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Compassionate Touch®, Dementia Live, Faith Community, Family Caregiver, Senior Care Professionals, The Family Caregiver

The Trauma of Relocation for People with Dementia

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A sudden relocation from home for a person with dementia can be traumatic.

My husband and I have made the decision to right-size our lives and sell our house of 23 years. For many years now, I have anticipated this moment wondering how I would feel.   Surprisingly, it wasn’t a hard decision to make.  However, I recognize that moving day could be a different story.

The decision to relocate is one we made being of sound mind and body.  As overwhelmed as I sometimes feel about our move, it must pale in comparison to what people with dementia feel when they are moved to a different environment.

Easing the Trauma of Relocation

My husband and I will adapt to our new surroundings.  I will find a place for all of our things and make our new house into our home.  The people I love most will be with me,  including my fur-babies.  I’ll drive to visit my friends and attend the same church.  All will be right in our world.

This mile-marker in my life makes me think long and hard about what moving day must be like for someone with dementia.  I can’t even imagine.  The sudden loss of leaving the familiar and the people you love must be horrifying.

Stop and think for a moment how you would feel if someone walked into your home and said that you had to leave for a new place that you had not chosen for yourself.

Imagine your behavior.  Would you be crying, screaming, punching, kicking?

The AGE-u-cate Training Institute program Compassionate Touch begins with looking at life through the lens of someone with dementia.   We discuss the grief and loss that often accompanies a person with dementia when they move into a long term care facility.

Realizing that people with dementia communicate with us through their behaviors is a pivotal moment in Compassionate Touch and Dementia Live Training.

So how can we ease a transition into a long term care facility for someone with dementia?  Here are a few tips:

    • If possible, set up their new space with familiar items prior to move-in day.
    • Remain positive and keep your personal emotions in check.
    • Minimize chaos on move-in day by limiting the number of family members present to no more than two.
    • Allow the staff to immediately begin bonding with your loved one.
    • Refrain from prolonged day-long visits until your loved one is settled in and comfortable.
    • When your loved one says, “Take me home” don’t say, “this is your new home.”  Rather, “I understand how hard this is, and I love you.”

Julie has worked in Aging Services for over 30 years and has been a Licensed Nursing Home Administrator since 1990. She is a Certified Master Trainer with the AGE-u-cate Training Institute. Through her company Enlighten Eldercare,  Julie provides training and educational programs on elder caregiving for family and professional caregivers.  In addition, she is an instructor and the Interim Director of Gerontology at Northern Illinois University and lives in the Chicago Northwest Suburb of Mount Prospect, IL.

Compassionate Touch®, Dementia Live, Senior Care Professionals

Specialized Dementia Training and Employee Turnover

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Specialized Dementia Training can have a positive impact on reducing employee turnover.

The AGE-u-cate Training Institute received encouraging feedback from a client, and it is worthy of a share. A home health agency that utilizes Dementia Live for staff training reported that their employee turnover is decreasing. Furthermore, the turnover correlates with their implementation of  Dementia Live, a simulation training experience of what it might be like to have dementia.

This news made us curious about the connection between specialized dementia training and employee turnover.

PHI is an organization with a mission to promote quality care through quality jobs. PHI identifies staffing in long term care a national crisis and reports conservative estimates of turnover across the long-term care sector ranging from 45 to at least 66 percent. In addition, one in four nursing assistants and one in five home health aides report that they are actively looking for another job.

The Dementia Care Foundation (DCF), based in Darwin, MN, studied staff retention and turnover in those working with persons with dementia. The research premise is based on findings by Brodaty et al., 2003 that turnover is particularly challenging in dementia care.

Effectiveness of Specialized Training

Researchers with the DCF also cited findings from Chrzescijanksi, et al., 2007; Coogle et al., 2007 that specialized training has been shown to reduce staff turnover while simultaneously improving the quality of care.

Relationships with co-workers was the most significant factor contributing to employment exodus.  However,  findings also reveal a connection in turnover and the lack of specialized training.

The DCF also uncovered a relationship between dissatisfaction with training about managing dementia behaviors and how likely respondents were to leave their job within the year.

Specialized is the keyword. Training for staff working with persons with dementia needs to heighten understanding and empathy. In addition, it should equip staff with knowledge and skills to respond to and reduce difficult behavioral expressions.

Something else to ponder is if and how employee relationships improve with specialized dementia training.

The training philosophy behind  Dementia Live is that it is hard to care for someone that you don’t understand.  Lack of understanding leads to stress, burnout, and ultimately turnover.

In conclusion, consider investing in specialized dementia training as a strategy to reduce employee turnover.  In addition, the impact on employee relationships following specialized training would also be an interesting aspect to explore.

