sometimes takes a while to figure out just who will do what.

In this episode of “Life, Death and What Matters In Between,” Perry limes interviews Jessica Whittemore,  clinical practice specialist for social work with Hospice of the Chesapeake. She discusses the necessity of advance care planning, the procedure, and the problems that families may experience when discussing the subject. She also discusses the difficulties that families face when a family member suffers from dementia. She also mentions the signs and behaviors of dementia sufferers, as well as how to deal with them. She went on to explain what a Social Worker does and why it’s crucial when dealing with dementia patients.

Click here to listen to Episode 2 of Season 1 of  “Life, Death and What Matters In Between”

Transcript

Perry: Good afternoon and welcome to Life, Death and what matters in between. I’m your host, Perry Limes, and I am joined today by my esteemed colleague and wonderful human being, Jessica Whittemore. Welcome to the show.

Jessica: Hi. So excited to be here. Thanks for having me, Perry. Awesome.

Perry: Awesome. And today we’re going to look at our journey with dementia from the perspective of a social worker. And Jessica is a social worker by profession. And I’m going to let you tell the audience about yourself, Jessica.

Jessica: Sure. So, as Perry said, I am a social worker by profession. I got my undergraduate degree from UBC. And from there, I went and got my master’s UMD school in social work in downtown Baltimore. And I went into it with a specialization in clinical mental health. And that’s kind of where I started. I worked in many different settings. I worked in a prison, a school, a juvenile justice center, detention centers, group homes, and things like that. But there came a point where I just had some personal things happening in my life, and I needed a new direction. And one of my friends was like, Hey, I work at a hospital. Come work with me. We have an opening in our oncology unit. And I was like, I don’t know anything about medical social work. I don’t know anything about anything. It was awful. But I said, Let’s do it. I know you. You’re fun. Let’s just go for it. And I spent almost five years working at one of the University of Maryland hospitals on an oncology med search floor. And I found that’s where I kind of belonged in this medical field. Working on that unit, I found that there is such a gap in care for people with chronic illnesses. And I decided I want to go into palliative care. So I looked everywhere high and low for palliative care, social work, and jobs. And they were few and far between. And then my friend that works at the hospice, the Chesapeake’s like, hey, we have an opening. And they were kind of suckers and took me on. And now they’re stuck with me. I’ve been here since 2018. I was on their palliative care team and now I am the clinical practice specialist for social work for all of hospice, the Chesapeake Awesomeness.

Perry: Awesomeness. Well, thank you. Thank you so much for that. So before we get started, as we mentioned in the last episode, we created a composite case scenario with a patient whose name is Joe that has dementia. He’s currently residing with his wife, who is 40, a wife of 40 years at home. And at this stage of Joe’s journey, some of his behaviors are changing and becoming more challenging. In addition, his wife, Veronica, is not sure how to talk to their adult children about some of the decisions that she and Joe have discussed and documented regarding his advance care planning. So with that, Jessica, when we think of a person with dementia such as Joe, how does advance care planning work?

Jessica: Yeah, so advance care planning is important for anybody of any age, but for someone with dementia, I’m going to say it’s even more important because as we know, it’s dementia. You eventually lose your capacity to make any type of complex decision. So advance care planning is so important to be done early so that the patient, for example, Joe, is following his wishes, what he wants for himself or his so that Veronica is not having to make these hard choices, that these conversations have already been had. And she’s not making them when it’s a crisis or when something scary is happening. When we wait too long to make these decisions, we often make them in very emotionally charged situations. And sometimes it’s hard to know what is right, what’s the right thing to do. And the answer is there’s no right or wrong answer. Everybody wants something different for themselves. But if we’ve not opened it, is that platform for them to tell us about what medical decisions they would want to make in different situations. Told them what all the options are. It comes down to people just having to guess, and that creates so much stress for family members and the patient’s wish not being followed. So it’s really important for everybody to do it. But especially with dementia, because we know that’s a part of dementia that you’re going to need someone to speak for you and talk to your wishes.

Perry: Awesome. So for the audience out here and you know, we live in the world of you can Google this or there’s an app for that. With advance care planning, how would one go about actually starting this process? But what does it look like for a family? And particularly definitely in Jo’s case, somebody who’s on that path of dementia as well?

