Tag Archives: compassionate touch

Family Caregiver, Hospital Professionals, Senior Care Professionals

Why State Dementia Training Requirements Are Expanding

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More than 5.5 million people across the United States are living with Alzheimer’s disease and other forms of dementia.  As the baby boom generation ages, the numbers are projected to grow at alarming rates.  Although state dementia training requirements vary greatly, overall requirements are expanding for certified nursing assistants, administrators, licensed practical nurses, health aides, personal care assistants and law enforcement and emergency personnel.

People living with dementia are living in a variety of settings – nursing homes, independent and assisted living communities, adult day centers and at home.  Professionals and families provide daily care, but beyond that, the community at large is touched by dementia.  Our police, firefighters, and emergency personnel come in contact with persons living with dementia.  Hospitals are treating more persons with dementia every day.  Social workers, too are helping a growing number of persons with dementia and their families.  Volunteers in a variety of settings are assisting persons with dementia and their families.  the need for dementia training is growing and state requirements are expanding to meeting the demands across the healthcare spectrum.

Until just a few years ago, state dementia training requirements were minimal, with the exception of a few states that were leading the charge, thanks to visionary leaders that saw the when those caring for persons with dementia had little or no training, the quality of care is greatly compromised.

Although states are deciphering best practices in dementia care, as we understand more about the needs of persons with dementia and how to best serve them and their families,  more defined training requirements and being implemented quickly.  Person-centered care practices, when integrated properly, can lead to a transformational change in the quality of care.  Quality dementia training leads to reduced care partner stress and equips caregivers with effective tools to better respond and meet the needs of persons living with dementia.

Improving state training requirements is incredibly important work as we prepare for the fast-growing numbers of people who will be entering long term care.   As we move forward, it is our hope that states are expanding training requirements for those who serve people in all settings, not just those facilities that market themselves as serving individuals living with dementia.  Adult day centers,  assisted living and independent living communities are all seeing a dramatic rise in serving persons with dementia.

When communities train all of their staff who interact with their residents, person-centered culture change is possible.  This includes dietary, housekeeping, maintenance, administrators and others.

And finally, states are looking at programs that are effective, feasible and lead to sustainable change.  This is not easy, as program implementation across large entities requires training providers who are adaptable, understand the needs of that organization, and are equipped to partner with organizations to effect positive change.

Pam Brandon is President/Founder of AGE-u-cate Training Institute and a passionate advocate for older adults and those who serve them.  She is the creator of the internationally acclaimed Dementia Live® empathy training program and led the development of Compassionate Touch®, a clinically proven skilled touch program for those living with dementia and at end-of-life.  Pam may be contacted at pam@ageucate.com.

 

 

 

Compassionate Touch®, Family Caregiver, Hospital Professionals, Senior Care Professionals

Is Stress Reaction a form of Behavioral Expression in Dementia?

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Stress Reaction is a term being used more often to describe communication in persons living with dementia.  Behavioral expression, too, is communication.  In a growing number of circles, the term behavioral expression is being replaced by stress reaction simply because behaviors sometimes leans toward being a negative descriptive of how persons with dementia express unmet needs.

Stress reaction is communication that is caused by changes taking place in the brain caused by the progression of dementia.  These changes can cause behaviors such as:

  • Aggression
  • Irritability
  • Pacing or wandering
  • Withdrawing
  • Resistance to care
  • Crying
  • Yelling

It is important for care partners to understand that stress reaction is always caused by an unmet need.  The most common causes of unmet needs can be categorized in the following areas:

  1.  Physical discomfort – perhaps caused by pain, hunger, thirst, fatigue or other barriers.
  2. Nonsupportive environment – this might include noise, chaos, inadequate lighting, temperature changes or excessive clutter.
  3. Unmet social needs – boredom, lack of sense of purpose, lack of companionship, touch deprivation are some examples.
  4. Ineffective care partnering – examples include unrealistic expectations from caregivers, distrust from either care partner or inappropriate care (care that is not conducive to caring for persons with dementia)

Now that we’ve discussed stress reactions from persons living with dementia, we must then look at stress reactions from caregivers.  Understanding that it is how we as caregivers react to their stress reactions, is a core value of person-centered caring practices.

We cannot control their behavior, but we can control how we respond to their behavior.   Healthy care partnering means we understand that they cannot change what’s going on in their brain.  Their behaviors or stress reactions are a response to unmet needs, and it is the care partner’s responsibility to put the puzzle pieces together to help their care partners meet their unmet needs!

A few basic guidelines for care partners to keep in mind when there is a stress reaction:

Allow adequate space (in other words, step back if necessary)

The rule is always safety first for both care partners

Observe the environment, and what can quickly be changed, such as taking the person from a noisy room to a calm atmosphere

Observe body language and facial expressions, especially if the person is non-verbal.  What might they be trying to express?  And care partners, observe your own body language and expressions, as your stress reaction can either cause the situation to escalate or de-escalate

Watch your tone of voice!  It’s amazing how a calming voice will immediately bring calm to another person.  And just the opposite is true.  If stress reaction is met with similar behavior, it’s almost always a certainty that the outcome will not be positive.

And finally, learn techniques and tools that can prevent stress reactions.  Touch, music, redirection techniques, companion pets or dolls and more can have amazing outcomes and are simple to implement with the correct training.

