April 2022
What Effect Does Television Have on the Person with Dementia?
By Deborah J. Way, MD, CMD, FAAHPM

The nurse in the long term care unit at your facility reports “Our patient says that his PTSD is out of control with the news about the Ukraine on the television.” The staff in the dementia unit also report that agitated behaviors are increasing. You wonder if the television and other media can affect your residents like this. Many times, I have walked the halls of a long term care facility and seen the televisions in the resident rooms tuned to Jerry Springer or a court TV show. I think “Do the residents REALLY watch this?” and “What effect does it have on them?”
Since 1993 when M. Aronson put forth a hypothesis that excessive television viewing contributes to the development of dementia1, there have been studies that correlate television viewing and the development of dementia.2  There have also been studies like these3,4 that measure the development of PTSD as a result of watching images on the television. This study4 comments on making the use of and viewing of TV more accessible to persons with dementia.
The concept of the Progressively Lowered Threshold Model describes the idea is that every person has a threshold for stress and that this threshold is lower in persons with dementia.5 The television that is always playing could be a stressor and may contribute to agitation.6
In my literature review, I found a few mainstream media articles that discuss that the mind with dementia does not respond well to images on network and cable television. I have had personal experience watching people with cognitive impairment get confused or upset by what they see on the screen. Voices and sounds can be loud and the images frequently move too quickly to process.
Finally, there are sites with programming specifically designed with the dementia patient in mind like Zinnia TV. (https://www.zinniatv.com/) The “programs” are about 10 minutes long and are easy for a person with dementia to digest.
While I did not find a great deal of support in the literature to explain your first patient’s concern of increased PTSD symptoms, or to explain the increased agitation in the dementia unit, I did find literature to consider. What are your thoughts?

  1. Aronson M. Med Hypothesis 41(5), 465-466 (1993)
  2. Fancourt D, Steptoe A. Television viewing and cognitive decline in older age: findings from the English Longitudinal Study of Ageing. Scientific Reports. 9:2851 (2019)
  3. Pfefferbaum B, Nitiema P, Newman E. Is Viewing Mass Trauma Television Coverage Associated with Trauma Reactions in Adults and youth? A Meta-Analytic Review. Journal of Traumatic Stress. 32,175-185 (2019)
  4. Ahern J, Galea S, Resnick H, Vlahov D. Television Images and Probable Posttraumatic Stress Disorder After September 11. The Journal of Nervous and Mental Disease. 192(3), 217-226 (2004)
  5. Chaudhury, H., Cooke, H. Design matters in dementia care: The role of the physical environment in dementia care settings. In M. Downs and B. Bowers (Eds.), Excellence in dementia care (2nd Edition 144-158 (2014)
  6. Funnell L, Garriock I, Shirley B, Williamson T. Dementia-friendly design of television news broadcasts. Journal of Enabling Technologies. 13(3) 137-149 (2019)
Any views or opinions presented in this article are solely those of the author and do not necessarily represent any policy or position of PAMED, PMDA, AMDA, its affiliates, and members.
PMDA Spring Symposium – We Can’t Wait to See You in Williamsport!
 
Join us in Williamsport, May 21, from 7:30 a.m. to 4:00 p.m. at the Williamsport Hospital for a day of education and celebration!
 
After a pandemic hiatus of nearly three years, PMDA is pleased to announce a return to in-person meetings and the camaraderie and networking we have all missed since COVID-19 became a household word.
 
The full day of education and celebration features outstanding clinical sessions, tips to improve your next QAPI review, and the recognition of our certified nursing assistants, the pillars of the interdisciplinary health care team in PALTC.
You will not want to miss this line-up:
 
Cwazy for QAPI: A Practical Guide for Medical Director and IDT Engagement – Daniel Haimowitz, MD, FACP, CMD - This is a “how to” session for thinking about, organizing, running, and evaluating quality assurance and performance improvement (QAPI) meetings. Common barriers in QAPI meetings will be discussed, with practical tips and tools that QAPI team members can use to overcome challenges and improve team functioning upon returning to their facilities.
 
Rethinking Dementia Care in the Midst of a Staffing Crisis – Rollin Wright, MD, MS, MPH - This session will use a case-based approach to interpret the meaning of challenging behaviors commonly seen in people living with moderately severe dementia in long-term care settings. Imagine what world-class dementia care might look like and identify barriers to achieving the kind of care and quality of life we would want for our patients and even family members living with dementia. In the last few moments of the session, explore ways to strike a balance between the daily stress of staffing shortages and providing high-quality, dementia-friendly care.
 
Non-opioid Strategies for Management of Low Back Pain and Diabetic Peripheral Neuropathy– Vwaire Orhurhu, MD, MPH - The presentation will discuss non-opioid strategies including, medications, physical therapy, and advanced procedures to mitigate low back pain and diabetic peripheral neuropathy.
 
