Part 4. Bitove Academy

Yesterday, I went to the Bitove Academy to experience “patient centric” care in its truest form. The entire experience was very unique for me as a medical student since 1) I’ve never worked with people afflicted with dementia and 2) had never been exposed to such a unique model of care. Over the 4 years of med school, I’ve been accustomed to the standard physician-patient paradigm where issues and problems are addressed with solutions and treatment plans. Standard medical therapy is very ‘prescriptive’, or ‘regimented’, or  ‘a means to an end’, if I may. Whereas at Bitove, the ‘therapy’, if I may even call it that, is intrinsic to the process. There may not even be an ‘issue’ to resolve, but rather healing and growth simply comes from being present in the moment and by embracing relationships. The members of Bitove are all afflicted with memory loss to some degree, but more importantly, their care is dictated by nobody but themselves. Program assistants are there to help navigate and interact, but the members are essentially free to engage in whatever they please.

I recall one special encounter while listening to Buddy Holly with a member with advanced dementia. He was essentially non-verbal and required 1-on-1 care, but when the music came on, he would dance, spin, twirl, clap, and sing out the lyrics. It was uplifting to say the least.  I spent the rest of the day dancing to ABBA, watching improvisation performance, playing crossword puzzles and colouring with the different members there.

Overall, I think the experience is useful and healthy in broadening the perspective of future physicians. Medical students should be exposed to this model of care in their training and attempt to incorporate parts of it into their own practice, wherever possible. For example, the areas of where this may be useful are somewhat obvious for geriatricians, pediatricians, and palliative care physicians, but I argue even surgical practices may benefit with caring in this way. Encouraging freedom of expression, music and other art forms in recovery areas or waiting areas, may promote better communication and outcomes with those dealing with cognitive impairment. -AC