Pam Brandon is the President/Founder of AGE-u-cate® Training Institute, creator of the Dementia Live® Sensitivity and Empathy Training program and directed the development of Compassionate Touch® for persons living with dementia and end-of-life.  She is a passionate advocate for older adults and those who care for them.

 

 

 

 

Hospital Professionals, Senior Care Professionals, The Family Caregiver

Creating a Sustainable Culture of Compassion

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I have to be direct in asking – isn’t this every elder care community’s goal?  After all, we should be in the compassion business, and sustainability is the hot topic today.  Creating a sustainable culture of compassion – makes sense right?

As I write this I can see my readers head shaking.  “It would be ideal, however…….”.  And the list starts adding up quickly of all the barriers to creating a sustainable culture of compassion.

Let’s break this down a bit, starting with Creating.  To create is to bring into existence;  to bring about a course of action or behavior;  to produce through imaginative skill.   Creating should be a blend of many and in elder care, that means everyone from our residents, dining staff, front-line caregivers, housekeeping, clinical staff, administrators and right “up the line” to the CEO.  It’s not a top-down mechanical procedure.  We create things and ideas by listening to each other, churning ideas and then embracing it all with passion.

Sustainability if the ability to be maintained;  In elder care, maintaining a high level of care for each resident is critically important.  High levels of satisfaction from residents, families, and staff are benchmarks upon which our business either succeeds or not.  Sustainability takes a strong commitment from leadership and perseverance to maintain standards even when the going gets tough.

 Now we look at a Culture of Compassion.  Wow, now we’re getting to the real meat here.  Compassion is simply empathy and concern for others.  Culture is the characteristics and knowledge of a group of people.  It’s a collective whole that creates a certain environment.
Aren’t we in the compassion business?  
Most certainly we are in the compassion business and I believe most of us found our way to senior or elder care because somewhere in our life experiences we found that this caring business is pretty dog-gone important to others and ourselves.
Why, then do we struggle with creating a sustainable culture of compassion?  Are we not looking at the vision we must create as leaders?  Are we not listening enough to those who are really doing the work that makes our business?  And, goodness knows, are we forgetting to listen to the very people who live in our communities?
I believe that creating a sustainable culture of compassion is not only doable but essential.  So many good things will happen when compassion cultures are created and maintained.  It is a domino effect of great leadership, teambuilding, happy residents, staff and families.  It’s getting down to the basics of why we do what we do every single day.
To coin a phrase, Just Do It!
Pam Brandon is President/Founder of AGE-u-cate Training Institute and a passionate advocate for older adults and those who serve them.  She led the development of the Compassionate Touch® program.  She may be contacted at pam@AGEucate.com.
Family Caregiver, Hospital Professionals, Senior Care Professionals

The Healing Power of Touch. Why are we Depriving our Elders?

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It the first sense to develop in the womb and one of the last ones to go during the dying process.

It is one of our most fundamental human needs.  It remains for a lifetime.

As we experience decline of the body or mind due to aging or illness, the need for human touch may be accentuated in the search for reassurance,  comfort, and connection.

Is Touch Deprivation Real?

Touch deprivation in old age is very real, especially for the medically frail elder, persons living with dementia, and older adults living alone.  Despite their need for touch and being especially receptive to touch, they are often the least likely to receive healing or expressive touch from health care providers or family members.  Studies have confirmed that nursing students have been shown to experience anxiety about touching older adults.  This anxiety, along with demands on staff time and duties, lack of training on distinguishing the differences between effective and ineffective touch, and simply society’s fear of touching ill and frail elders has led to wide-spread touch deprivation in our aging adult population.

Touch deprivation leads to feelings of isolation, anxiety, poor trust in caregivers, insecurity and decreased sensory awareness.  These kinds of distress can lead to behavioral responses or expression.

“It is well known in professional circles that young nursing students tend to avoid touching elderly patients, and especially the acutely ill…touching as a therapeutic event is not as simple as a mechanical procedure or a drug, because it 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, Touching: The Human Significance of the Skin

Physiological Effects of Touch

Healing, compassionate touch tilts a person’s response away from stress towards well-being.

Touch stimulates the production of oxytocin, a chemical in our brain that leads to feelings of closeness and security.  When oxytocin is released, feelings of safety, caring, trust and decreased anxiety take place in a person’s body.  Oxytocin has often been referred to as the “care and connection” hormone.  Simply put, when your brain releases oxytocin, you feel good!

At the same that oxytocin is released, another chemical is decreasing when we experience healing touch.  Cortisol is a hormone that increases when we are stressed.  Studies show that cortisol levels decrease after even five minutes of skilled touch.  Apart from the physical relaxation, skilled touch increases our emotional well being.

Is the Tide Changing?  

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

We are witnessing transformational shifts in dementia care across the globe.   No longer is status quo acceptable, as we now understand the importance of person-centered care, the meaning of life enrichment and our responsibility to create moments of joy and purposefulness.

We have the opportunity to get back to the basics of human needs with effective, feasible and transformative tools that are literally in our hands.

Pam Brandon is President/Founder of AGE-u-cate® Training Institute and worked with leading Touch expert, Ann Catlin, ORT, LMT in the development of Compassionate Touch® program for eldercare providers, hospitals, practitioners and families.  Pam is a passionate advocate for creating positive change in aging care.  Pam may be reached at pam@AGEucate.com

To learn more about the Compassionate Touch program visit www.AGEucate.com