New recovery program with special dementia treatment at St. Cloud VA Health Care System

March 31--Susie Hills noticed the biggest change in herself, after her husband, Army veteran Danny Hills, returned home from the new Behavioral Recovery Program at the St. Cloud VA Health Care System.

She learned how to help manage Danny Hills' dementia in their Waite Park home.

The Behavioral Recovery Program treats veterans with dementia and behavioral problems, and then returns them home with tools and support. The new unit has 11 beds and dovetails with the 24-bed Memory Care unit.

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Danny Hills' condition took a turn for the worse late last year. He was talking "way off the wall," and Susie Hills thought the 84-year-old veteran might be having a stroke, she said. Staff at the VA adjusted his medication, kept him for five weeks and helped manage the anxiety that came with his memory loss.

"I think I was the one who changed. I grew more accustomed. I learned what to expect," Susie Hills said.

She sees improvement in her husband as well.

"He's very laid back compared to what he used to be," she said. "I think he was really scared before."

An Iowa facility launched the Behaviorial Recovery model. It started as a pilot project in St. Cloud last year, and now the St. Cloud VA is proud of its program to help veterans with dementia and behavior issues. Eight St. Cloud VA employees explained the program to the St. Cloud Times in mid-March.

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Dementia is a growing issue in VAs as veterans age and face additional challenges from conditions such as post-traumatic stress disorder or a traumatic brain injury. Staff learn triggers for each veteran and develop tools to help calm them down -- such as certain music, activities, smells. They also develop different ways to approach them.

"We get to know them probably better than their families know them," said Christine Rushmeyer, the registered nurse case manager for the Behavorial Recovery Outreach team.

The program is taking off in St. Cloud as federal officials talk of privatization in the Veterans Health Administration. David Shulkin was fired Wednesday from his post as secretary of the U.S. Department of Veterans Affairs. President Donald Trump nominated his physician, Navy Rear Adm. Ronny Jackson, to replace Shulkin.

"The political pieces are performed in Washington. That's not our role here," said Barry Venable, St. Cloud public affairs officer. "Our role here is to take care of the veterans that come to see us. And we stay focused on that goal."

The St. Cloud VA dates back 90-plus years. A black-and-white movie played in the Behavioral Recovery unit this week while one veteran, wearing a starred-and-stripped hat, napped in a recliner.

Another patient, Michael Van De Berg, walked hand-in-hand with recreation assistant Sarah Rueter, purple headphones playing some of his favorite music. His playlist includes music from the 1950s through the 1970s, country music and one of his favorite songs: "Strangers in the Night."

Rueter and other staff work with dementia patients to find comforting activities and sensory stimuli. It could be puzzles, music, baking, animatronic animals, the smell of maple syrup or a certain spice.

"We try to keep it individualized," Rueter said. "It's really cool to see the changes as you work with them."

She's seen one veteran's mood change visibly and for the better when staff put on his headphones with familiar music, Rueter said.

Staff in the Behavioral Recovery Program work for noticeable results, and they say it's rewarding to see veterans improve so much under their care. The patients then return home or to a nursing home where they can spend the rest of their days.

"The whole goal is to improve their quality of life," said Janine Paxson, chief psychologist for the facility. That includes placement in "the least restrictive and best place possible."

The science of the program is well-researched, but there's also an art to figuring what works for each veteran, Paxson said.

After discharge, the VA staff continue to work with patients and their caregivers, even as the dementia worsens.

Danny Hills returns to the VA two days a week since his in-patient time in the Behaviorial Recovery Program. It gives Susie Hills, his 72-year-old wife and caregiver, a bit of a break.

She's learned to become more understanding with her husband, such as when he asked her last week if she was his wife or sister.

Susie Hills learned to agree with him or change the subject when he's confused and to not ask him: "Don't you remember?"

"It's an absolutely wonderful program," she said. "They're angels that work there."

The program may expand to other Veterans Health Administration centers in the country, said St. Cloud VA Director Stephen Black. "It's just a concept that makes sense for our aging population."

And staff in St. Cloud want to do more outreach to veterans with dementia in their homes before they need in-patient treatment.

Patient improvements through the program are evident. There's a demand among staff to work there, Venable said.

"To me, it's my job, but it's more than that," said nurse practioner Emily Luitjens.

Registered nurse Rushmeyer seconded that: "We have a passion for this."

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Nora G. Hertel:320-2558746 and on Twitter @nghertel.

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