Jessica: Mm-hmm. Absolutely. I mean, there are probably tons of apps out there for advance care planning. So I will say just check the app database. But the first thing to do is to really sit down and start thinking about your own wishes, what you would want for yourself, and start talking about it. That’s the biggest thing you can do is have those conversations. There’s a really good website called The Conversation Project, so I hate to say Google it, but you know, go to the Conversation Project dot org and it’s a really good way to just initiate those conversations. These are all scary and hard things to talk about. Nobody wants to talk about the end of life. Nobody wants to talk about death. But, you know, it’s something that happens. There’s a quote by Benjamin Franklin where he says, Nothing in life is certain except death and taxes. And it’s very important to make sure you’re fully engaged in the process of your end of life. So talking about it is the first way to start, if you’re not a master of Google and you don’t want to go look at things on websites, I suggest talking to your physician, say what? What does it mean to have CPR? What does it mean to be at the end of life? What does it mean to be in a vegetative state? Those are all different things and they mean something different to all of us. Right? So becoming informed is the best way to do that. And the only way to do that is to start talking about these hard things.

Perry: And you know, for families out here, what would you find? What would be some of the challenges that would face families in this discussion? Because I know Joe and Veronica have talked to each other, but they’re probably having a difficult time talking to their children who are adults. So what challenges might families face in having that advance care planning discussion?

Jessica: Oh, my goodness. So many challenges and John, and Veronica are perfect examples of it. I find a lot of times husband and wife have that connection, especially in older couples, and they’ve talked about it, but they’re afraid to communicate that to their children even when they’re adults. Because, you know, if you have kids, you will always view them at some point as of your baby is right, you’re not going to want to talk to them about the scary things. The other issue is that if you have more than one child, I can almost guarantee you they’re going to have different opinions on things. Right. They’re very different people with unique personalities. So they’re going to respond differently to the information you’re giving them. And I find that’s hard for a lot of families. You know, you’ll have the one cat who’s very emotional and is going to just cry through the whole thing, you know, the other kid who’s very practical and, you know, okay, dad, thanks for getting this all laid out for us. It’s just a difficult conversation to have. As I said, end-of-life stuff is not easy to talk about. We’re all afraid to talk about death and what choices we would make for ourselves. So that’s one challenge, is just it’s scary to talk about. You don’t want to. Bother your kids with it. You don’t want to be burdensome, burdensome to your family and friends. This is funny because if doing it your advance care planning is the actual opposite. You are unburdening them. They’re not having to make those decisions. They’re you’re making them. And they’re just following your wishes. Other challenges. You know, I think one of the big ones is not understanding all your medical options and choices. And, you know what CPR actually does to the body and what it does to a healthy body versus what it does to a body who has a chronic illness. Right. And things like that. So really just making sure you get all of your information and being okay with those emotionally charged conversations and being okay with this might not go how I want it to go, but it’s so important. I’m still going to have that conversation.

Perry: Oh, that’s good. Now is an advanced care plan. Is it something that can be challenged by children? Is this a legal document? How does that stand with their health care providers or, let’s say, in the legal realm as far as the wishes of that individual?

Jessica: Yeah. So advance care planning is a very broad term and it’s really important to do. The actual document that’s called Advanced Care Directives. Right. So advance care planning is a broad term that just covers everything we’re talking about everything, every situation, what you would want, and what you wouldn’t want. And we’re expressing our wishes. But those advanced care directives are a tangible piece of paper where you’ve recorded your wishes. They have two parts, both the directive and the proxy, and that’s where those who can challenge it come in, right? So when you are doing advance care planning and you’re filling out your advanced directives, you’re going to name someone to speak for you if you are unable to speak for yourself. And this is only dealing with medical decisions. I always get the question, financial things like that, that you need to talk to an attorney. I’m just here to talk about the medical piece and the advanced directive form usually holds up because it’s your wish. You’ve designated that person to talk for you and the form is very clear. You can check off different boxes. I want them to follow this exactly as it says, or I’m going to give them the liberty to change some of the things I’ve requested because they’re getting different information from physicians. That’s why it’s important to have these conversations. So whoever you’re choosing as your health care proxy knows that they’re going to be responsible for these decisions and knows what you would want for yourself. So it’s got to be signed by two witnesses. And those witnesses can’t benefit from your death anyway, right? Like, I can’t make one and have my husband and daughter sign it. Right. Because they’re probably going to be my proxies and have things, you know. So it has to be two independent witnesses and it’s a portable document. It’ll follow you to every health system that you go to, which is great because once you have this conversation and you get these forms done, they live there. And you don’t have to keep constantly talking about death and having those scary conversations.

