All posts by Ann Catlin

Senior Care Professionals

Senior caregiving: Remember your why

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lonely-old-man-in-senior caregiving

Anyone working in the field of senior caregiving knows how important it is to find meaning in our work and service. Author Simon Sinek tells us to Start with Why. I’m haunted by the memory of a man who reminded me of why I continue to love senior caregiving.  I met Frank in a nursing home where I was teaching a Compassionate Touch workshop.  I first noticed him because he wasn’t particularly old, at least not by senior care standards, and because he was tall and muscular. He was sitting in a corner in the hallway near the nurse’s station. By his appearance, I was pretty sure he had suffered a stroke some time back.

During the first two days of the training, my students and I went about our business interacting with elders and memory care staff. On the third day, I noticed Frank sitting in the same spot– for hours, just sitting there.  He didn’t interact with anyone and seemed frustrated. He restlessly pushed on the wheelchair footrests. The wheelchair was locked so he couldn’t go anywhere and I’m pretty sure he couldn’t propel the wheelchair himself. Lots of people passed by in the hallway, but no one paid him much mind. He seemed invisible. And lonely. And really frustrated.

Frank is exactly the person I love to seek out to serve.  So, on the third day I pulled up a chair and sat next to him, introducing myself and there was immediate eye contact. While he had trouble with speech, he still could carry on a conversation. He told me he was a veteran and grew up in Illinois. I also learned that he believed his age to be 37. Other signs of confusion were there, too.  I held his hand and arm  affected by the stroke. He was receptive to touch. I asked if his back was uncomfortable. He indicated yes, so I gently rubbed his shoulders and He told me it felt good and with very clear speech, thanked me.

The next day he was again sitting in the same spot. I asked him if he would like to sit somewhere else. He pointed to a spot about six feet
away that was near a desk. With a little effort, because of his size, I maneuvered his wheelchair around so he could reach the desk with his hands. He reached out took hold of a newspaper and proceeded to read it! Regardless of his reading comprehension, he engaged in something purposeful that clearly meant something to him.   The restlessness stopped.  I sat with him about five minutes and I saw a glimmer of a sense of humor. As I left, he took my hand and said “thank you for stopping.”

Now, Frank’s memory haunts me. In a bad way and a good way. Bad because his plight troubles me since I’m pretty sure that he is sitting in that same corner spot as I write this. Invisible again. However, good because Frank is a gut-check of why I do what I do.  Thank you, Frank, for reminding me of  why I love senior caregiving.

 

Senior Care Professionals

Mandatory Dementia Care Training: A Good Start

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Dementia care training: learning is just the first step.
Learning is just the first step in dementia care training.

Many  adults with dementia reside in nursing homes or assisted living. Still others attend adult day care  or receive home care services. The need for caregivers to provide quality care has never been greater. Dementia care training standards is a hot topic since federal and state legislation established new mandatory dementia care training requirements.

The New Training Standards:
 Each organization is now tasked with ensuring that training requirements are met. This applies not only to direct-care staff, but ALL new and existing staff. Maintenance, dietary, office workers,  volunteers and contracted workers are included. The new regulations require a specific number of hours of dementia training when first employed, as well as annual training updates.

The Federal Register published October 4, 2016 provides only broad guidelines for training topics in Section 483.95. It states training topics must include:

  • Communication
  • Resident rights
  • Abuse and neglect
  • Quality assurance and performance improvement
  • Infection control
  • Ethics and behavioral health

For nurse aides serving  individuals with cognitive impairment, training “must address the care of the cognitively impaired.” Also required is training for feeding assistants.

Most who work in eldercare want to feel confident in their jobs and welcome training. However,  I think it’s time to leave behind the monthly required employee in-service model.  I’m sure I’m not alone in having presented at these meetings only to find a lethargic audience that was there only to pick up their paychecks after the meeting.  Consequently, nothing productive, let alone inspiring, results.  It begs the question: What kind of training truly leads to dementia care competency?  Furthermore, how can mandatory training reach beyond the basics to change attitudes and actions?

Re-frame Training: Now is the Time
In a series of posts I’ll explore components of core education that will help meet the new training standards. Especially relevant, training should lead to skills, knowledge and behavior expected for the delivery of dementia services.  What components do you think are essential?

Senior Care Professionals

Dementia Communication: Learn how to understand

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Dementia trainingHealthcare is quickly becoming dementia care. Whether you work in a clinic, long term care, home care, or hospital, you will interact with people dementia.  And these people will likely have speech and language challenges.  Dementia care training often focuses on the underlying impairment when care partners really need practical solutions.  Easy-to-learn dementia communication skills, save both parties frustration. Here are a helpful strategies.

When she has trouble finding the right words to tell you want she wants to say or you can’t understand her because of “word salad” or slurred speech.
  •  She may understand more than she can express with words.
  • Use skilled touch to reassure her.
  • Listen for a key word or phrase to give you a clue about what she is telling you and repeat the word to let her know you are paying attention.
  • Remember the emotions behind the words are more important than the words. Validate the emotion. Mirror the non-verbal expression: facial expression, movements or sounds.
  • It is easier for her to answer yes or no questions or those requiring one word response rather than open ended questions.
When he has trouble understanding what you say:
  •  Use touch to engage his attention.
  • Supplement your speech with gestures.
  • Be patient. Allow time for him to absorb what you said.
  • Pay attention to your non-verbal expression. It “speaks” when words are lost.
  • Point to objects that will clarify the message – or act out what you are trying to say.
  • Ask one question at a time.

When you feel confident in your ability to handle dementia communication challenges, you’re more at ease. You can then shift your focus away from the physical condition to what is even more important—the person you are serving at the moment.  You will be freer to connect with the person as a human being, a form of communication that speaks louder than words ever can. Isn’t that what person centered care is all about?

 

Senior Care Professionals

Assisted Living: Technology and Quality of Life

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Woman in assisted living on her computer.
Woman in assisted living on her computer.

Technology can boost quality of life for people in assisted living. As baby boomers age technology will take a much bigger stage, as suggested in some consumer trends.

A Few Real Life Examples

I once volunteered at Rowe Sanctuary, a nature center along the Platte River in Nebraska where thousands of Sand Hill Cranes gather on their way to points north.  People of all ages from around the world visit the sanctuary to witness this spectacle of nature.  I operated the Crane Cam, a remote camera placed on the river. The camera sent images to the National Geographic website.  While operated the camera, a couple approached, curious about what the process.  After I explained how it all worked, the woman told me about her mother who was in a nursing home in another state. Evidently her mother had been to the sanctuary several times in the past. She had been an avid bird watcher for many years. But since in long term care, she no longer participated in bird watching.  The daughter became so excited because she had recently set up a personal computer in her mother’s room at the facility.  It was possible for her mother to peek in on the Cranes via the internet and reconnect with her love of bird watching.

A gentleman in memory care used a PC to write poetry and letters to his family. In his career he’d been a successful business man, therefore the desk and computer in his room helped him retain an important part of his identity.

One young man with cerebral palsy resides in assisted living. He plays keyboard and records music on his PC. Sounds like a typical twenty year old, doesn’t it?  His keyboard was modified to compensate for poor coordination, so he managed independently. He proudly played his musical creations for guests.

We surely can expect more people in community care with their own computers. It might serve as one way to lessen the feelings of isolation and boredom that plague so many who must reside in assisted living.

What are your thoughts about the link between technology and quality of life?