You know that feeling when you “sort of by accident land in geriatrics” and find your niche, passion and strengths all at once? Registered nurse Rose Merke does.
Rose worked as a licensed practical nurse for four years before going back to school to earn her RN diploma. Later, she enrolled in university to obtain her baccalaureate degree in nursing.
“I was working on a gynecology surgery floor. I was young and looking for as many experiences as I could get. When I saw an opening on the geriatric rehabilitation floor, I thought, I’ll ask for a transfer just to do something different. I applied, got into it and it felt like I had come home; it fit so well,” says Rose.
From there, she took on a variety of roles in geriatric care, including staff nurse, clinical educator, and long-term care manager. She also worked in continuing care psychiatric consult services where upon referral she would assess residents in continuing care centres with psychiatric and dementia behaviours, and make recommendations along with a psychiatrist.
“My next career move was to Heath Link,” recalls Rose. “From there, I came across an internal opportunity for a trial project for dementia.”
Dementia is an overall term used to describe a set of symptoms that are caused by disorders affecting the brain. Symptoms may include memory loss; difficulties with thinking, problem-solving or language; and changes in mood.
Rose joined the trial project as part of an Alberta Health Services team that provides dementia advice through Health Link, a telephone information line staffed by registered nurses. Members of this team have extensive training and experience in senior’s health and possess in-depth assessment skills to gain an understanding of each individual situation. They also provide support and advice to patients and caregivers, including tips on navigating the system, and linking callers to services available in their community.
Alberta Health Services says about 40,000 Albertans are living with dementia.
This dementia team was initially available to rural Albertans in north, central and south Alberta who have less access to support resources. “[Callers] sometimes have trouble finding a family doctor because they don’t stay long in those areas. We have the ability to look up geriatric teams nearby – ACE teams: acute care of the elderly,” shares Rose. “There are other kinds of supports. The Alzheimer’s Society is great – they have phone support groups.”
On May 30, the team became accessible to the entire province.
“We are supporting people calling in who are taking care of loved ones still at home. Often they’re at a total loss. They may not have a diagnosis yet and don’t know how to go about getting one,” describes Rose. “The patient may absolutely refuse to go to the doctor in the most challenging cases. Sometimes we have to say to people that unfortunately the people they care for are allowed to make bad decisions – you have to wait for people to fail or crash before they’re ready to accept help.”
The team also assesses caregivers for stress and burnout. They recommend support for them, too, such as Caregivers Alberta.
Alberta Health Services says “The rate of dementia is expected to more than double in Alberta as the baby boom generation moves into older age. By 2038, it is estimated that about one in ten Albertans over the age of 65 and nearly half over the age 90 will be living with dementia.”
“We provide education around personal directives and enduring power of attorney. This is a big problem when patients are not willing to go to doctors. They’re still their own decision-maker, it’s not like you can make them go,” Rose points out. “Then when they finally get assessed, the personal directive might be enacted.”
“It’s an awesome job,” says Rose. “We all get along, we love each other. It’s a really supportive team: we chat with each other about issues. It’s nice to discuss what you should do with a really challenging case.”
“It’s a very rewarding job, a very positive place to work. It’s a privilege to hear peoples’ stories of their journey caring for someone at home and the heroic efforts they make at keeping their loved ones at home to care for until they can’t,” Rose empathized.
“We hear almost all the time how grateful people are and how they don’t know what they’d have done if they hadn’t talked to us. Even though we can’t give all the help they need for everything, they still feel it’s a great service.”
Research shows that expert professionals have a positive impact on the quality and cost of patient care. The presence of RNs in the health-care system is known to improve the health of long-term care residents and control health-care costs. By better supporting individuals and caregivers, Alberta Health Services says this service aims to reduce the number of avoidable emergency department visits for dementia-related concerns.