It’s easy to become overwhelmed by all the options available in Alzheimer’s care. Where can you turn for help to make the best choice for your loved one?
In “Alzheimer’s – Dementia: Find the Best Nursing Home with Sister Ann,” author Ann Marie Gallogly shares just what to look for.
The Importance of Person-Centered Care
Gallogly, a retired nurse with more than 30 years of experience in dementia and Alzheimer’s units in Northern Ireland, believes person-centered care is a critical component of dementia care.
In short, person-centered care involves looking at residents and seeing more than the disease. It’s about treating the whole person, taking their interests, strengths, and identity into account.
“The care needs of people with dementia are greatly enhanced by the implementation of a person-centered philosophy,” says Gallogly. “Person-centered care is not a matter of choice but a necessity in ensuring positive-valued social identities far beyond the possible restrictions of dementia.”
What does person-centered care look like in the lives of real residents who present challenging, baffling behaviors? Consider the following stories. (Names have been changed for privacy.)
“Jack”: Looking for Work
Challenging Behavior: Each morning, Jack would get up early, get dressed, and tell staff members, “I’m looking for a start.” Since no one had a clue what he meant, Jack would get angry and keep repeating himself all day. Gallogly and other staff members contacted his family and learned that Jack used to work in construction. He had to arrive early at a building site and ask for a “start,” which meant he was available to work.
Person-Centered Solution: Jack’s family recommended the nursing home staff ask Jack his name and his trade, write it down, and tell him work on-site would start tomorrow. That’s what the site foreman would have done. This satisfied Jack, and he was able to resume his normal activities.
“Michael”: Looking for Activity
Challenging Behavior: Michael was always taking off his shoes and pulling out the laces. Because of that, his shoes and laces would get lost, and he would end up walking around with only one shoe. This presented a falling hazard, so Gallogly and other staff members talked to Michael’s family to figure out what was going on. They learned something interesting: Michael used to work in a shoe factory.
Person-Centered Solution: The nursing home activities therapist helped Michael get involved in arts and crafts, giving him plenty of fabrics and textures to handle and use for collages. These tactile aids were very stimulating for Michael, and alleviated his challenging behavior.
“Jack”: Looking for Pay
Challenging Behavior: Jack would get distressed when he had no money in his wallet. Though his family gave him cash when they visited, he kept losing or hiding it. When staff members talked with Jack, he explained that he was not getting paid for his week’s work. He worked in the construction industry and was accustomed to receiving cash in an envelope every Friday. By not getting paid, he felt undervalued.
Person-Centered Solution: Jack’s family and nursing home staff decided to photocopy paper money from the currency that had been available during Jack’s working days. They even crinkled the paper to make it look used, and put it in an envelope with his name on it. Though the solution was unconventional, it worked wonders for Jack’s self-esteem. “As a direct result of intervention, Jack’s body language changed immediately and considerably,” says Gallogly. “He walked straighter, with a confident swagger and purpose. He smiled and talked to everyone who would listen. It was a delight to see.”
Sharing Life Stories
To find out if the nursing home you’re considering provides this level of care, make sure the staff is committed to getting a complete history of your loved one, including likes and dislikes in music, movies, and sports, and hobbies such as gardening, sewing, and painting. This should be an ongoing process, particularly when challenging behaviors arise.
This “life story work” helps staff members get to know each resident as an individual, which can lead to high-quality, person-centered care. After all, when families, residents, and staff are true partners in care, residents have the opportunity to experience the best possible quality of life.
“Choosing the right nursing home for your family should enrich your loved one’s life experience in the face of adversity and also give you peace of mind,” says Gallogly. “You will know whether you have made a good decision when you see the standard of care in the home, and your life can move on too, alongside that of your loved one.”
CHIME IN: How do you look for person-centered care in a nursing home?