Perry: That’s awesome. Well, it sounds like something that should not be written on a napkin.

Jessica: Forms completed. They’re readily available. Your health care provider will have them for you. If you ask for them. You can also Google them, but your health care provider will have them for you. Do not write it on a napkin. Nothing like that.

Perry: Awesome. Awesome. Well, look, I like to deep dove into Joe because we’ve been following him now. And I wanted to get your perspective on some of the unique behavioral challenges that a person with dementia experiences and what you’ve experienced in your role as a social worker.

Jessica: Yeah, I think, you know, people with dementia, they have a lot of unique challenges because a lot of times we see their personality altered, right? Their brains are not functioning the way they used to function. Things are not firing the way they used to. So we see a lot of behavior changes. Things like paranoia, agitation, hallucinations, and even delusions are all things we commonly see as dementia progresses. And they can be super scary for family and friends. You can see the total. I see this all the time. Personality changes. They’ll say, you know, my Seymour never custody in his life and now he’s just hurling curse words at me all the time. And I have to have that conversation about that’s kind of a normal part of disease progression. I know it’s scary and it’s hard, but there are those behavioral challenges that are fairly unique to dementia and require a lot of different skill sets and different ways to manage it.

Perry: So it’s interesting that you discuss that because we are seeing more and more in media and the news. Mental health becoming more prevalent and a spotlight is being put on it. We’re seeing it in even intelligence television shows. This is us. One of the main characters, Beth, the mom is starting to have advanced dementia and it’s talking to children. Yes, absolutely.

Jessica: I always like the first season, so now I’m going to have to go catch up. You just spoiler alert me.

Perry: I suppose I spoiler alert it. But yes, so this is the final season. So no plugs for this is us. But yeah, so they’re bringing it up and they’re talking about the family dynamic. So, and it’s very compelling to the audience. We watch this. What are some of the family dynamics that are specifically challenging when they’re facing somebody that’s starting to progress through this journey of dementia? What have you experienced?

Jessica: Yeah, it’s really hard. And it kind of goes back to what I was saying earlier in terms of everybody in the family is going to react differently. Right. You’ve got the practical one, the emotional one. We all kind of fall into different categories and throughout the spectrum of it. So it’s really hard because some family members are like, okay, we can do this, let’s go in summer, you know, really focusing on different things like eating and sleeping. Some are focusing on health conditions. Can we reverse this? Everybody is in a different stage. A lot of times with dementia, it’s hard because a lot of people don’t realize, but they’re going through that grieving, you know, all those grieving stages at different times and their loved ones are still here. And that can be confusing for family and friends and loved ones of the patient with dementia because they don’t quite understand what’s happening. It doesn’t feel like they should be grieving because they’re still here. But that loss of personality is gone and everyone’s going to react to it differently. I notice with a lot of these behavioral things we’ve talked about, some people get really, really frustrated and really angry. I don’t understand why Mom’s yelling at me. I don’t understand why Dad doesn’t want to do crossword puzzles anymore. Eating is a huge one that I see a lot. A lot of families love to show their love through food and things like that. And why is it mommy eating anymore? Changes are happening and that’s why it’s really important to work so closely with your health care provider and have someone in your corner to help you through these normal changes of dementia. Right. We know with dementia your tastebuds change, so you’re not going to like the things you used to. We also know that your brain functions are not firing how they used to. So you forget at some point how to swallow things like that. We see patients, you know, and it took me 6 hours to feed mom breakfast today because she just chews and chews and chews. And, you know, that’s something that we see is normal. And it can be very hard and frustrating for caregivers. This is their loved one. They want to see, you know, that I’m doing well. I also get a lot of moms who will only eat Reese’s. She won’t eat the broccoli, she won’t eat a sandwich. And so it’s a lot of those her having those conversations about taste buds changed and if this is what she wants to show what she wants, you know, where it was more important to talk about what’s keeping her happy and grounded rather than forcing her to eat something which can lead to an increase of those behaviors and increase of those of that agitation, hallucination, and delusions. It can be hard for families. And if those are the issues where you’re going to see disagreements with family members because they all want to handle it differently, we all have instincts to handle it differently.

