Dementia care. Seemingly simple, but it is actually quite a broad term. It isn’t something that can be learned overnight, and it is most definitely not generalizable to every person living with dementia. Working at Melabev, you learn just that.
Melabev is an NGO working out of Jerusalem, Israel specializing in dementia and Alzheimer’s care for patients and their caregivers. Five days a week ‘clients’, or persons with dementia (PWD), are bussed to the center and participate in activities based on their ability to speak, move, and eat on their own. Daily activities include singing, dancing/creative movement, and playing memory games. Melabev also houses a research and development department to support both clients and caregivers. Findings from research are directly applied to daily life at the center, creating a cyclical manner of providing care. Students are incorporated into this process by working on research projects and directly interacting with patients in their daily activities.
Here, acquiring knowledge on the student end occurs mainly through experiential learning, a process in which one learns by doing. This style of learning creates an interdisciplinary experience with circumstances similar to the workforce in the real world. In this environment, the student is the teacher, and therefore the activities must be engaging and hold personal relevance to the student for them to gain insight from the experience. Learning is enhanced when students are pushed outside of their comfort zones. Interning in a foreign country, learning from caregivers how each person with dementia has different needs, and gaining insight from students with different backgrounds all play a role in the intern experience at Melabev. Here, students are urged to learn in areas one wouldn’t see in a conventional classroom.
This highly valuable experience allows one to understand what life is like for someone with dementia. It provides a deeper level of awareness regarding the struggles that PWD face, even with things as simple as moving on their own or remembering song lyrics. It also allows one to see the implementation of the research and how new findings may impact quality of life on a firsthand level. Most students here are working towards careers in medicine, and exposure to any clinical settings including geriatric care are highly beneficial.
The work environment at Melabev discloses valuable lessons in patient interactions and narrative medicine, which teaches that the patient themselves comes first, not their disease or condition. Much of this can be learned through daily interactions with PWD. This is important to experience as oftentimes external factors take precedence over research and keeping a controlled environment, and it is important to stay flexible to stay productive. For example, clients are often unwilling to put their best effort into the activities of the day if they’re not in a great mood. At Melabev, students are involved in every aspect of the day from activities to meals, which allows one to develop close personal relationships with the patients that often improve participation and lends to a more narrative medical approach.
Personal relationships and interactions with PWD can truly alter their course of treatment from a psychological standpoint. The clients are aware of what is happening even if they appear unaware or unresponsive, so it’s important to treat them as people, not patients. Studies have shown that spending time with PWD can remedy negative attitudes towards the disease, which is apparent working at Melabev. Daniella Yarrow, who has nearly completed her national service at Melabev, recounts, “The first time I felt comfortable here was during my second week. I was sitting with a particular client who couldn’t move or talk singing songs with him for two hours. I thought how he must think I was being so annoying, but suddenly he reached over and began to hold my hand. He was my best friend here.” To summarize, the most important part of this experience has been learning that it is nearly impossible to truly understand dementia unless you see it firsthand.
Every person with dementia experiences it differently, so it is important to know each person’s limits and strengths. There is not one way to approach dementia care as each case is unique, but one thing we know for sure is that compassion goes a long way. It is our hope that more students have the opportunity to experience person-centered learning the way we have at Melabev as it is truly the most valuable mode of learning.