Tag Archives: caregivers

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.

Rural Healthcare: Helping Caregivers and Persons Living with Dementia

Access to quality rural healthcare, resources, education, and support is a growing challenge in the US and around the globe.  What does this mean for the growing numbers of persons living with dementia and their families who are caring for them?  How does this affect the quality of care being offered by nursing homes and other care providers?

There are no easy solutions as options are dwindling for many rural communities.  Closures of hospitals mean less health care professionals to diagnose Alzheimer’s and other forms of dementia.  Community education for families, often a service offered by hospitals and clinics, is then not available.  When the infrastructure of healthcare, private providers and community-based services is compromised, access to much-needed support dwindles quickly.

I recently had the honor to work with the University of Waterloo School of Pharmacy who collaborates with the Gateway Centre of Excellence in Rural Health, both in Ontario Canada.  The University will be training its pharmacy students using our Dementia Live® and Compassionate Touch® programs and beyond that, they are will be working with Gateway to reach rural communities with desperately needed dementia education and training for families and professionals.

Reaching the indigenous people of the province will be part of this project.  In the 2016 census, the indigenous or Aboriginal peoples in Canada totaled 1,673,785 people or 4.9% of the national population.   Many of the indigenous peoples live in rural areas where access to services is limited.   Bringing dementia awareness and education to rural areas will help to spur collaboration amongst various organizations who need to work together to serve their aging populations and families.

Limited access to rural healthcare is a growing initiative in the US and other countries as the aging population swells.  Because family caregivers make up the vast majority of those caring for persons with dementia, providing quality training, support and access to resources is a top initiative for healthcare, long term care services providers and community-based organizations in urban areas who can collaborate with local services, faith communities and others who have a direct reach to many of the families who are struggling.

Finding local champions who see the value of collaboration, education and support services is ultimately the best measure of success, as the communities themselves embrace the challenges and solutions for their aging communities and the unique needs of persons living with dementia and their families.

Pam Brandon is President/Founder of AGE-u-cate® Training Institute and a passionate advocate for older adults and those who serve them.  

 

How Do You Score in Empowering Your Caregivers?

From the conversations I have every single day with our partners, I’m guessing most of you would give yourselves an adequate score at best.  And perhaps this is on a good day.  “Empowering Your Caregivers” – some of you might just be asking what exactly I mean by empowering caregivers.

Our old friend, Merriam-Webster says that Empower is to promote the self-actualization or influence of or to enable.  An example: the women’s movement has been inspiring and empowering women.  

What makes the challenge so difficult when we talk about empowering our caregivers, especially those who are serving persons living with dementia?  This is where it gets fuzzy, right?  We have massive numbers of persons living dementia and not enough caregivers to go around, so those that are doing so by and large are stretched – to the max.  And like all professions, when demand outweighs supply,  people look for other jobs if they are not satisfied.  Thus the reason for a very high level of turnover among caregivers, especially those who care for persons with dementia.

Certainly, there are other factors that are equally as important such as pay, benefits and the stress that comes with caring for another person with cognitive decline.

Why then, are some providers able to outperform others when it comes to staff turnover, more satisfied employees AND happier residents, clients or patients?  They are as vulnerable as anyone else is to staffing shortages, wage and benefit offerings and the job itself is just as challenging no matter where one works.  Right?

Maybe that’s not always true.  My discussions consistently come down to the winners in this game invest in their caregivers.  They invest their resources, time and attention in Empowering their Caregivers.  The winners stand out with simple but strongly held core beliefs:  that caregivers MUST be:

  • Educated
  • Have the Tools with which to do their job well
  • Listened to
  • Rewarded

It’s funny, that when someone is educated or trained to do their job well, they then have the tools available.  If they are listened to, they feel a part of the team, and low and behold, when they are rewarded, they feel like what they do everyday matters.

And what our caregivers do every day DOES matter – it matters to your resident, to their families, to the culture of your business and ultimately it matters in how others view who you are as a provider of services.

Let’s not underestimate the power of empowering your caregivers.

Pam Brandon is President/Founder of AGE-u-cate Training Institute and the creator of the Dementia Live® Sensitivity Awareness Training Program.  She is a passionate advocate for older adults and those who serve them.