Category Archives: Compassionate Touch®

A Reflection: The Comfort of Touch for Family at End of Life

 

Touch is is a comforting gesture for both the dying and their loved ones.

My friend Andrew shared with me his reflections on the care his family received while his mother was in the hospital dying. He poured out his heart on paper to discuss how frequent expressive touch was a comfort to his mother, and himself.

He writes, “We would kiss her forehead, touch her shoulder or hold her hand with varied responses. Holding her hand was the clearest communication and the best way to tell if she was with us or not. Most days she would squeeze our hands or lift them to her face for a kiss. At times, these actions were silent, and other times accompanied by grunts or whispers or even an attempt to speak.”

“The staff were lovely and compassionate people who understood her needs, but also our needs as family members. I saw many nurses and aides greet Mom on a good day with a hug or try to wake her gently with a hand on her shoulder, but there were also hugs for us.”

“We craved something to do, some way to comfort her and let her know she wasn’t alone. These small gestures of touch were all we had in her final days and the only way we could communicate with her.”

Touch:  A Final Connection

“In the end, she no longer responded to touch because hospice was doing their job correctly. We will never know what she understood and felt in those precious moments, so we continued to touch her. That small amount of physical contact was as much a comfort to us as we hoped for her.”

“Holding her hand, the hand that comforted me as a child, was again comforting me as an adult.”

Andrew’s words flew off the page at me because it gets to the heart of the work we do at the AGE-u-cate Training Institute with Compassionate Touch training. Touch is the first sense that develops in the womb and is a fundamental human need throughout our life course.  Through touch, care-giving professionals who work with families of dying persons can positively impact end-of-life care for both patient and family.

Thank you, Andrew, for reminding us of the impact that touch can have on the living, and the dying.

 

Shared by permission from Andrew Azzarello, a person with a personal and professional passion for eldercare.  Andrew continues caregiving responsibilities for his father and is the former Director of Human Resources for two aging services organizations.

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 to private 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.

Employee Education = Engagement = Quality Care

Employees at Emerald Health and Rehab in North Carolina are immersed in education about the positive effects of expressive touch.

We understand the negative impact on quality care as a result of high employee turnover.  However, more elusive is an understanding of how lackluster engagement of employees with longevity impacts quality.

Much of the focus is on recruiting new employees, and rightly so. Estimates show employee turnover nationally at 45%-66%.

At the same time, it is important that we also maintain the spirit and engagement of current employees. However, scare resources have forced employers in Aging Services to make tough decisions.

Cuts into the marrow of the employee education budget in light of the current staffing challenges could be devastating.  In doing so, we inadvertently create a more disengaged workforce and impair quality.

Defense Against Declining Quality Care

The vital connection in health care is that employee engagement drives quality of care. To that end, one of the best ways to engage employees is through ongoing hands-on education and training.

Guard against what could become turn-over induced decline in quality with a robust and engaging employee education program for your experienced and dedicated employees.

Employees with longevity have also felt the devastation of workforce challenges.  Fatigue with over-time and the constant flow of new employees in and out impacts the spirit of our dedicated workers.  All the more reason to dedicate resources and efforts towards their ongoing growth and engagement.

The absence of training appears on this list of reasons for poor employee engagement. Employees with longevity also need to continue to learn and adopt best practices. In doing so, we ensure the evolution of our quality of care and service.

In conclusion,  a corporate culture that supports growth and education for long-term employees will promote engaged workers and defend against declining quality care and service.

 

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 to private 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.

Learn the The ABC of Compassionate Communication

I’m delighted to share that our Australian Master Trainer, Sue Silcox has authored and published a book – The ABC of Compassionate Communication.  Sue is passionate about helping people become empowered through learning, practice, support, and self-care.

Brain Sparks and the ABC of Compassionate Communication is the result of her many years of working and playing with people of all ages, many of whom needed more compassion in their lives as well as an empathetic ear.

In the ABC of Compassionate Communication you will learn:

  • How we can use our brain to increase empathy
  • Where we can connect with other people and groups
  • When friendships matter
  • What laughter has to do with compassion
  • Why people react the way they do

We communicate every day.  Sometimes in subtle ways, sometimes in frighteningly revealing ways, mostly in different ways in between. Often we are misunderstood, or we interpret the messages incorrectly.  Becoming aware of how, through understanding, we can send and receive those message with compassion will make not only the lives of those we love and care for better but ours too.

Through this easy-to-read book, which uses the letters of the alphabet to describe steps to compassionate communication, you will receive twenty-six facets of compassionate and their relationship to improved communication compiled in a way that you will have not seen before.  Each facet gives you the chance to delve deeper with tips and ideas that you can try for yourself.

In the ABC of Compassionate Communication, Sue starts by asking our aware are you, firstly of your own self?  Self-awareness helps us find our strengths and allows us to work out where we need to improve.  Self-reflecting on situations can show us where we match up to our expectations and values.

Sue points out that working on your self-awareness brings benefits not only to you but to those around you.  Thinking about how you reacted with others brings awareness to your connections with others and ultimately makes you happier.

The book is full of compassionate communication tips that will serve anyone, especially those who care for persons living with dementia.  This book may be ordered through the Brain Sparks website.

Pam Brandon is President and Founder of AGE-u-cate® Training Institute and a passionate Advocate for older adults and those who serve them.  She is the Creator of Dementia Live® Sensitivity Awareness Program, helping caregivers worldwide to better understand and communicate with persons living with dementia.  

Sue Silcox is Australia’s AGE-u-cate® Lead Trainer and may be reached at Sue@brainsparks.com.au

 

Is Stress Reaction a form of Behavioral Expression in Dementia?

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.