Bringing dementia core training resources to SKLD
The Gilead Memory Care Unit at SKLD Zeeland is one of the largest and most comprehensive facilities for dementia and Alzheimer’s care in the Western Michigan area. This means that finding ways to provide better skilled nursing care for patients with dementia and Alzheimer’s disease is a constant priority for the staff.
On regular intervals employees at the Western Michigan skilled nursing facility join extra training programs to support residents who live with cognitive and physical impairments associated with Alzheimer’s and dementia.
This summer, SKLD Zeeland staffers Tammy Reiffer, Rachael Stapley, and Kristy Woodwick participated in a dementia core training for two hours a week for 10 weeks.
The goal of the training program was to help staff customize care for each resident with dementia by focusing on bringing them “contented involvement.” This involves guiding a person with dementia to remain in a “calm, safe and pleasant” manner as much as possible. Planning and adjusting daily activities to the ability of each resident at the moment allows for their comfortable involvement. This flexibility helps a person with dementia stay engaged in an enjoyable and appropriate activity for whatever their particular stage.
Tammy has worked with SKLD as a social worker for the last eight months and has worked in long-term care for 12 years. She says, “We learned techniques to help residents with behaviors to allow them to feel good and get the most out of their day.”
Kristy is the newest SKLD staffer who joined the core training. She has been with SKLD for four months as the activity director. Kristy says, “This was my first dementia training experience. The biggest takeaway is to dive into the residents’ past experiences like their jobs, family, hobbies and religion and use them to make their time at the facility more meaningful.
Amber Stroven, admissions director at SKLD Zeeland, worked for seven years down in the dementia unit as a CNA and is now the transitional care liaison and admissions director. She says, “That unit still has my heart. I make it a point to go down every day to get my hugs. It’s a different atmosphere, and you can feel the love like a heartbeat.”
Meaningful connections for residents with Alzheimer’s
When residents with dementia or Alzheimer’s are having a hard day or hour, the staff steps up to connect with them and improve their situation. Kristy says, "If a resident is feeling tearful or having a rough day, reminiscing on past life experiences or loved ones with them helps deescalate the situation.”
One way the staff makes connecting to residents easier is by having them fill out an “All About Me” sheet. Kristy says, “It has several questions for us to get to know the residents like what pets they had, special family members and if they liked to travel. We gather that information from residents and put it in a binder to use as a helpful reference point.”
Tammy adds, “It’s a learned technique to not take it personally however they respond. Our job is to learn the best way to respond and approach a behavior or situation. The technique is to validate their feelings and then redirect. It’s helpful to be face-to-face, which means squatting down next to them sometimes so I am not above them. I try to remember that they don’t live in our workplace, we work in their home.”
Following the training, Kristy shared some changes that the team hopes to implement:
Ensure staff interact with residents individually based on their interests, as well as their stage of dementia, behavior or memory loss.
Be more mindful of how staff present activities so that they interact with each individual person depending on their mood.
Train the rest of the SKLD staff with their new knowledge and techniques.
Make time for reflection and implementation, as well as evaluate if further changes would be beneficial for the residents.
Therapeutic fibbing is OK
Families often find it challenging talking to loved ones with dementia who can say something that’s not based in reality. Kristy says, “In my experience, when working with people with dementia and having a family member myself with dementia, it’s important not to correct them.” For example, says Kristy, if a loved one asks where their mother is, it’s not helpful to remind them that their mom died.
Amber agrees and says, “This can start the grieving process all over again. If a resident is confused and doesn’t remember someone passing away, just say something else like they are taking a nap or ‘If I see him I’ll let him know.’”
Kristy continues, “We encourage the community to understand that those comments are upsetting and instead use ‘therapeutic fibbing.’ Just go with the flow of their story and live in their world. You could redirect and explain to the resident that mom is at the store and she’ll see her later. This will make the loved one feel more comfortable.”
Families also sometimes get irritated when a loved one repeats a story. Kristy says, “Often a resident will repeat the same statement or tell me what they had for lunch five times in 10 minutes. You don’t have to say, ‘You just told me that.’”
How to best help loved ones with Alzheimer’s
The SKLD Zeeland staff builds special connections with the residents in the memory care unit. Amber says, “We have one resident in the dementia unit who I have a special bond with. If he’s agitated, they’ll call me. As soon as he sees me, he cries and his eyes light up. He gives me a hug, and even though he is mostly non-verbal, he’s told me multiple times that he feels safe with me and loves me.”
Kristy shares, “I’ve witnessed his reaction to seeing Amber, and it’s so special. When she started working here all the staff thought he was a relative of hers.”
Tammy adds, “You can’t help but fall in love with them.”
Each staff member has their own specific way of helping the residents. For Tammy, “It’s the simple things. Lean on their history or music interests, and it brings back positive energy. This works whether it’s at home or in a facility. Once a resident was delusional, so I asked if she prayed. She said yes, so we prayed together and then she calmly laid back to take a nap.”
Kristy says, “If family members don’t know the best way to relate to their loved one with dementia, the staff can help. I’ve had family members of residents ask me how to cope with a loved one not recognizing them. I recommend you start talking about yourself and memories using your own name in third person. That can be a great way to stay connected.”
It can be very challenging learning how to navigate a relationship with someone with dementia. Amber says, “The next steps aren’t always clear so asking for help is a must. It’s normal to feel tired and guilty sometimes when losing patience. That’s when it’s important to remember that your loved one would want you to ask for help and not be too hard on yourself.”
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