If you’re considering care for a family member who is living with the challenges of Alzheimer’s or other forms of dementia, one of the most important factors to consider is the training and education provided to their caregivers.
If you’re considering care for a family member who is living with the challenges of Alzheimer’s or another form of memory impairment, the items at the top of your checklist are likely related to finding a safe and healthy living arrangement where your family member will not just live, but live well. When you visit a senior living community, take every opportunity to ask questions about their memory care program.
When you’re making a personal visit to an assisted living community, take every opportunity you have to ask questions about Alzheimer’s and memory care.
It may be helpful if you divide your questions between a few main topics: Living Environment, Engaging Activities, Staff Training and Education and Quality Assurance.
In this installment of a three-part series, we’ll help with things you should look for in a living environment that will help your family member live well.
First, take a look around the community and observe the residents. Are the residents engaged in elementary activities, or are they living full, enriched lives in an environment that encourages grown-up engagement? Are they well-groomed and dressed neatly? They should be.
Take a moment to walk the community. Is the space welcoming, vibrant and purposefully designed to accommodate residents with memory impairments? Residents with memory impairments may wander to help relieve stress, boredom, relieve discomfort or pain. An ideal design of a memory care environment would include opportunities for residents to walk within the secured environment and access to outdoor space (during appropriate weather).
You want to feel confident that your loved one is safe, and also that they are free to move about with exposure to sunlight, plants, birds and other things that make them happy. You want to feel confident that your loved one is safe, and also that they are free to move about with exposure to sunlight, plants, birds and other things that make them happy. You should get the sense that your loved one will feel free and relaxed, rather than confined and anxious.
To this end, consider whether the staff greets and welcomes you with open smiles. That’s a pretty good indicator of a positive environment. If there is tension in the air, you can generally see it on staff members’ faces.
Safety, of course, is of utmost concern. It’s easy to see the signs of a safe neighborhood:
Ask questions about the community’s call system and the staff’s ability to respond timely to your family member’s needs. Staff carry pagers and/or radios with them as means to communicate with each other. Pagers alert staff when something unusual happens (a door opens that generally shouldn’t, a door leading out to the courtyard or an alert button/pendant).
Another safety feature is systematic and routine checks on residents to be sure they are okay. The need for status checks and their frequency are based on each resident’s service plan. Certainly, basic cleanliness is worth considering as well. Are all of the rooms and open areas clean? Are there any lingering odors? What about the dining room? Is it clean and comfortable?
A supportive community will always promote independence by offering their residents choices. Simple choices work best for those with memory impairments. For example, a choice between a blue shirt or a yellow shirt versus choosing any shirt from their closet. We pride ourselves on offering our Life Guidance®residents the same dining experience as in Assisted Living. Pay particular attention to the dining experience, the quality of food the community offers and if they adjust their menu selections to accommodate the changing needs of the residents. Stay tuned for Part Two of the series, which will focus on Engaging Activities and their role in the lives of residents with memory impairments.
I recently sat down with Mike Gentry, Senior Vice President of Care and Life Guidance®, to talk about the role social interaction plays in helping those who are living with memory impairment.
ASL: Does an active social life have a positive impact on people with memory impairments? In what way?
MG: Long-standing research suggests that people with a history of untreated clinical depression are more likely to develop Alzheimer’s disease. The saying, “The brain loves company,” comes to mind. So yes, being around other people – being socially engaged – definitely has a positive influence on dementia and depression.
ASL: Why is social interaction so important to productive memory care?
MG: Studies have shown that social interaction is the best therapy for dementia care. It has value in the treatment for dementia because when a person with dementia feels that they’re surrounded by friends and family, they feel free to be more active. This freedom helps fight depression and builds their confidence and self-esteem. It makes them feel comfortable.
We’ve seen that when Life Guidance residents feel comfortable and more connected, it leads to less challenging behaviors; they are not as likely to try to leave or seek exit. They feel more at home.
ASL: How do we encourage social interaction among our Life Guidance residents?
MG: We’ve found that focusing on each residents’ life story encourages them to open up and talk about what they can recall in their past more than discussing their more recent memories. Additionally, our programming and activities encourage social interaction throughout the day. We encourage staff to help residents leave their apartments and participate in events, and invite people to be together – including introducing residents to one another. Our activity program is designed to bring together residents who share similar interests. And our caregivers make connections with residents as well.
ASL: Have you encountered families of Atria residents who have demonstrated delayed memory degradation that you believe we can attribute to social living?
