Dementia is not a normal part of aging.
These eight words should help anchor and inspire the long-term care and senior living industry’s collective work to change, renew and elevate the ways in which we serve this unique segment of our customer base. Dementia care communities often borrow operational practices from their counterparts in assisted living or even independent living. In areas of resident care plans, food operations and resident activities — to name a few — most of our industry’s memory care communities are just assisted living plus (AL+).
Resident activities in assisted living and independent living largely follow social models and are typically represented by the activity calendar. Even programs and philosophies around dimensions of wellness (ex: physical, social, emotional, etc.) are still simply line-item variations within an overall framework of a calendar.
Consider what a calendar does for most people. It is a means to organize, plan and make decisions about your day, week and month ahead. What are some of the most common symptoms for a person living with dementia (PLWD)? They typically lose the ability to organize, plan, and make decisions. A foundational belief about person-centered care is to assist the person in their own decision-making — not to make decisions for them. The traditional activity calendar, then, serves as a direct contrast to person-centered care without proper and intentional modifications.
Bella Groves’ approach to resident programs and activities is foundationally about experimentation and learning how to infuse person-centered or person-directed support where care and activities are a blended priority. Whereas many dementia care communities prioritize care plans and relegate activities to “things to do” outside of care tasks, our team is given a different framework.
Instead of prescribing what specific activities will happen at different times on different days, our team is taught about dementia — not activities. We help team members to understand how dementia affects a person’s experience of a day and how we might be able to assist them in having a more successful one. For example, following a roadmap for the circadian rhythm (the natural and internal patterns of physical, mental and cognitive/behavioral changes that occur along the sleep-wake cycle) may be more informative to a care partner than simply planning activities.
Understanding that most people’s naturally occurring moments of highest alertness happen around mid-morning, care partners can be given tools and supplies to assist the PLWD to take advantage of this peak of alertness. Within this window of time, the care partner can assess what cognitively stimulating activity feels appropriate for (or directed by) the person they’re supporting.
For example, one resident may wish to have a phone call with his daughter at this time, which gives him a feeling of a successful social interaction with someone he loves. Another resident at this same time may wish to work on puzzles that she enjoys but may have greater difficulty with later in the afternoon. Though these are very simple examples, consider how faithfully they meet the definition and spirit of person-centered care.
Resident engagement has been viewed as ‘nice to have’ and ‘fun’ but not an important part of a resident’s overall well-being. Furthermore, the traditional view of activity is to “do a program for,” while the person-centered approach is to think of resident engagement as collaboration with the PLWD so they can find purpose.
When residents are engaged in a meaningful and person-directed way beyond the traditional activity calendar, it will decrease their loneliness, keep them independent longer, and improve their well-being. This, in turn, offers providers the opportunity to experience improved clinical and financial outcomes.
Dementia is not a normal part of aging. Our actions, whether related to resident activities or family consultations, should not feel like a normal or routine framework we utilize in independent or assisted living. If we move away from the calendar being the center of activities, we may potentially move towards a better frame of reference — the person. Learn more about this topic by watching this recording from Linked Senior’s #ActivitiesStrong initiative Executive Edition webinar series.
James Lee has served in the senior and aging services profession for 15 years. In 2021, he transitioned from progressive and successful work in established senior living organizations to launch three interrelated endeavors: co-founding a dementia support company, establishing a consulting firm for small businesses in senior living, and creating a leadership podcast and associated content/events. He resides in San Antonio, Texas and is a graduate of the McCombs School of Business at the University of Texas.
Charles de Vilmorin is the CEO and co-founder of Linked Senior.
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.