As the Senior Social Services Director at SKLD Muskegon, Merice Raber helps bring meaning and joy to Western Michigan skilled nursing residents with memory loss.

September is World Alzheimer’s Month and September 21st is World Alzheimer’s Day. According to Alzeheimer’s Disease International, “This year’s campaign will shine a light on the warning signs of dementia, encouraging people to seek out information, advice and support, as well as contacting the Alzheimer’s or dementia association in their country.”

Merice works with the long term care staff in her facility to continuously train them on how to create a dementia savvy and capable culture. One of the ways the team recently brought meaning to the residents was by giving them their own pet.

Pets provide comfort for long term care residents with memory loss

About six months ago, SKLD received a grant from the Michigan Long Term Care Ombudsman Program to provide animatronic pets to residents. Merice shares, “We have electronic cats and dogs that meow and bark, roll onto their sides and can even open their mouths.”

SKLD Muskegon’s Merice Raber is pictured with the animatronic pets that residents love.

She continues, “We gave the pets to the residents and found especially the ones who had real pets in the past found the most comfort from them. There is no daily care or feeding required. It’s just such a comfort to pet and have around.

The staff even set up a groomer station in Merice’s office. Merice says, “One female resident sets her puppy on the table for grooming, which is really special to see. The residents come and ask for cats and dogs to be cleaned and they come to pick them up later. It’s so much fun to see their eyes light up when they come back.”

The pets provide comfort to the residents but also help residents connect to the staff. Merice says, “The staff will ask a resident if they are bringing their puppy to an activity. Some will ask if they should brush the kitty while the resident’s hair is being brushed. It’s a great way to connect throughout the day.”

During the pandemic, the pets provided a great deal of comfort to the residents. Merice shares, “Especially during COVID, a tool like this provided physical comfort while waiting for a window visit. It’s been nice to refer back to saying, ‘Don’t forget about kitty,’ or, ‘Should we bring our pets to the groomer?’ It helps create a sense of community and share joy with each other.”

A pet highlight story for Merice:

“We had rolled out the pets and it had been going for a few months. A newer resident with limited movement and non-verbal didn’t have the ability to engage in conversation at all. One morning we sat at a team meeting discussing what we can do for this gentleman. We decided to see if he would be receptive to a puppy. We brought it down and his eyes immediately lit up. He gave us a big smile and wrapped his arms around the puppy. It is so special to see that while he couldn’t use words to communicate, he was so receptive to the animal touch. It was validating to see the comfort and excitement.“

New tricks for families and staff

Recently, a new Core Dementia Training program started which many SKLD staff members have participated in. Merice says, “I have gone through the training, and we are encouraging our staff to participate as well. The training provides different interventions and ways to talk to residents.”

The Core Dementia Training offers staff tools and training that help staff with the residents. The staff also works with families to teach them these tools when visiting with relatives.

Merice says, “It’s all about learning to help them feel more comfortable or heard. For example, the training talks about using segmented conversations and not asking several questions at once. Asking one question at a time can help the resident focus on a question so that they are better able to respond without confusion.”

Breaking down the conversation can be a beneficial technique in having a positive interaction with a resident or family member with memory loss.

Making sure residents are accommodated during activities is paramount. Merice says, “The residents all love bingo. Some residents need more assistance when finding chips or needing numbers repeated.”

She continues, “Keeping residents involved in activities has created a strong community atmosphere. The residents remember each other’s names. When they go down to the snack cart they will ask, ‘Do you want anything?’ It’s so amazing to see that across levels of cognition, they are still so friendly and have really built a community.”

In January, a new psychologist joined the SKLD Muskegon skilled nursing facility to provide supportive visits along with a social worker. Merice says, “I always hear good things from the residents about their visits with Dr. Silo because they love having someone to talk to. When they come in, they feel the strong sense of community we have cultivated here.”

Tips for dementia capable care

Person-centered care is a big deal at SKLD Muskegon and it is the same with dementia capable care. Merice says, “The main goal is for the residents to be understood to the best of their abilities and we try to meet them where they are at.”

Instead of saying, “No, it’s not Wednesday in 2020,” change the focus to “It’s a good day today.” Merice says, “Don’t remind them what they are forgetting. Our job as staff and family members is to help them feel comfortable and meet them where they are in cognition.”

The animatronic pets can help serve as a grounding force in confusing times. “Alzheimer’s disease or any memory loss can be scary and confusing. The pets bring immediate comfort and open the door to talk with others, whether it be residents or staff.”

Merice shares some beneficial tools for family members of a loved one with Alzheimer’s disease, dementia or memory loss:

Break sentences down

Try to keep sentences to one thought at a time. Any more than one idea can be confusing to the resident or family member.

Meet loved ones where they are

They might not remember seeing a relative grow up and may have trouble recognizing them if they look different. Redirecting the conversation by saying something like, “This is your husband, and he’s so excited to see you.”

Highlight the positive in conversation

If something negative comes up in conversation or they remember something unpleasant from their childhood, try to redirect them by reminding them what they are doing today. Saying comforting phrases like, “Today we are safe and together.” Try not to highlight what they don’t remember, but bring something positive to the conversation.

Be patient
It can be hard and emotional to see loved ones re-experience a hard memory. When it comes out and it’s not how they want to say it, try to understand what they are trying to communicate. It takes a lot of time and patience, but it’s so worth it. It’s not about reminding them what they are missing, but what is possible to share together in the present.

Merice says, “The residents have good days and harder days. If a family member has a difficult visit, we always encourage families to try again. With memory loss, it can be a trial and error process. It’s hard work, but it is so rewarding.”