MG: We often hear families say, “Mom is doing so much better since she moved into Life Guidance.”
Whereas before, many residents either lived home alone or stayed in their assisted living apartment, they now have less worries, feel more confident and participate in social activities.
We don’t have anything clinical to show that we slow the progress of the disease, however, our Life Guidance programming helps residents operate at their best – rather than their worst. Enhancing their quality of life is our goal, and the social living model is a powerful way to achieve that. The environment brings out their old personalities, mannerisms and habits. It’s really therapeutic.
We recognize that the commitment to care for a family member suffering from Alzheimer’s disease or dementia is one of the greatest sacrifices a caregiver can make. You’re challenged not only to adopt a new role with your mom or dad, but also to commit to tasks that challenge traditional parent/child social boundaries. Providing this sort of care often calls for tremendous emotional and physical strength.
From an emotional standpoint, you are tasked with caring for your parent or family member, who, in most cases, cared for you through a good portion of your formative years. Making the shift to being their operative parent is difficult, at best, particularly when they suffer from a progressive memory impairment that requires a nimble caregiving approach.
For example, the early signs of Alzheimer’s disease may not seem like they warrant a second thought – difficulties with short-term memory, losing track of items around the house, forgetting to fill prescriptions or buy groceries, and getting lost in familiar places. However, those symptoms can progress quickly and require a more attentive approach. People suffering from early Alzheimer’s disease may become irritable or withdrawn and may appear depressed at times. Certainly, when the disease has progressed to this point, a higher level of care is required.
Furthermore, as Alzheimer’s disease advances to moderate and severe stages, providing care at home becomes highly challenging. Your parent’s sleep-wake cycle may alter, for instance, causing them to wander in the middle of the night. Impulsive behaviors such as inappropriate comments in public may occur. Hostile or even violent behaviors, often directed toward caregivers, can occur. Impulsive behaviors may lead to falls and debilitating injuries. Other symptoms of advanced dementia include urinary and fecal incontinence. Intensive assistance is required for basic daily activities such as using the toilet, bathing, and even eating. As the symptoms of dementia progress, so does the burden on the caregiver.
Even with the most dedicated of caregivers and maximal support from the community, many people suffering from Alzheimer’s disease will often thrive better in an assisted living community. Caregivers frequently feel guilty for moving their family member to a community, particularly when they have cared for that person for a length of time; however, the burden of caring for a family member is often simply too much for any one person to handle.
Many memory care communities provide extensive support and comprehensive care to an extent that is difficult for many families to provide at home. These communities allow you, as the caregiver, to focus on what’s important for your parent, which is your emotional support.
As we grow older, forgetting a few things here and there is to be expected; in fact, absent-mindedness is fairly common. When memory loss becomes more than just a little absent-mindedness, it might be a sign of a degenerative illness such as Alzheimer’s or dementia. Although memory processing may slow with age, forgetting details like your home address or the current year are signs of a considerably different issue.
The statistics regarding Alzheimer’s and dementia in the United States are staggering. According to www.alz.org, more than 5 million Americans are living with the disease and nearly 15 percent of caregivers for people with Alzheimer’s are long-distance caregivers.
In response to this trend, many senior living communities now offer services that accommodate older adults with memory impairments. In our case, we call this service “Memory Care” or “Life Guidance.”
But, what does this mean?
It is our position that a person with dementia can continue to live an engaging, meaningful and joyful life. Why should their experience with aging be much different? Emotionally, they seek the same thing we all do – security, fulfillment and joy.
For these individuals and their families dealing with the challenges of dementia, we offer a forward-thinking memory care program featuring thoughtfully designed spaces, innovative programming and industry-leading quality standards.
We purposefully structure an intimate setting that allows our specially trained staff to provide more personalized care and attention. We also create welcoming, vibrant neighborhoods that feature comfortable amenities and secure outdoor spaces.
But, most importantly, we employ a whole-person approach to events programming that offers abundant opportunities tailored to personal interests.
For any memory care community, there are a few expectations you should keep in mind when you are considering your options.
First, there should be private or semi-private rooms available for your family member. This allows for as much independence as possible, with appropriate monitoring given the state of the resident’s impairment.
Of course, you should expect regular services such as daily meals, housekeeping and laundry service. There should also be careful and documented medical management services available.
An effective memory care provider should feature a full calendar of engaging events, specifically designed for those with memory impairments. Daily engagements should be planned and the caregivers should be equipped to handle these types of residents with confidence and meaningful attention.
And, of course, 24-hour assistance from a personalized team of caregivers is a necessity.