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.
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?
Healthcare 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.
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?
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?
It’s no secret that memory care is one of the fastest growing senior care service, providing healthcare professionals increasing opportunities. But, if you are new to dementia care, I suggest you ask: “Am I really prepared?” and “Do I have what it takes?” Serving people with dementia requires a unique combination of knowledge, skills and personal awareness.
Knowledge gives you a foundation to act from. When informed, you can offer your care with confidence and ease. It’s essential to be informed about the characteristics and needs of people with dementia, such as:
Age related changes. It is important to understand the “normal” physical and functional changes of aging versus changes that are manifestations of a disease resulting in symptoms of dementia.
Common conditions found in eldercare settings. If you work in long term care, you will encounter people living with the effects of stroke, Parkinson’s disease, Alzheimer’s disease, hip fracture, cancer, among others. A basic understanding of these conditions will ensure that you provide safe, effective and meaningful service.
Special needs of elders in facility care. Those who live in care settings are often dealing with loss, grief, feelings of helplessness, lack of control, boredom, touch deprivation and feelings of isolation. Your awareness and compassionate acknowledgement of these sensitive issues will deepen your therapeutic relationship with each individual.