Sunday, April 14, 2013

Movie Review: Do You Know What My Name Is?

We went to see Do You Know What My Name Is? at the 2013 Cleveland International Film Festival. This movie is about the Cleveland nursing home, Eliza Jennings which is using the SAIDO Learning Memory Support Program from Dr. Kawashima who created this program in Japan. Many of the descriptions of this movie state that the SAIDO Learning Program reverses the symptoms of dementia.

You may remember that I wrote a blog post a while back about how we should not ask people with dementia, "Do you know what my name is?" because this is a memory based questions which can be highly frustrating and it is really only a question we ask out of our own need. We need our loved one to acknowledge us and we think the only way they can do that is by remembering our name, which is not true.

The Eliza Jennings staff uses the question "Do you know what my name is?" as a marker for improvement in short term memory. If the person does not know, they say "That's ok, my name is John." So, they were not pressuring the person with dementia as most people do when asking this question.

This was a great documentary following the six month study of using the SAIDO Learning Program with a small group of residents with dementia. The program is based on providing simple math and reading tasks in 30 minute sessions five days a week with a learner/leader ratio of 2 to 1.

The documentary did not go much into the science behind the program, just that it focuses on working with procedural memory. Procedural memory is the part of your memory that helps you perform tasks, but most often tasks we eventually perform without really thinking about them, such as driving.

I did not see a reversal of dementia in the movie, what I saw is what all of us who work with people with dementia see, that compassionate care, socialization, and simple yet interesting tasks that speak to a persons emotions allow people with dementia to be more engaged and function better. Dr. John ZeiselDr. Cameron Camp, and Tom and Karen Brenner all use activities focused on procedural memory in their innovative dementia care programs. The programs are less about math and more about art and the latter two follow the Montessori method. The simple math and matching that the SAIDO system uses is not all that different than the simple color and shape matching and art of the Montessori and Zeisel methods.

It is important to notice that none of the facilitators corrected the learners. If they got a math question wrong of spelled their name wrong, they always said "That's great!" This is essential in dementia care. People learn not through being reprimanded and being told they are wrong, but by being encouraged and allowed to work within their limits. They did not need to be told they had not gotten everything right to know six months later that they could perform the tasks better. In six months the learners improved, but not because anyone corrected them when they got something wrong. 

One thing that was not stated in the movie as being important, but which I saw as really the key to the success of the program was the socialization. Each day the learners were engaged with a facilitator and one other learner in special time together. One resident, Mae, was not engaged at all in the beginning of the trial but later started talking more and recalling childhood memories. The key to that seemed to be her learning partner, Esperanza who really brought Mae out of her shell.

Then there was Evelyn who often sat by herself in the begining of the trial and did not engage in group activities. She received personal socialization every day through this learning program and became more talkative. By the end of the six months she was able to recognize her family better, talk more, and knit again.

Even Dr. Kawashima who created the SAIDO Learning Program commented in the movie that he thought the communication at Eliza Jennings was better than what the dementia patients in Japan going through the SAIDO learning program were receiving.

One stand out component of the movie, for me, was Eliza Jennings' staff member John Rodeman who narrated the movie and eventually was one of the facilitators of the learning sessions with the residents. He was the one who in the beginning of the movie was asking residents if they knew his name and by the end, a few of them did. John has a skill rarely seen in those caring for people with dementia. He believed in them and showed them dignity and respect. He saw the person, not their illness. John engaged in casual open ended conversation with the resident and really was an important part in socialization and reaching their emotions to help them feel loved and show them dignity and respect. He was kind and if they did not know his same, he said "Ok, let me tell you." You have to see the movie to see the way he interacts with residents. John instinctively knows how to communicate with people with dementia. I wish I had that innate ability. I learned a lot by watching John's example.

Matt & Karen Cahill, Dale & Chris Windsburg (all four are children of resident Evelyn), and John & Adrienne Rodeman at the Cleveland International Film Festival
For me, this movie showed how the right style of learning, whether it is math based or art based, music based, compassion, and socialization are key to good dementia care. This method takes a lot of people. Eliza Jennings worked with all of the staff members- nurses, maintenance, kitchen staff, and volunteers to make this program work. In fact, John used to work in maintenance and did so well with residents that he became an integral part of the SAIDO project. Clearly the facility put their full effort into this program and all the residents in the initial trial are still doing the program and they have added new residents to the program.

This was an inspiring movie to me, but maybe not in the way other people might think it is inspiring. I did not really see a reversal of dementia, rather I saw a program that understands the brain and knows how to create an environment which allows people with dementia to function to the best of their ability. This means that even three years later, when a persons dementia inevitably progresses, the SAIDO program would still help the person function as well as they can, better than if they had not had this intervention. This program does what our Carolyn L. Farrell Foundation for Brain Health and others advocate for: focusing on what ability a person still has and maximizing that to help them have a happy life. Far too often it seems that people with dementia fade away quickly due to the illness, but really it is due to not knowing the proper care to engage them.


Rev. Katie