Tag Archives: leadership

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.

 

 

 

 

How Do You Score in Empowering Your Caregivers?

From the conversations I have every single day with our partners, I’m guessing most of you would give yourselves an adequate score at best.  And perhaps this is on a good day.  “Empowering Your Caregivers” – some of you might just be asking what exactly I mean by empowering caregivers.

Our old friend, Merriam-Webster says that Empower is to promote the self-actualization or influence of or to enable.  An example: the women’s movement has been inspiring and empowering women.  

What makes the challenge so difficult when we talk about empowering our caregivers, especially those who are serving persons living with dementia?  This is where it gets fuzzy, right?  We have massive numbers of persons living dementia and not enough caregivers to go around, so those that are doing so by and large are stretched – to the max.  And like all professions, when demand outweighs supply,  people look for other jobs if they are not satisfied.  Thus the reason for a very high level of turnover among caregivers, especially those who care for persons with dementia.

Certainly, there are other factors that are equally as important such as pay, benefits and the stress that comes with caring for another person with cognitive decline.

Why then, are some providers able to outperform others when it comes to staff turnover, more satisfied employees AND happier residents, clients or patients?  They are as vulnerable as anyone else is to staffing shortages, wage and benefit offerings and the job itself is just as challenging no matter where one works.  Right?

Maybe that’s not always true.  My discussions consistently come down to the winners in this game invest in their caregivers.  They invest their resources, time and attention in Empowering their Caregivers.  The winners stand out with simple but strongly held core beliefs:  that caregivers MUST be:

  • Educated
  • Have the Tools with which to do their job well
  • Listened to
  • Rewarded

It’s funny, that when someone is educated or trained to do their job well, they then have the tools available.  If they are listened to, they feel a part of the team, and low and behold, when they are rewarded, they feel like what they do everyday matters.

And what our caregivers do every day DOES matter – it matters to your resident, to their families, to the culture of your business and ultimately it matters in how others view who you are as a provider of services.

Let’s not underestimate the power of empowering your caregivers.

Pam Brandon is President/Founder of AGE-u-cate Training Institute and the creator of the Dementia Live® Sensitivity Awareness Training Program.  She is a passionate advocate for older adults and those who serve them.  

The Family Caregiving Tsunami is Here. How are We Supporting Them?

We have a family caregiving tsunami whose tidal waves are affecting every corner of our society.  I venture to say that most communities are not prepared for the domino effects of a fast-aging population let along to provide support to their families that are scrambling to stay above water – emotionally, physically and financially.

November is National Family Caregivers Month.  Spearheaded by the Caregiver Action Network, the theme is Caregiving Around the Clock.  

As I travel abroad, I certainly see first hand that the challenges in the US are felt around the globe as this age-wave takes hold.  Public institutions are already stretched to serve current needs and despite the growth of

Let’s look at a few staggering US statistics compiled by the Family Caregiver Alliance:

  • Approximately 43.5 million caregivers have provided unpaid care to an adult or child in the last 12 months. [National Alliance for Caregiving and AARP. (2015). Caregiving in the U.S.]
  • About 34.2 million Americans have provided unpaid care to an adult age 50 or older in the last 12 months. [National Alliance for Caregiving and AARP. (2015). Caregiving in the U.S.]
  • The majority of caregivers (82%) care for one other adult, while 15% care for 2 adults, and 3% for 3 or more adults. [National Alliance for Caregiving and AARP. (2015). Caregiving in the U.S.]
  • Approximately 39.8 million caregivers provide care to adults (aged 18+) with a disability or illness or 16.6% of Americans. [Coughlin, J. (2010). Estimating the Impact of Caregiving and Employment on Well-Being: Outcomes & Insights in Health Management.]
  • About 15.7 million adult family caregivers care for someone who has Alzheimer’s disease or other dementia. [Alzheimer’s Association. (2015). 2015 Alzheimer’s Disease Facts and Figures.]

What is the Economic Impact?  

  • The value of services provided by informal caregivers has steadily increased over the last decade, with an estimated economic value of $470 billion in 2013, up from $450 billion in 2009 and $375 billion in 2007. [AARP Public Policy Institute. (2015). Valuing the Invaluable: 2015 Update.]
  • At $470 billion in 2013, the value of unpaid caregiving exceeded the value of paid home care and total Medicaid spending in the same year and nearly matched the value of the sales of the world’s largest company, Wal-Mart ($477 billion). [AARP Public Policy Institute. (2015). Valuing the Invaluable: 2015 Update.]
  • The economic value of the care provided by unpaid caregivers of those with Alzheimer’s disease or other dementias was $217.7 billion in 2014. [Alzheimer’s Association. (2015). 2015 Alzheimer’s Disease Facts and Figures.]

The clock never stops for family caregivers, and globally the clock is ticking for public and private institutions, community organizations, faith communities and each one of us in this space to make a committment-  that in 2019 we do more to reach family caregivers, provide support services and needed resources.  They are and will remain the largest group support our aging population in the years ahead.

Pam Brandon is President/Founder of AGE-u-cate® Training Institute and a passionate advocate for older adults and those who serve them.

Creating a Sustainable Culture of Compassion

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.