Innovative strategies for successful dementia care Presented By: Mary Ann Drummond, RN Vice President of Operations Carillon Assisted Living Author: Meet Me Where I A I Choose to Remember Janie Benton, RN Director of Clinical Services Carillon Assisted Living Have you Ever? Lost your car at the mall parking lot? Started to go after stopping at a red light before it turned green? Forgot your four digit ATM code? During a long drive found yourself wondering where the last 30 minutes of the drive went? Had someone start talking to you who knew you but for the life of you, couldn t remember who they were? 1
A Picture. Is Worth a 1000 Words!!! So what makes the picture not so perfect? 1. Let me do that for you. 2. Hear, let me help you with that. 3. Oh my, that s nice but let s try doing it this way instead. 4. That s too hard for you. 2
Which Would You Choose? Can t Won t Failure Loss Wrong Stop Trying Can Will Success Gain Right Keep Trying Three Keys Successful Dementia Programs: 1. A care PROGRAM verses bricks, mortar, food and water 2. Staff that are well trained in dementia care techniques, do s and don ts 3. Activity that promote opportunities for success in the care environment for the population served Dementia Program Math 86 Years Minus 50 years = 36 years of Age 2015 Minus 50 years = 1965 2015 Minus 86 Years = 1929 3
Born in 1929 12 years old in 1941 You Might Remember? 4
What Was Going On? Lyndon Johnson became the 36 th President The T.V. series Star Trek started 2 nd season Sound of Music was released Martin Luther King lead 2 nd march to Montgomery First combat troops arrived in Vietnam Medicare was created via the Social Security Act A Charlie Brown Christmas premiered Dr. Zhivago was released Man walked in space for the first time 1965-Top Music Groups The Beatles Sonny & Cher The Rolling Stones Dining Room Music Shouldn t be Elevator Music anymore 5
5 Steps to Meet Me Where I Am : 1. Practice the ABCs (Anticipate, Believe, Create) 2. Know the three key questions to ask yourself to help determine if you should make an intervention. 3. Understand how to use R&R to achieve R&R. 4. Remember to include auditory, visual, and tactile stimulation when presenting information. 5. Develop a unique plan of care tailor made to embrace the resident s interests, hobbies and life story. Anticipate Care Needs: 1. Bathing 2. Toileting 3. Eating 4. Dressing 5. Mobility Believe in the Ability Too often when we hear the word dementia, we think: DISABILTY To maximize one s potential, we need to change our thinking and focus on ABILITY 6
Create Opportunities for Success 1. Everyday chores can be some of the best forms of therapy for individuals with dementia. 2. One s response to the task is the best litmus test to determine if the task is therapeutic. 3. Sorting, stacking, connecting, packing, matching, and mimicking are great places to start! 4. Avoid tasks that cause frustration. 5. Provide praise and positive feedback for any task that is successful. Heads Up! What does this mean? Often the difference between a successful day and a frustrating day is dependent on the amount of boredom present. Whenever possible, take the opportunity to engage in a heads up moment, making eye contact and providing positive, affirming one-onone interactions. 7
Sweet Success! Know the Three Questions: 1. Hurting self? 2. Hurting others? 3. Is this normal behavior for the individual? R&R to Achieve R&R Rest and Relaxation can be an elusive butterfly for caregivers of dementia patients. To achieve the most R&R in your day, know how to Redirect and Reminisce. 8
Provide Auditory, Visual and Tactile Stimulation: We process information in three forms: What we see, what we hear and what we physically feel with our hands and body. When information is communicated to the dementia patient using all three forms of information, there is a higher chance the communication will be received successfully. Create a unique plan of care for daily success: 1. Consider the individuals likes, dislikes, hobbies and special interests. Include these items as activities and topics of interest throughout the day. 2. As much as possible, try to follow the daily routine the individual adhered to prior to becoming ill. What time did they like to get up? What did they like for breakfast? Etc. 3. Plan the tasks that need to be accomplished effectively so you will not need to rush to get them done. Your stress will always show through. 4. Place wonder/plunder activities strategically throughout the home to entice self motivated engagement. 5. Create a memory box of items that are familiar to the individual and relevant to their primary career, accomplishments, and special memories that they still relate to. 6. Organize old photos to include the names of who the people are and how they are related to the individual so you may reminisce effectively. 7. Include physical, cognitive, social, spiritual and sensory stimulation daily specific to the individuals interests, beliefs and preferences. 8. Include outdoor activities as much as tolerated. 9. Offer hydration and toileting every two hours. 10. Celebrate the successes as often as they come! The Best of the Best 9
Music is still the universal language: Music that is specific to one s special memories and relevant to the primary decades of late teens to early forties is proven to be beneficial in engaging dementia patients in positive and productive activities. There are many ways to use music as an activity beyond just listening. Consider chair exercises, dance, name that tune games, sing-a-long games, and growing in popularity with the baby boomer dementia crowd, karaoke! Other Recommended Activities: 1. Toss and talk ball 2. Table top hand manipulates 3. Lacing cards 4. Yarn wrap 5. Reminiscing kits 6. Baking/cooking 7. Gardening 8. Cognitive games 9. Arts and crafts 10. Story telling Let s Review Describe the three ways information should be presented to the dementia patient in order to increase the opportunity for successful communication and receptiveness of the message by the dementia patient. Identify at least two methods of intervention to use when the person with dementia is demonstrating inappropriate behavior to avoid the need for medication intervention. Identify measures that can be implemented in the daily care environment to enhance opportunities for successful daily interactions between care staff and the patient with dementia. 10
Remember: Focus on the enjoyment rather than the achievement! Meet Me Where I Am and you will find a place for you beside me. 11