Family members and professionals alike struggle with how to interact with a person living with the bewildering condition of dementia. As a caregiver, it’s easy to forget that this person can often answer and follow much more of a conversation than given credit for.
These are two “magic phrases” that many times will get the person’s attention and foster meaningful interaction: “Would you help me with this?” and “I need your help”. Individuals still long for a sense of purpose and when engaged in this way, he/she indeed feels that they are still a part of things.
We all feel valued and respected when asked to give advice or to help with something. As a caregiver, we feel we matter. The same is still true for people with dementia. Although the advice or help may or may not be quite on track, they will notice that we asked and are willing to listen to them. The same feelings of value and respect remain.
Actually, more times than not, I’m surprised by the response that tells me the person not only knows what I’m talking about, but offers spot–on insight. I saw this first-hand when I recently visited my brother who has mid stage dementia. I was lamenting, mostly to myself, that I will be turning 60. I said, out loud, “Sixty! How did this happen?” Without missing a beat my brother replied, “Well, we grow older every year and wiser and then it just comes around to that.” I was shocked and it made me smile. I was given a reminder that he was still with me.
So, next time you are at a loss for how to connect, you might say, “Tell me your thoughts on…” (Recipes, a favorite season, songs, politics, or anything about just plain life). See what gems, humor, and stories you discover. The person with dementia will thank you for it.
Most of us don’t give much thought to items we use in our everyday lives. But the memories of these seemingly benign objects reconnect us with moments of meaning in our lives.
One woman found a moment of joy in… a sponge roller? Who thinks of a sponge roller anymore – or even knows what one is? But for this woman, it evoked sweet memories of her grandmother “putting up” her hair on a Saturday night to get ready for church the next day. With tears in her eyes she told about swapping stories and memories about laughing and eating yummy snacks as her grandmother wound her hair around rows of pink rollers that she would later sleep in. She relived those sweet times and reconnected to her grandmother- sparked by a sponge roller!
Everyday items have the power to ignite our senses and memories about people, places, experiences, and emotions of all kinds. Our days are filled with the “stuff of life”. A phrase usually meant philosophically is quite literal too.
I have an old, scratched up metal recipe box that lives among my cookbooks. It was THE recipe box in my mom’s kitchen. It’s filled with recipes cut from newspapers- lots of things made from Jello and marshmallows. But it’s the hand-written recipe card for peanut butter cookies that gets to me. You see I made dozens and dozens of those cookies. The card is stained with butter and there are little bits of fossilized cookie dough stuck to it. Hold it, and I’m right back with the memories of making a mess in the kitchen baking with my friend Shelly. I even still use the same old aluminum measuring spoons. Someone else might wonder why I don’t get rid of those old things. But there’s history in those spoons- and it’s MY history.
What “stuff” causes you to say, “Oh wow, I remember that!” How might caregivers use this same reaction to help people living with dementia reconnect with meaningful moments.
Sustainability in training programs that improve patient and resident outcomes is critically important. Upper and middle managment must embrace change initiatives in order to successfully compete in an increasingly crowded marketplace.
But what happens after these programs are implemented? Far too often we hear that wonderful “culture change” programs faded in time, often because the champions were no longer with the company, or had moved to other positions. Unfortuantely for the organization, this means an investment of time, money and resources had gone to waste. This may be a result of poor planning and program implementation or simply a matter of not enough staff to oversee the program to ensure its success. In addition, many such programs are limited by proper funding and acceptance by upper management to the extent that there is never a cohesiveness to keep the elements of the program working smoothly.
It IS possible to have program sustainability. With proper planning, collaborative efforts with training partners and the placement of champion leaders throught the employee spectrum, sustainable programmming is very possible. In fact, we know that it can work! Below are just some examples of how programs can be made sustainable.
- Champion leaders are made of upper, middle management and staff. All team members working together on change initiatives is vital.
- Management should encourage problem-solving skills among all staff as new programs are implemented. Without idea generators, how would new practices every get off the ground?
- Provide incentives for staff who practice culture change initiatives and embrace these in their everyday care routines. By including simple accountability systems using champion leaders, this will insure that new tools are being used effectively and efficiently.
- Make certain that everyone understands the big picure of why new practices are being implemented.
- And finally, sustainability is afterall, not just about how you run your business but how you treat your staff.
When elderly people spend time in a hospital, they often leave more disabled than when they got there. That’s pretty stunning considering the condition they may be in when admitted. Some of the most common reasons for hospitalization are injuries from a fall, pneumonia, infection, cardiovascular disease and dehydration. Treatment of the acute condition frequently doesn’t include special care needed to prevent rapid, and sometimes irreversible, physical and mental deterioration. Weakness from bedrest, weight loss, adverse drug reactions, delirium, and hospital-acquired infection are all too common. At a time with people 65 and older make up the fastest-growing segment of our population, our hospitals should take notice. Fortunately, some are. Special services such as the Acute Care for Elders (ACE) unit exist, but in only small number of our 5000+ hospitals in the U.S. What’s different about this specialized care? There’s a greater emphasis on maintaining mobility and preventing functional decline, cognitive assessment, a communal dining room to encourage better nutrition and social interaction, early discharge planning, and staff with training in geriatrics play key roles. I’m glad to see that hospitals are addressing this pressing issue, but wonder if it’s enough to prepare for the sheer number of us baby boomers beginning to need this kind of care.
Does your local hospital highlight special care for older patients?