With 80-90% of senior living facilities reporting staffing shortages, operators of these facilities should be generating ways to lower the risk of burnout and increase the likelihood of retention in their employees, besides just pay raises and bonuses.
Additionally, some states have moved toward nursing students to act as licensed practitioners and non-certified staff who have minimum training with a nursing facility to provide direct care. Although this helps with staffing numbers, these individuals are likely at a higher risk for burnout and turnover if they aren’t provided the needed resources to feel successful in their roles.
Staff efficiency is key right now
Because nearly half (48%) of residents in nursing homes have some form of dementia, there are simple engagement programs that can be developed and used that allow the staff to initiate the interactions with residents so they get started on the activity, while the staff member continues their duties.
The staff can still chart, clean and pass medications while monitoring the residents. This allows for efficiency to take place where the staff have resources to accomplish their work while residents are engaged in a meaningful way.
What happens when dementia residents are not engaged
It’s all too often that residents with dementia, who are not in activities for one reason or another, are sat around the nursing station with nothing to do. When those with dementia are not engaged, this can lead to wandering, falls, repetitive behaviors, yelling out and even aggression, and increases the chance for sundowning.
This occurs because they may need emotional support if they are feeling confused, bored, scared or anxious, or sad or depressed that is being caused from simply sitting there with nothing to do – there is no structure or purpose to what the residents are doing, therefore, they express this through their facial expressions and body language.
On the other hand, they may need physical assistance, like they are hungry, thirsty, need to use the restroom, in pain, or tired. Since for decades they have taken care of this on their own, they will move to try to satisfy this need for themselves if they are just sitting there, leading to the above-mentioned behavioral expressions. Therefore, there are simple engagement activities that can help.
Creating an efficient engagement process
In using the Dementia Connection Model, a cognitive-behavioral approach to dementia care, sensory stimulation is the main approach. The stimuli detected through our senses either directly or indirectly affect our limbic system, which houses our amygdala (emotion development) and hippocampus (memory). When these areas are affected with positive stimuli, positive feelings and memories are influenced.
Here are some simple sensory-stimulating engagement programs:
- The use of animatronic pets is a multi-sensory tool – visual, auditory and tactile stimulation – for those moderate to late stage. Add therapeutic essential oils, like lavender for calming, to their fur to stimulate one’s olfactory sense as well. Also, pets provide a sense of unconditional love and support. Staff should approach residents with the animatronic pet in their arms, asking something like “Can you watch my puppy for a while?” Staff should observe residents’ facial expressions and body language to see if they seem to like it. Then, turn the pet on and place the pet in front of the residents or on an individual’s lap; even provide a brush for grooming. If an animatronic pet is not available, then use a life-like stuffed animal. Residents will spend hours interacting, petting and grooming the pet, with such love and affection.
- Infant-dolls are also multi-sensory in nature. Use the same approach as described with the animatronic pets. However, include all the fun accessories, like bottles, diapers, blankets and clothes to use with the doll, or by themselves for organizing, sorting and more, which helps stimulate the residents’ cognitive skills too.
- Adult coloring is a visual and tactile approach. It’s also incredibly beneficial, because it allows the person with dementia to express their emotions on paper when maybe they can’t find all the words to express how they are feeling. Great for all stages of dementia. Staff would place either paper or coloring pages with coloring utensils in front of residents and guide them on where to start. Then, watch them create!
- Puzzles provide visual and tactile stimulation, and even more importantly cognitive stimulation. These can include traditional jigsaw puzzles, word searches, crossword puzzles, etc. Use puzzle types appropriate to their stage. Provide residents with proper writing tools and ensure they have their glasses if needed.
- Technology-based tools have slideshows, music, serene landscapes and more that can provide visual and auditory stimulation. Set residents up on iPads or in front of the screen to start the program, and they can enjoy tours of museums, cities and sites or playing their favorite games, watching calming scenes and the like. Appropriate for all stages.
It is important to note that each of these should be considered with what residents prefer. Never force these upon residents if they aren’t interested, or that will influence negative emotions. Then, they will start to associate those negative emotions with staff.
With these simple sensory-based engagement programs, residents can be engaged for hours and feel happy, content, safe, secure and relaxed, while the staff are taking time to complete tasks and be efficient at their jobs. Now that’s a win-win!
Jennifer Stelter, Psy.D., CDP, CADDCT, is the co-owner of NeuroEssence, LLC at the Dementia Connection Institute and the author of “The Busy Caregiver’s Guide to Advanced Alzheimer Disease” published by Johns Hopkins Press.
The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.