Perry: Wow. It’s so challenging because I guess there are so many varieties. And as you say, not all families handle it the same, but not all patients are the same when it comes to dementia. So have you seen market differences? So we know Joe is starting to decline. And I know there’s an acceptance for families and loved ones to accept that this decline is happening. The elevator is not going back up, it is going down. And it could be a slow, steady decline where they’re watching these changes. Up. And over time, do you see any huge swings, pendulum swings in terms of the decline, whether it’s aggression or just forgetfulness? Is there anything that sticks out in your mind when it comes to that?

Jessica: I see them sometimes. I will say with dementia it’s usually more of a slower decline. And it’s really interesting because the person that lives with the patient, that primary caregiver who sees them day in and day out, is going to notice things first, right? Veronica probably noticed Joe leaving a cup out and then saying, How come I haven’t had my coffee this morning? Things like that. Whereas one of their adult children might come over and Joe’s ability to articulate and be on point for the hour that they’re visiting. So they’ll see things very differently and they’ll be like, Well, what do you mean, mom? He’s not that bad yet. He’s not this. So they see things differently. I will see that at some point. There usually is a huge decline in dementia. Dementia is a tricky one because you’ll see that big decline and then it’ll kind of plateau out and they’ll stabilize at a different point. And so as soon as you think this is your new normal, we’re adjusting to life. There’s another decline or a change. And people with dementia are often susceptible to other injuries and illnesses like UTIs, eyes, falls, and things like that. And when they get something like that, they don’t recover or bounce back as they normally would. So that usually leads to a decline as well. So we see that a lot. And, you know, it’s difficult. The challenging behaviors are very hard for, you know, our patients and our families to experience. It’s hard to see your loved one looking agitated, you know, and being agitated.

Perry: Do you see a difference in the dementia patient that is being cared for at home versus being cared for in a health care provider facility, let’s say a skilled nursing facility or an assisted living facility because the individual’s there, it’s a different caregiver. It’s a professional caregiver versus the family who normally would be the caregiver. Do you see a difference when it comes between that cognitive decline and the response to that intervention?

Jessica: Still, I’ll be honest, I honestly don’t typically see a difference in the decline. I think the decline rates are the same. I think that’s something family members are so scared about. Well, if I put my loved one in a memory care unit or an assisted living, they’re going to decline faster. It’s going to be so much harder for them. And I don’t always see that to be true. But there’s no data to support that. It’s just my opinion because it’s impossible to do a study where we look at one person at home and one person in a facility because it’s so different. We can’t have the same human being in both settings to compare and contrast. So in my opinion, I don’t see that there is a more rapid decline in facilities. But what I do see is that difference in that caregiving. When you are a caregiver 24 hours a day, seven days a week, 365 days, every year of the year, you are likely to get very frustrated. You’re going to get burnt out. You’ll probably also be your loved one. So it’s a much more emotionally charged situation. So you’re going to react very differently than, say, a staff member who’s only here for an eight-hour shift and then is off to the beach with her kids. Right. Like she is trained. She knows that this is part of normal functioning. If things like that, they get a break. So I do see a difference in responses and neither one is right or wrong. It’s just different. Being a caregiver is so, so hard and if you don’t get burnt out, you’re probably not doing it right. So it’s, it’s, it’s just a natural part of it. So I think it’s a lot harder to manage those behaviors at home because it’s your loved one, right? Like you’re you don’t want to see your husband of 40 years. Veronica does not want to see Joe, you know, throwing a chair or envisioning someone outside their house. That’s not they’re being paranoid and pissing. She’s going to get much more emotionally charged from that situation than, say, a staff member in assisted living. So that is a difference I see in the reactions to the behaviors also.

Perry: Well, that’s a perfect segue way, then. What do you feel can help families and those with dementia as the disease progresses? What we’re talking about at home as opposed to in the professional care setting, what would be of support to families dealing with those loved ones with dementia?

