Tag Archives: Memory Care

Family Caregiver, Hospital Professionals, Senior Care Professionals

Validation in Dementia Care: Thank You, Naomi!

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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.

Senior Care Professionals

Alzheimer’s Disease: What Would Maslow Say?

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Human needs remain intact regardless of age, situation, or condition.

Abraham Maslow was an American psychologist who taught that survival needs must come before social or spiritual needs. Alzheimer’s disease impacts all these needs, for instance, as in a woman named Faye.

The need for physical survival. Faye relied on caregivers to assist with physical needs. 

The need to have personal security and to feel safe.  Faye didn’t recall recent events, so she didn’t realize where she was. Memories of past experience faded.

The need for a sense of belonging and connection to others. Faye had been active in her church.  The move to a nursing home separated her from familiar people and consequently became withdrawn and anxious.

The need to express feelings and have them acknowledged.  Alzheimer’s decreases a person’s ability to express thoughts. Faye was frustrated because care-partners didn’t understand her.

The need to give to others and to be treated with respect.  We all need to feel useful. We thrive with mutual understanding and respect.  However, people with Alzheimer’s may believe they have nothing to contribute.

The need for a sense of self and a connection to spirit. Many assume that Alzheimer’s robs people of their identity.  Although memory and cognition become impaired, it appears that the person living with dementia seems to retain a sense of self—the essence of who he or she is.

In conclusion, understanding human needs may help us to be a little more empathetic with people living with Alzheimer’s disease.

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.

Compassionate Touch®, Hospital Professionals, Senior Care Professionals

Why Touch is Good Medicine in Caring for Persons with Dementia

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“Touching as a therapeutic event is not as simple as a mechanical procedure or a drug, because is, above all, an act of communication…the use of touch and physical closeness may be the most important way to communicate to acutely ill (and aged) persons that they are important as human beings…” – Ashley Montagu

Touch is good medicine.  Research supports the beneficial effects of skilled touch as a powerful, yet under-utilized means to address an urgent need:  person-centered care for people with dementia.

Let’s look at the need.  Our aging population is having a major impact on hospitals, long-term care companies, aging and regulatory services and hospice providers.  Clinicians and front-line staff will serve more people over age 75 than any other age group and prevalence of dementia is being seen in every sector of senior services.

  • About one-quarter of all older hospital patients are people with dementia
  • People with dementia constitute about half of all nursing home and assisted-living facility residents
  • An estimated 15 million family and friends in the U.S. provided care to a loved one with dementia in 2013

Touch deprivation leads to feelings of isolation, anxiety, poor trust in caregivers, insecurity and decreased sensory awareness.  Older adults living with chronic illness, dementia and other conditions are especially receptive to touch.  Unfortunately, they are the least likely to receive expressive human touch from health care providers and caregivers.

Touch stimulates the production of oxytocin, leading to feelings of safety, caring, trust and decreased anxiety.  It’s been called the care and connection hormone.  When your brain releases oxytocin, you feel good.

At the same time, cortisol is a hormone that increases when we are stressed.  Studies show that cortisol level decrease after even five minutes of skilled touch.

Instrumental vs. Expressive Touch

Touch in caregiving is NOT the same.  There are two basic kinds of touch that commonly occur during caregiving:  Instrumental touch is necessary to perform a task or procedure such as transferring or bathing.  Expressive Touch is offered spontaneously to show care, concern, reassurance, affection, and empathy.  It has the power to affect our feelings about others, ourselves and the world we live in.  The person receiving the touch feels validated and distress in the moment is eased.

Skilled Touch has a structure and method designed to achieve a desired clinical impact.

Compassionate Presence is both a personal quality and professional skill that can be learned and developed.  With compassionate presence:

  • you connect with individual rather than the disease
  • you connect in the moment as it unfolds
  • you accept the reality and current experience of the person you are serving

“The most important innovation in medicine to come in the next 10 years:  the power of the human hand.” – Dr. Abraham Verghese

Expressive touch provides a feasible, effective tool to respond to behavioral expression in persons living with dementia;  reduce stress for both care partners, and a means to calm, connect and comfort.  With training, it is a powerful tool that is literally in the hands of those caring for our older adults.

Research supports positive changes in physical behavior, mood and expression, resistance to care, and reduced stress for both care partners, leading to greater staff satisfaction.

Skilled touch:

  • alleviates aches and pains
  • provides tactile and sensory stimulation
  • induces a relaxation response
  • supports psycho-social well-being

There is an urgent need to provide more effective and feasible tools to improve dementia care and reduce the use of psychotropic drugs.

We can transform care… it’s in our hands!

Pam Brandon is President/Founder of AGE-u-cate® Training Institute and worked with Ann Catlin, OTR, LMT in the development of the ground-breaking Compassionate Touch® program, used throughout the US, Australia and Canada to improve care for persons with dementia and end-of-life.  

To learn more about the Compassionate Touch® program please visit http://www.AGEucate.com

 

 

 

Compassionate Touch®, Senior Care Professionals, The Faith Community

AAHHHH….. To Sleep Like a Baby Again. Is it Possible?

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I know I’m not the only one munching on graham crackers and milk in the wee hours.  For those of you who sleep like a baby and wake up refreshed and energized… well let’s just say the rest of us are green with envy.

Good quality sleep is not overrated.  It’s absolutely essential to our health and well being.  According to Nancy Foldvary-Schaefer, director of the Cleveland Clinic Sleep Disorders Center, “We now know sleep is an active process – all your organ systems behave differently during sleep, restoring themselves.”

During sleep,  our bodies are busy at work repairing itself, cleansing toxins, reducing inflammation.  And in recent years, research has linked higher risks of brain disorders, diabetes and obesity to sleep deprivation.

People living with dementia are certainly not immune to sleep challenges.  Disturbances can be caused by changes in the brain that cause restlessness,  urine or prostate problems, pain or discomfort, sleeping too much during the day, nightmares or environmental factors (for example external noise or feeling too hot or cold).

As dementia progresses, routine becomes more important to one’s feeling of safety and security.  This is certainly true with evening and bedtime rituals.  Not unlike what all of us should practice, here are a few reminders of what may help prepare for a better night’s sleep:

  • Light exercise in early evening, and wind down 90 minutes before bedtime.  Electronic devices should be minimized.
  • Dozing should be discouraged, as this may make falling asleep even more difficult.
  • Avoid tea, coffee, sodas or alcohol should be discouraged, as all of these can have an opposite effect, especially for someone living with dementia.
  • Make sure bed and room temperature is comfortable (cooler is generally better than warmer).
  • A regular routine of listening to soft music, a light back rub or applying aromatherapy lotion may be very helpful in creating a calming atmosphere that may induce sleepiness.

As more holistic therapies for sleep are ushered into person-centered care practices, less use of pharmacological aids will be needed.  Side effects of sleep-inducing drugs can have negative consequences on quality of life for those living with dementia and their care partners.

Pam Brandon is President/Founder of AGE-u-cate® Training Institute.  Their groundbreaking program Compassionate Touch® is a practical and feasible means to reduce behavioral and psychological symptoms of dementia and crete positive engagement of elder, staff and family caregivers.  

www.AGEucate.com