Silos Deter Collaboration: Implications for Dementia Care and Research

When I began working with proposal teams for a major defense contractor during the 1990s, I came up against silos. If someone outside the program made a suggestion, team members didn't want to hear it. "NIH," they said. Aka, "Not invented here."

Raised in a competitive household, I have rebelled against this mindset throughout my life and strive to enthusiastically embrace a collaborative approach. Unfortunately, I have encountered this silo mentality when working with organizations tasked with helping caregivers and people with dementia. And the stakes couldn't be higher in this arena.

[See: 5 Ways to Cope With Mild Cognitive Impairment.]

When Silos Stifle Synergies

Eighteen years ago, after presenting at an Alzheimer's conference, a dozen of us gathered to celebrate. We raised our wine glasses in a hopeful toast: "Here's to finding a cure for Alzheimer's within five years!" Despite the optimism felt that evening, my father, who lived with Alzheimer's, died two years later.

It's time we hold accountable those who receive tax dollars for government-sponsored research. With millions of lives at stake and hundreds of billions of dollars spent annually on health care, time is of the essence to apply more meaningful metrics to research and care initiatives.

One way to achieve success is to fund teams who collaborate across organizations and even geographic lines. There is no time to waste with leaders who breed mediocrity through an incestuous winner-takes-all approach. Sure, healthy competition fosters innovation, but with millions of lives at stake, this is not a game. We urgently need a solution.

Too many organizations run not-invented-here-style silo operations in the very communities they serve. Some focus more on self-promotion, while their customers wait for a solution to a problem. Instead of collaborating with experts in their communities, they invest time and effort (not to mention donor dollars) reinventing in-house what's already available.

Several years ago, I began approaching exhibitors at conferences where I presented the keynote address. Assisted living communities had attractive displays and pads of paper, pens and even my books to help build awareness of their care services. Research organizations had informative displays and invited people to sign up for details about clinical studies. As attendees returned to the breakout sessions, and all was quiet, they'd either stand, read, snack on something or visit the restroom.

I asked one research representative about how her organization found volunteers to sign up for clinical studies. She explained that it was hard to find research participants. Beyond the lack of volunteers, each study had unique requirements. I asked, "Have you worked with other organizations that may refer people to you? The adult day care two tables down or even that assisted living community across the aisle work with people who serve as your target market." Sometimes, exhibitors would stare at me as if I were speaking a foreign language. "You can improve your results with referrals," I'd add. Others looked down and shook their heads. The brave ones rolled their eyes and answered, "Upper management won't allow us to work with these other organizations." When I asked why, they shrugged. They didn't have an answer.

With so many organizations competing for recognition, the family caregiver faces a dizzying array of choices. "What are my care options? Which one is best given my loved one's needs? How do I choose?" Most family caregivers end up overwhelmed and don't make a decision -- a result of these primary agencies not talking to one another. Agencies best serve caregiving families when they are willing to work together and refer each other's services when theirs may not initially be the optimal choice. For example, in-home care and adult day services can work to offer their services before families are ready for assisted living.

[See: 14 Ways Caregivers Can Care for Themselves.]

Invite the Outliers -- Those at the Fringes, Who Think Differently

We can do better. It means identifying and inviting diverse thinkers to the table. Take an outlier who only has elementary knowledge of chemistry. On a whim, a Ph.D. researcher invites this person to look through the lens of a microscope. Seeing something that even the trained eye of the researcher missed, this outlier's observation becomes the bud of a new discovery.

Years ago, members of leading agencies and policy-recommending governmental groups met to help people with dementia and their caregivers. Surprisingly, the very people they were tasked with serving were rarely -- if ever -- invited to present at these meetings or to serve in paid advisory roles alongside other staff in their organizations.

[See: Easy Ways to Protect Your Aging Brain.]

Celebrity spokespeople are often invited to help gain recognition and funding, since they have access to a greater range of resources, unlike the millions of families struggling to care for a loved one. Meanwhile, the voices of people with dementia fell upon deaf ears. Due to the persistent advocacy efforts of longtime organizations such as Dementia Advocacy and Support Network, or DASNI, and the spearheading of the Dementia Alliance International, or DAI, people with dementia have been invited to the table to help guide the initiatives and policies designed to help them. These agencies and organizations must more proactively include the very people they intend to serve -- currently, the outliers -- as they take steps in the right direction.

Whether it's creating leading technologies for our nation's defense or defending against the onslaught of dementia while offering creative care options, leaders are encouraged to step out of their silos and invite diverse thinkers to their teams. Our ever-changing health care industry demands it. The millions of families who care for people with dementia demand it.

Brenda Avadian, M.A., is the president of The Caregiver's Voice, bringing family and professional caregivers knowledge, hope and joy since 1998. She is a caregiver expert speaker at state and national conferences. The author of nine books, Brenda's career includes university professor, executive coach, keynoter, corporate strategy consultant and caregiver. She also serves as a STUFFologist at STUFFology 101, where she advises people on how to declutter, while helping elders prepare to downsize. Born and raised in Milwaukee, Wisconsin, Brenda resides in rural Los Angeles County, California, and frequently hikes in the Angeles National Forest.