Jessica: Absolutely. I would say there are many different techniques out there, and things to do. The very first and most important thing for families who are caregiving for a loved one with dementia is to let go of some of that guilt. You’re allowed to be frustrated and you’re allowed to be burnt out. Those are normal. Once you accept that, then we can stop blaming ourselves and move on. The next thing is to stop trying to, I guess, like to fix someone. I see that a lot. Like, maybe if I just remind him that, you know, his mom’s death and I just keep doing it, he’ll remember, but he’s not going to. So I always say, let’s get to the underlying issue, right? So if someone with dementia is exhibiting a lot of agitation, a lot of paranoia, a lot of anything like that, any of those behaviors we’re talking about, what is causing that? What is the root cause? Because a lot of times it’s from an unmet need, but they can’t communicate that need anymore. They don’t even fully understand what that unmet need is. I always say it’s kind of like, you know, if you have kids, you remember those toddler stages and that baby stage, they’re just crying and you’re like, I gave you a blue cup instead of a red cup. I’m so sorry. It doesn’t make sense in our brains, but for them, it’s very distressing. So when our loved ones with dementia are agitated, it’s usually because of something like that, they don’t know what’s going on. They’re cold, they’re hot. They can’t figure out how to take off their sweater to get cooler. Like, you know, we dress in layers. If you were outside and you were sweating, you would take your hoodie off and be fine. They can’t figure out how to do that work, communicate that. So they’re just showing those agitation behaviors and getting worked up. Stay for families. The first thing I always recommend doing is checking for those things: pain, hunger, thirst, and constipation. What’s going on there? Is the room temperature uncomfortable? Is it an itchy shirt? What’s happening? See if you can pinpoint it. I will say you can only do that about 50% of the time. So don’t beat yourself up. Right. But those are the things we want to check for first, especially pain. Are they rubbing the same part of their body or are they grimacing? What’s happening? Conservation is another big one, right? Like, when’s the last time you had a beam? Mom, start thinking about that. Could that be contributing to it? So let’s say you did all that. There’s no use. They’re still agitated. You have all their needs met. That is when I go back to again what I can control and what I can’t control and what’s important and what’s not right. Like I pick your battle moment. I hate to say it again, but it’s like being with a toddler, right? I need to figure out what the most important thing is. And honestly, if you want to eat the same Reese’s cups every day and not eat your broccoli. That’s a battle I’m not going to pick. Right. Because when we talk about it over and over and say Mom, why don’t you eat your vegetables? Mom, there’s broccoli on your plate. Mom, have another bite of broccoli. That is going to increase the agitation rather than letting it go. Whereas I feel my time would be better spent getting into getting mom into a shower once a week. Right? Because that’s another trigger for a lot of people because it’s very disconcerting. So keeping a calm tone, a calm voice. It’s very easy for me to say this on a podcast behind my desk because I’m not out there doing it. And I know it’s so hard and I feel like this is the first time today mom has said, Where’s my dog? And, you know, this dog’s been dead for 20 years. And she’s getting agitated and agitated. Going over and continually reorienting them doesn’t always work. So I talk a lot about another technique called therapeutic fibbing and distraction. So instead of saying, Mom, the dog’s dead 30 times, I always say, Try it a couple of times if it doesn’t work. Mom, the dog is fast asleep. Let’s go look at that. Birds outside. It’s such a beautiful day, right? You’re not lying. You’re. The dog is fast asleep somewhere and you’re easing their mind. You’re easing that discomfort and you’re distracting them to another situation. It’s really important to know what your loved one enjoys and what they like. Is it music? Is it nature? Is it calming? Touches? What helps them in those situations? So when they are so agitated, you do not continue that trauma because it is real to them all their hallucinations and delusions. You know, no man is standing outside right now, but they believe it. So let’s go into another room. Let’s go have lunch. Oh, my goodness. The sun is out things like that. So really doing that, calming, reorienting, therapeutic fibbing if need be, and distracting, getting them involved and engaged in something else can be super helpful. I always call I call it the rule of threes. I don’t know if it’s a real thing, but I always tell my family, to try three times. Hey, Mom, don’t forget your broccoli. You know, give it to him three times. If they’re still saying no, let’s move on from that. Right. Let’s change subjects. Let’s not make this a situation where they’re agitated. I do want to say I know I said it very first, but, you know, always checking for pain, hunger, thirst, things like that. That’s always your first go to a very quick decline in agitation like if they were perfectly fine and you weren’t noticing the symptom and they’ve completely changed into indicative of like a UTI, things like that. So it’s another great reason to have already had these conversations with your physician, right? You can call and say, this is what’s going on. What do you think? So it’s really important to build that relationship with your medical team when you have a chronic illness so they can guide you through these things.

Perry: That’s awesome. I love your analogy about the children because, you know, therapeutic fibbing. You know, you think about the tooth fairy, you think about the Boogey monster. You know, we have to talk to our children about things that we know are not real, but in their mind, it exists. Yeah, I appreciate that. That, that perspective.

