Tag Archives: caregivers

The Trauma of Relocation for People with Dementia

 

 

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.

Aging Services Future Focus

On the brink of a new decade, I contemplate what the next ten years will look like for the aging services industry. Reflecting on the past provides me some hope for the future. In some respects, we have come a long way.  By the same token, we should maintain a future focus and continue to develop more strategies that support the quality of living of frail elders.

One future focus could be to equip our caregivers with best practice strategies to respond to resident behaviors utilizing therapeutic approaches. 

We realized years ago that physical and chemical restraints weren’t the answer. The emergence of Compassionate Touch, Music & Memory, and Joy for All Companion Pets are best practice possibilities. All of these interventions provide a non-pharmacological approach to improving quality of life.  Expressive touch, music, and pets to love address basic human needs of connection, inclusion, and purpose, to name a few.

A second future focus could be to educate our employees about the process of aging and dementia to demystify, normalize, and create an environment of understanding and acceptance.

Can we say that our caregivers understand the process of aging? In addition, do they comprehend and empathize with the struggle of living with memory loss and sensory changes?  To that end, employee education creates empathetic caregivers, and that leads to better care. In the same way,  this is also true for family members.  More understanding leads to better care partners.

As one example, the educational program Dementia Live provides caregivers with an inside-out understanding of what it is like to live with dementia. It is a powerful experience for employees and family members.

Workforce

A third future focus could be to cultivate a revitalized workforce.

The workforce challenges that face the aging services industry seems overwhelming and hopeless.  But keep this in mind, nurses did not take care of post-heart transplant patients twenty years ago in skilled nursing.  We rose to the challenge. Nothing is impossible.  Providers alone cannot entirely solve this problem. However, there are things to do that can get the ball rolling.

In conclusion, while the future may look daunting, consider how far we have come over the previous 10-20 years. Celebrate the evolution of an industry that was once “warehousing,” and face the future with boldness and ample self-care, we will need it.

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.

Validation in Dementia Care: Thank You, Naomi!

Validation helps caregivers step into the world of a person with dementia, creating understanding and empathy.

The most powerful communication tool I’ve learned is Validation. Created by Naomi Feil, Validation is a method of communicating with people with dementia. Stepping into the world of the elder leads to understanding, therefore easing distress.

I’ve distilled the concepts of Validation into two questions.  They help me respond to someone with dementia who is confused and distressed.  First, I ask, “What is this person’s reality at this moment?”  The answer gives me a clue into her world at the moment, and then I can be with her in her world.

Then I ask, “What is she feeling right now?”  I can’t see a motion picture of what’s going on in her mind, but there are clues about how she is feeling. What is her facial expression, body language, or voice intensity telling me?

Now comes the action part.  First, I reflect her reality and then acknowledge the feeling.

Let me illustrate with a story about a woman in a skilled nursing facility where I provided Compassionate Touch® sessions. At around four o’clock, she fretted about getting home to make supper for her family.  Pacing the hall, she asked everyone how to get back home. As time passed, the more anxious and upset she became. The staff was expected to take her to dinner at five o’clock, not an easy task when she was so determined to leave.

What is her reality?  It’s time for her to get home to make supper for her family.  In her mind, her family would be back soon, and she needed to be there for them. Now that I understood where she was at the moment, I could be with her in her world.  What is she feeling? She seemed frustrated and increasingly angry and fearful.

I walked with her, asking simple questions about her family and what they liked to eat for dinner.  I acknowledged her feelings, saying, “it’s so frustrating to be late.” I used humor, “my son thinks he will just starve if I’m five minutes late with a meal!” She nodded and laughed with me.  At one point, I reassured her with touch by gently stroking her back and holding her hand. She became more present in the immediate moment, and she let go of her fixation on getting home.

What created the shift in her was not so much what I said, but rather that she felt seen and heard, therefore, validated. We walked again, but this time to the dining room where she joined her friends for dinner!

How do you feel when someone validates you?

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 now serves as a Master Trainer and training consultant.

Education First in Dementia Care

Foundational Education is critical for inexperienced caregivers of persons with Dementia. Don’t rely on understanding through experience alone.

Working in senior care for over 30 years, it takes digging deep to recall my early experiences interacting with the elderly and those with dementia.  I was a volunteer and an intern during college when my first encounters occurred.

My experiences were mostly pleasant and fun. The people were just older versions of my grandparents. I enjoyed visiting with the independent seniors. They showed me around their cute apartments and told me stories.  However, encountering people with dementia was another story.

It puzzled me when one lady repeatedly said, “I want to go home,” when she was at home. I didn’t know what to say. One lady forgot that I was picking her up for a concert, even though I reminded her the day before. I thought maybe she didn’t want to go after all.

Little did I know that these people had Alzheimer’s Disease.  Learning that their memory was impaired, I assumed they had NO memory.  Therefore, I thought it was my job to remind them of everything.  I thought their brains could be fixed. I was wrong about a lot of things, albeit well-intentioned.

Learning Through Education and Experience

Over-time, I “got it” and became more comfortable being around people with dementia.  My confidence grew as time went on.  I learned that the things they said and their behaviors didn’t define their personhood. Consequently, I came to enjoy being with them.

Looking back, I can see how extraordinarily helpful training like Dementia Live would have been. I genuinely think it would have propelled my understanding and improved my interactions ten-fold.  Webinars and lectures barely scratch the surface to learn what it takes to promote quality of life for persons with dementia.

Time and experience alone should not be our only path to understanding.  The valuable lessons that the  Dementia Live experience teaches learners include:

  • persons with dementia experience feelings, even with impaired memory
  • their behaviors are a form of communication
  • the environment makes a big difference in their ability to connect
  • purpose in life is still essential for their well-being
  • our communication approaches can make or break an interaction

Learning does comes with time and experience.  However, I submit that ground zero isn’t the best place to start.  People with dementia deserve better than to be surrounded by uninformed, clueless people, such as I was years ago.

 

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.