My last doctor visit to discuss Margaret's medications for 30 minutes turned into 90 minutes with both the doctor and the nurse practitioner. They even have a follow up visit scheduled next month. I need to be more assertive rather than observe, comment, and let things happen. Save the Tums.
Margaret is now using half her Xanax pill. The therapy office has become fully staffed by added two more people: physical, occupational, and speech therapy. And best of all, they are people I can work with rather than they working for me or I working for them with little follow up.
An understanding has occurred of what services the residential contract includes (we have no contract with the new owners) and what therapy provides. Cedarhurst now has a full time Quality of Live Coordinator and a full time Director of Memory Care (position open as the person left after a couple of months).
Between the QLC and Therapy, Margaret is thriving. "Now keep in mind. We are not going to cure dementia. We are working to reach her, to unlock her, and to bring out the best she can be."
There is more to performing Memory Care than having the same people often enough that they actually learn how Margaret works; but also the need to train them to perform the same task in the same way consistently. How this is to be done with short-term new hires remains to be worked out. There is a need for a register of unique tasks for each resident in addition to the text book one-size-fits-all performance.
The therapy office has the know how but the end result must be correct practice with the resident in the resident's world. [This brings to mind the experiment in which laboratory instructions were included in the 120-seat lecture hall General Biology presentations rather than in the 24-seat laboratory itself. A total failure. Learning at this level is position dependent. What happens in one setting has little effect 100 feet away in another setting.]
Arlo, the butterfly video clip camera, has captured some task performances that may make good instructional resources. Several care givers have granted me permission to download and edit them into movies. We have discussed how to make an effective instructional movie from the video clips.
Which gets me to the point of this post. There is a dismal lack of communication within the operation with the former owners and the current owner in many aspects. Memory Care and Therapy are now working together to sort out Margaret's needs.
Yesterday the QLC sat down with me and used Margaret's iPad to select software that lets a resident type messages by selecting words to create sentences. I have tried this with no success. I bring a lot of baggage that Margaret does not want to sort through. It makes her unhappy. With a new person she only has the task at hand. This service is part of the Memory Care we have not had for over two years.
And then, as I was eating the noon meal (lunch), I overheard the same comment again, "Surely they would let you use a table knife." This time I stood up and asked, "Could I take a picture?"
[The traditional way of cutting up something in memory care is to use a fork and a spoon, use your teeth, or don't eat it. Also when this location first opened, plates were fully prepared in the kitchen. There was no need for a serving knife.]
This time the meat cut fairly easy. There was one person setting up the plates. A resident's relative pitched in to help. She found the meat too hot with a shake of her hands.
"Surely there could be a locked cabinet where you could keep restricted useful tools."
Times have changed. The hot table provides servers the means of quickly adjusting serving size for each resident. Residents can have seconds. Now servers need a way to quickly make the servings.
Perhaps this post with actual iPhone 8 video, spontaneous and un-staged, will help resolve the issue.
Draft 3:35 pm. Only once have I written a post in one day.
Posted 6:00 pm. After the evening meal.