Jessica: That’s my favorite thing to like let people know, like, it’s okay to tell a little, a little therapeutic for white lies.

Perry: Just white lies.

Jessica: Yes. Little white lie. Because in their mind, it’s so real and it’s so important to validate that experience. That must be so scary. Let’s leave this room if something’s happening in here. Another thing that I think is really important. See, I’m gonna talk for hours. I’m going to run up over time. It’ll be fine, though. But one of the things I think is important is with paranoia and things like that, you’ll hear a lot. Well, my wallet’s missing. Just blankets, missing things like that. I always tell families to buy three of the same wallets. That way, if they are harping on it, you can say, here it is. I have a lot of patients, especially older men, who were, I guess, just in charge of money their whole life. Like, my money is missing, my money’s missing. And I’ve had great success with putting fake bills in there in that wallet so they have something tangible. So it’s really important to have those extra things on hand if they always go missing because it reduces that amount of trauma to them because we know it’s not missing. We know they just dropped it somewhere. But to them, it’s so real. So being able to bring it back is so important. Also focusing on things like making sure the temperature is comfortable, not too warm, not too cold. Having calming music on is nothing too distracting, things like that can be really helpful. I think those are my tips. If I think of more, I’ll just interrupt you.

Perry: Well, no, that’s awesome. Listen, I don’t want to stray too far, but because you’re a social worker, I would love for the audience to understand what the role of the social worker plays regarding the dementia patient and how you can be an asset to families and patients in your profession.

Jessica: Absolutely. This I can talk about also for hours because I love social work. I think social workers are so, so important when you have a fully rounded medical team and that includes like a physician, nurse practitioner, a nurse, a social worker, spiritual support as well as related arts, like music therapy, things like that. When you have a really good, well-rounded team, the outcomes are going to be so much better for the patient and the loved ones. Social workers working with patients with dementia, they’re key in education, helping families understand what’s going on. These changes are normal. Let’s talk about it. Let’s talk about some tips and tricks. How are you managing it? They’re also great support for that family member because I’ve said it several times on this podcast, you are going to get burned out, you’re going to cry. It’s going to be hard. You’re also grieving, so you’re going through that grief process. So having that social worker there, you know, is great. We’re all licensed therapists, so we’re here to help, not just be a resource to that patient, but to help that family and that caregiver burnout. How can we help you understand what’s going on with your loved one? How can we make this easier on you, whether it’s just being a supportive ear to listen to or connecting you to resources? There are so many great community resources out there in terms of real-life support groups, online support groups, even things like just, you know, one time one of my families was really like I was staying up all night watching my mom because she keeps pacing and I don’t want something to happen. I was like, Why don’t we get a little camera for the house? So she’s like, I never thought of that. That way you don’t have to keep getting out of bed. Every time you hear anything, we can look at your phone, right? We can help with those kinds of creative things, all sorts of resources. There’s just a ton of I mean, you can’t live without a social worker or just get a good team is that is why I love well, loved working on Chesapeake Supportive Care. It was one of my favorite programs. So if anybody is listening to this and they’re in Anne Arundel or Charles County, I always say call us and ask for Chesapeake supportive care because then you do get the whole team, you get the nurse practitioner, you get the social work. You get the chaplain, you get a registered nurse, and we’re looking at that holistic approach and trying to make that person so comfortable. You’re not just getting a doctor coming in and here are some meds to help with those behavior changes. You’re also getting that social worker to help provide that psychosocial support and those non-pharmacological interventions that can be huge. Right. So it’s very different. So I always say, call us CSC because I’m very passionate about that program. And I think it’s such an advantage, especially to any family member who has a loved one with dementia. It is such a hard process and a hard journey. So I always tell people, take any help you can get.

Perry: Awesome. Do you have a website or phone number for you?

Jessica: So the website is Chesapeake Supportive Care, Dawg. And I’m going to give you our phone number 4438373376. And that number will take you to our office. The girls in the office are lovely and we’d love to provide you with more resources or more support, whatever, whatever you need.

Perry: Jessica, you have been amazing. Thank you so, so much for your time, your energy, your wealth of knowledge, and the invaluable service that you provide to your patients and your families.

Jessica: Oh, my gosh. You’re too nice.

Perry: It is well-deserved. So again, thank you so much for joining us today. With that, we like to thank the John and Cathy Belcher Institute for their generous support of our community outreach and education programs. Thank you so much for joining us.

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