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Engaged and transformed

March 1, 2011
by Julie Thompson
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St. Leonard finds success with Alzheimer's therapy program
Caregiver laura spain is able to spend one-on-one time with a resident while two other residents enjoy viewing a dvd together.
Caregiver Laura Spain is able to spend one-on-one time with a resident while two other residents enjoy viewing a DVD together.

Step inside the 600 Hall at St. Leonard Franciscan Living Community in Dayton, Ohio, and you'll witness a scene like no other. The hall, which is dedicated to the care of 18 residents with Alzheimer's and dementia, is often quiet and the demeanor of its residents is rather calm. All around the community sit residents actively engaged in their own individualized activity: One is wearing headphones and listening to music reminiscent of his or her past while another is flipping through a worn hobby book with a visiting family member.

This wasn't always the picture. Just a year ago St. Leonard was faced with the same challenges that all continuing care retirement communities have when it comes to Alzheimer's and dementia care. The disease's unpredictable patterns were causing patients to become easily agitated and caregivers mentally and physically exhausted.

Sisters cindy copas and fran schlegel visit with their father eugene miller, a former pilot. a book about airplanes helps create a way of communication.
Sisters Cindy Copas and Fran Schlegel visit with their father Eugene Miller, a former pilot. A book about airplanes helps create a way of communication.

At the time, resident engagement activities were carried out in group settings, and when caregivers did offer something one-on-one it was often with a magazine or game that was chosen with no specific personality in mind. As a result, residents would become disengaged and bored, creating opportunities for unhealthy behaviors such as anger, roaming, rummaging, and increased falls.

Those familiar scenarios, however, quickly changed when Dayton's Wright State University Professor Dr. Govind Bharwani and his daughter Meena combined their knowledge of ergonomics with their healthcare experience to create the first Behavior-Based Ergonomics Therapy (BBET) program. This special program prevents the two main causes of behavioral problems in residents with Alzheimer's or dementia-boredom and disengagement-and gives caregivers the tools they need to proactively stop them from happening.

The BBET program has transformed the way St. Leonard residents spend their days and the way their caregivers and family members are able to communicate with them. In less than a year, the community's 600 Hall has seen incredible results from the program including a 35% reduction in falls, a 70% decrease in anti-anxiety medication usage, and increased quality of one-on-one time between residents and caregivers.

“It is a unique approach to healthcare that came from somebody looking at our industry from a new perspective,” says Tim Dressman, executive director of St. Leonard. “Now our staff is happier than I have ever seen them before because they're able to spend more time interacting with residents in a way that is individually meaningful.”


Ergonomics is synonymous with workplace safety and each year companies employ consultants in an effort to create environments that prevent injuries and avoid long-term disabilities. This was the mind-set when Dr. Bharwani was first employed at St. Leonard.

“Therapy library”: meena and govind bharwani in the new resource area created for st. leonard's adult day services program, day away.
“Therapy Library”: Meena and Govind Bharwani in the new resource area created for St. Leonard's Adult Day Services program, Day Away.

Music cds are cataloged and labeled for easy access by caregivers.
Music CDs are cataloged and labeled for easy access by caregivers.

Stimulating activities are coded and then cataloged on a shelf in the bbet resource room.
Stimulating activities are coded and then cataloged on a shelf in the BBET resource room.

“St. leonard knitting”: bbet dvds in the resource room in 600 hall are carefully cataloged.
“St. Leonard Knitting”: BBET DVDs in the resource room in 600 Hall are carefully cataloged.

As an independent ergonomics consultant and co-director of ergonomics at the College of Engineering at Wright State University, Dr. Bharwani had worked with more than 100 companies on improving their workplace environments. However, his passion for long-term care-and his position as director of Nursing Ergonomics and Alzheimer Care at Nursing Institute of West Central Ohio-caused him to look at St. Leonard's Alzheimer's and dementia care in a whole new light.

He knew the issues facing the Alzheimer's and dementia unit were unique to the community's other areas. With St. Leonard's blessing, Dr. Bharwani and Meena began researching how they could employ the core principle of ergonomics-the reduction of stress-in the 600 Hall.