Julie has worked in Aging Services for over 30 years and has been a Licensed Nursing Home Administrator since 1990. She is a Certified Master Trainer with the AGE-u-cate Training Institute. Through her company Enlighten Eldercare,  Julie provides training and educational programs on elder caregiving for family and professional caregivers.  She is an instructor and the Interim Director of Gerontology at Northern Illinois University and lives in the Chicago Northwest Suburb of Mount Prospect, IL.

Senior Care Professionals

Age-integration Study in Higher Education

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Students at Northern Illinois University in DeKalb, IL experience Dementia Live and share with classmates their feelings of frustration, anger, and anxiety.

Psychology Professor Laura Carstensen discusses the need for an age-integrated society. Her “The New Culture of Aging” Ted Talk reveals that our ancestors in the 20th-century built a world exquisitely around the young.

Infrastructure to meet the needs of the young was appropriate and functional at the time. However, we now need to envision an exquisite society also built around the old.

Just as differently-abled individuals and families have pushed the barriers of accessibility, baby boomers will break down structural age barriers such as role opportunities in work and education.

The idea of an age-integrated society becomes clearer the older I get. The small writing on medication and food labels is frustrating. Consider also airline gate attendants that give fast and muffled directions over the intercom.

Dementia and an Age-Integrated Society

An age-integrated society must also adapt to the needs of persons with dementia. This segment of the population will grow to the point that it can no longer be ignored.

The Alzheimer’s Association, Facts and Figures Report, projects 14 million people will live with this disease by the year 2050. It is the young that need to be the movers and shakers toward a more age-integrated society. However, it is incumbent upon wisdom-holders to provide them the information and education.

It is essential to expose students early to what it means to live with the symptoms of dementia.  Additionally, how the symptoms should factor into a truly age-integrated society.

Higher education should consider involving students in age-integration studies. Also, learning about  Dementia-Friendly Community movements should be a part of their learning objectives.

Exposing students to the study of dementia is vitally important. We need to expose young students to the diverse needs of older adults so that they can envision an age-integrated future. In doing so, we increase the chances that they will innovate and move us closer to a society that embraces the young and the old.

 

Julie has worked in Aging Services for over 30 years and has been a Licensed Nursing Home Administrator since 1990. She is a Certified Master Trainer with the AGE-u-cate Training Institute. Through her company Enlighten Eldercare,  Julie provides training and educational programs on elder caregiving to private and professional caregivers.  She is an instructor and the Interim Director of Gerontology at Northern Illinois University and lives in the Chicago Northwest Suburb of Mount Prospect, IL.

Senior Care Professionals

Get Ready for Trauma-Informed Care

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Beginning November 28, 2019, the Centers for Medicare & Medicaid Services will require nursing homes to provide trauma-informed care. Consequently, they must  “ensure that residents who are trauma survivors receive culturally competent, hence minimizing triggers that may cause retraumatization.”

What is Trauma?

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) describes the “Three E’s of Trauma.” First of all, the person is exposed to an event such as loss, violence, a natural disaster, or abuse. Next, he experiences the situation as physically or emotionally harmful or life-threatening. Finally, she has lasting adverse effects on well-being.

People express trauma differently, and some are more resilient than others. Furthermore, the impact of trauma is often confused with other conditions, such as depression or even dementia. Symptoms may have a delayed onset and include:

  • Physical: Aches and pains, poor sleep
  • Psychological: Anxiety, poor emotional control, flashbacks
  • Cognitive: Difficulty with memory and attention
  • Social: Poor trust in others, isolation
  • Spiritual: Lacks meaning in life

What is Trauma-Informed Care?

According to SAMHSA, trauma-informed care rests on a set of critical concepts referred to as “The Four R’s. These assume that all people within an organization:

  1. Realize that trauma exists and understand the impact and consequences of traumatic experiences.
  2. Recognize signs of trauma.
  3. Respond consistently using the principles of a trauma-informed approach.
  4. Resist the re-traumatization of people with traumatic histories.

Therefore new regulations for trauma-informed care expect facilities to:

  • Assess each resident’s exposure to traumatic events in their life.
  • Train staff in the impact of traumatic experiences.
  • Incorporate trauma-informed approaches into care plans.
  • Use strength-based interventions that maximize trauma survivors’ resilience to avoid retraumatization.

Acknowledging traumatic experiences and providing care that is sensitive to each individual is essential. However, I question how realistic this new regulation is for many nursing homes faced with high staff turnover. As a result, limited resources go to basic care and training in practical approaches.

In conclusion, how do you perceive the future trauma-informed requirements?

Ann Catlin, OTR, LMT: For twenty years, Ann led in the field of skilled touch in eldercare and hospice. She has nearly forty years’ clinical experience as an occupational and massage therapist. She created Age-u-cate’s Compassionate Touch program and serves as a Master Trainer and training consultant.