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People are being admitted to long term care facilities in later stages of dementia and are living longer than in the past, making the professional caregiver's job more demanding. The articles and resources in this section offer information about the challenges that professional caregivers face in caring for people with Alzheimer's and dementia, and some of the methods, including Montessori methods and principles, that can be used to overcome them.
While the articles in this section are specific to facilities, family caregivers may also find the information helpful.
Mother’s Day is one of those big day, special occasions in most long term care facilities - there is an anticipation much like Valentine’s Day. One of the reasons for this is that families try to ensure that they visit on Mother’s Day and there is a tradition of celebrating the occasion. Extra care is taken to ensure that everyone will look their best for the day and it feels like a very special day.
Mother’s Day celebrations don’t have to be one big event and it may be more enjoyable and meaningful for residents with dementia if there were several smaller programs in the week leading up to the big day.
A long term care facility with 24 dementia residents in a secure unit wanted help to develop a plan to give the residents with dementia the best care possible. They had already taken some steps towards improving the level of care by
recognizing the importance of providing dementia education for their staff and providing the appropriate level of training for all involved staff
ensuring consistent staffing in the secure unit including assigning a full-time recreation worker to the unit
These changes had a positive impact, but they soon realized that there was still room for improvement.
We often hear about “Person Centered Care” in the media and from healthcare professionals, but what does it actually mean? What is person centered care in dementia? In terms of an actual definition, I like this one from University of Buffalo Institute for Person‐Centered Care, The State University of New York the best:
"Person Centered Care encourages the highest level of quality of life and seeks to put the person ahead of the task while creating an environment that promotes a true quality of life regardless of physical or cognitive condition, wherever services are received or people reside."
In a previous article we offered suggestions on ways to get your Montessori dementia program going ("Montessori Quickstart"). Since then, we have had a couple of interesting discussions with people about the problem.
One person thought that rather than concentrate on small group programming for dementia and Alzheimer patients as we suggested, maybe it would be better to offer more training to recreation staff on providing individualized one-on-one activities and provide them with the necessary materials. She suggested that with 100 residents and 3 staff working four 8 hour days each, each dementia resident could receive individualized attention.
As a professional working in a facility, you are already aware of, and probably putting into practice, many of the concepts presented here.
The Montessori way is not revolutionary nor is it in conflict with your current approach. It does, however, provide a methodology and framework that can help you provide excellent dementia care consistently. Understanding the Montessori approach can help you discover ways to overcome problems, minimize responsive behaviors and help your dementia clients be the best they can.
Group activities for people with Alzheimer's and dementia play a major role in most facilities. What activity calendar would be complete without bingo, Wii bowling, bake groups, bean bag toss, and other traditional activities. They offer the opportunity to engage a number of clients at the same time, and provide them with social interaction. They are well liked by the clients. By applying the Montessori principles, they can be made even better.
Most care professionals agree, and studies support, that small group programming is more effective for people with dementia than large group activities. Unfortunately the reality of limited resources in a facility mean that while everyone recognizes the benefits of providing activities for small groups, more residents can be reached through larger activities and those tend to dominate the monthly schedule.
Here’s a way to start adding simple, short, small group activities for your dementia patients into your schedule and take advantage of the benefits without taking up too much time. In fact, by building these activities into an established routine, they can be taken over by other staff or volunteers. These activities take no more than 15 to 20 minutes. They require little preparation, are simple to do and easy to present. Portering requirements are minimal because the activity is done on the unit with only a few residents, ideally those that are already out of their rooms and ready to participate.
Imagine walking into a stranger’s home and trying to strike up a conversation with the person. Add to that the fact that the person has difficulty communicating. What do you talk about? How do you react when they say something that you aren’t familiar with? How do you think the person feels having a stranger in their house? These are the things that visitors and professional dementia caregivers face when arriving at a person with dementia’s home or room in a facility.
What if instead the caregiver had some background information that told them that the person was a school teacher all their life and that they have three children named Bob, Sarah and Cathy? What if they also knew that before starting to teach they went on a three month journey across Europe and that trip was one of the most significant events in their life? Wouldn’t that make the conversation flow easier!?
One of the challenges that we are faced with is trying to improve the level of engagement of residents with dementia.
We all know, and research confirms that engaging residents as often as possible in meaningful activity improves their quality of life and reduces responsive behaviors. The problem in most facilities is that there simply is not enough staff time available to do this. It takes a lot of time to find an activity, set it up and be with the resident while they do it. We can help with that.
Training and education are important ongoing aspects of any professional field, and dementia caregiving is no exception. Staff take courses and attend workshops throughout the year to improve their knowledge and skills, but if they run into barriers trying to implement what they have learned, the benefit of learning new skills is diminished.