Learning to step into a resident's reality
Each day the halls of the Hebrew Home at Riverdale are filled with dedicated staff members in bright red shirts. As a large facility with over eight hundred residents living in five buildings across a multiple acre campus, the Resident Transport Services team is a vital part of the community. They escort residents to therapeutic activities which enrich their lives, clinic appointments which keep them healthy, and rehabilitation therapy for strengthening and recovery. In one week, RTS staff assist residents to over one hundred clinic appointments, over two hundred rehab sessions, and over forty activities.
A common scenario that occurs in the RTS staff's daily work is inviting residents from one a memory care neighborhoodto a clinic appointment. Many residents are living with Alzheimer's disease and may have difficulty understanding what is being asked of them due to cognitive impairment.They are confused as to place and time and not sure why they should go with the RTS staff member to the in-house clinic. Encouraging residents with memory loss to attend important appointments is instrumental to the RTS team's work.
In order to support the RTS team, some of whom start their positions with limited training in dementia, an experiential and didactic training was devised and facilitated by creative arts therapists from the Hebrew Home staff. This is the first time in-depth dementia training has been implemented with members of the RTS department. Topics covered included an overview of dementia with a focus on AD and effective verbal and nonverbal interpersonal techniques with people living with dementia. The latter was explored through the drama therapy lens of role-play to help RTS staff explore solutions and challenges in the moment.
Time was also devoted to question and answer sessions in which the RTS staff were encouraged to bring up challenging situations they had encountered; trainers and staff then problem solved together through both verbal and action methods.
RTS staff reflected that the training was meaningful and informative for them. They shared that they learned about the different stages of AD, and how the illness impacts their ability to perform their duties. Blake Castro, RTS team member, said: “I learned it is not only okay, but preferred to step into a resident's reality, to play along and make them feel comfortable … It makes it easier to calm them down if they're feeling agitated.”
Staff also gained an increased sense of empathy from the training through the discussion and action-methods. They learned, as Castro said, “If it was one of my family members, how would I want them to be treated? Residents with dementia are humans just like you and me.”
Due to its initial success, the plan is for dementia trainings to be ongoing with the RTS team. Additionally, the hope is to explore expanding the training to other non-clinical departments.
Both clinical and non-clinical staff interacts with residents with memory loss daily in nursing homes. Incorporating interactive dementia overviews into staff meetings for both clinical and non-clinical staff help staff gain tools to help them through challenging situations. From the housekeeper to the nurse, each staff member has opportunities to engage with residents throughout the day. Because of this, we need to ensure all staff has the skills to provide creative, compassionate, strength-based care to our residents. Training provides a pathway to accomplishing this goal.
George Eley is the Manager of Special Programs at Hebrew Home at Riverdale. Mary Farkas is the Director of Therapeutic Activities at the Hebrew Home.