Lung Cancer - Screening and Latest Treatments - Abdalla Sholi, MD – The session will survey updates in lung cancer screenings and treatments.
 
Contemporary Management of Atrial Fibrillation – Sandeep Jain, MD – Learn about the risk factors and pillars of atrial fibrillation management.
 
TAVR – Syed Yazdani, MD – This session will provide a basic understanding of how to perform a TAVR procedure and identify the key players.
 
In between, there will be ample time to visit with our exhibitors and to catch-up with colleagues. The day will conclude with the presentation of the first annual CNA Awards, sponsored in part by Pfizer.
 
Registration is FREE for fellows in training; $35 for non-physician/non-members; $75 for PMDA members; and $85 for non-members. For more information and to register for the meeting, please visit: https://na.eventscloud.com/website/34925/
The Pennsylvania Society for Post-Acute and Long-Term Medicine to Present First Annual CNA Awards NOMINATE YOUR HERO

“In long-term care settings, the doctors have more name recognition, but the heroes–the souls who do the heaviest lifting–are the nurses and the certified nursing assistants. They are tireless. Administering medications, transferring patients into and out of beds and wheelchairs, bathing, incontinence care; they do it all."      
                       
-Danielle Snyderman, "The Things We Carry"
 
The pillars of the IDT, our nurses and certified nursing assistants, play a pivotal role in the day-to-day care of our patients. Often, their effort goes unnoticed and unrecognized, but this year, their contributions to the healthcare team will take center stage at PMDA’s Spring Symposium on Saturday, May 21, 2022, in Williamsport PA at the Williamsport Hospital.

Nominations are now being accepted through May 6, 2022, and the process is short and easy! Don’t miss this opportunity to nominate your hero to be recognized, rewarded, and thanked at the 2022 Spring Symposium.   
JAMDA April Theme Issue on Surgery in Older Persons is Now Available for FREE

The April 2022 issue of JAMDA is entirely devoted to Surgery in Older Persons: Challenges, Considerations, and Interdisciplinary Management. Its 28 research papers address a wide range of subjects, including estimation of surgical risk; formal surgical-medical partnerships around perioperative care and rehabilitation; conditions such as hip fracture, inguinal hernia, and traumatic brain injury in older persons; new techniques such as robot-assisted surgery; and potential adverse outcomes such as delirium and long-term cognitive decline. The entire April 2022 issue of JAMDA is available free of charge for three months.  
A Framework to Grow and Strengthen the PALTC Workforce

AMDA invites you to join a FREE series of virtual roundtable discussions, called More of a Good Thing: A Framework to Grow and Strengthen the PALTC Workforce.
 
Guided by the themes of the 4Ms for Staff, these focused, collaborative discussions will lead to the development of action plans to include concrete, practical steps that PALTC facilities can start taking immediately to build trust with current staff and recruit and retain new staff to grow and strengthen the PALTC workforce.
 
The first roundtable will take place on Thursday, April 28th from 4:00-4:45 ET. Monthly meetings will occur at the same time on the last Thursday of each month through September. Each roundtable will start with a brief presentation by an expert in the field, followed by an interactive discussion with participants. We value your input and hope you can join us for each of the six sessions. 
AMDA On-The-Go Podcast Wins Bronze Anthem Award
The Society’s AMDA On-The-Go podcast won a Bronze Anthem Award for its COVID-19 podcast series featuring Wayne Saltsman, MD, PhD, CMD, as host; Swati Gaur, MD, MBA, CMD, as guest; and John Gladstone as producer. Get more details and tune in to the latest episodes of our podcasts.
Upcoming Webinar:

Drive to Deprescribe: Optimizing Use of Antipsychotics (FREE)
Date: Thursday, April 21
Time: 4:30–5:15 PM ET
 
Assisted Living: Current Issues from Infection Prevention to Clinical Management of Residents
Date: Wednesday, May 25
Time: 7:00–8:00 PM ET
 
AHRQ Releases Updated Vaccination Tracking and Reporting Tools 

AHRQ has updated its vaccine tracking and reporting tools for nursing homes. These free resources include updated vaccine administration records for both residents and staff, a vaccination tracking tool, and a user guide with step-by-step instructions for using the tracking tool; they make it easier for staff to update the facility’s electronic medical records, respond to potential vaccine data requests from local health departments or other regulatory agencies, and plan based on the vaccination administration status and rates of both residents and staff. Access the COVID-19 vaccine administration tools. 
PMDA Job Bank

  • Geriatrician - Suburban Outpatient Pavilion | Lancaster, PA
AMDA On-The-Go
Podcast Series