Memory Care Stories

The change in management from Provision Living to Cedarhurst has brought into focus how memory care is specifically actually done. The best practices standout as the most experienced, skilled, and trained personnel remain or leave.

They are observing Margaret’s behavioral changes and changing how they work with her.

Margaret likes to eat, but she delays eating. A good drink starts her eating. Always put the ¾ full glass near her left hand for an accident free meal.

Eating once took 30 minutes. Then an hour; and even longer. Yesterday they fed her first; even though we were at a table at the back of the room. She finished just a bit after the others. 

Food is served from the front of the room to the back, so food is not carried by unserved residents. Also, anyone tending to wonder is served to keep them in their chair.

Transferring from bed to the wheelchair requires moving a 200 lb horizontal object to a vertical position and then folding into a chair. A caregiver noticed that, “Put that walker in front of her and she stands up by herself.” 

She may need some assistance, but it works. Bed to walker to wheelchair with little to no lifting.

Other caregivers have mastered the art of “sweet talking” her to stand up, turn, and sit down. It grieves me to see (two to three) new hires trying to lift her bodily, or go through learning the timing, talking, and touching needed to pull this off almost effortlessly. Just saying, “One, two, three, stand” does not do it. Until you get that “Yes” nod of the head, you must do the lifting.

Medication pacing can be a pain. Memory care residents have the “right” to refuse their medications. This morning I again saw that turn into acceptance. “Here is your morning meds, Miss Maggie.”

The spoon was held about six inches from her mouth. Just held there. Nothing more said. Just held there. No motion. Her lips slowly parted; and in went the medicine. The distance and the choice of technique were perfect for this morning. Again, the caregiver must be able to read the resident and pace accordingly. 

Is Margaret telling us she is not ready for bed or is she teasing? You have to catch the grin. 

Place and person have been found to be important. Margaret is changed in the common activity/dining bath and in our apartment. One pair of caregivers found that Margaret would stand up by herself in the common bath for one of the pair of caregivers and for the other when in our apartment.

The above stories give a glimpse into what real actual memory care is all about. As I have said from the beginning, it is grand theater. The result is a safe, secure, and happy resident.

It takes people who are more concerned about supporting the residents for a shift than about personal matters (social media, games, and nicotine addiction). These are intermissions. They are lost opportunities to create feel good moments (and hugs). It takes long term staff that are consistently assigned to the same memory care residents for optimum effect.

It takes time. The reduction in staff, that once provided these services (on time and personalized), results in unhappy behavior rarely observed before, “I am hungry” and residents approaching me with, “I need help . . .” There is not the staff needed to have the time to maintain the theater.

Time costs money. Time reduces profits. Each caregiver makes about a one percent change in profits. Management needs long term, well trained, and experienced staff to be successful at a full memory care level of care.

Expectations and a resident’s health dictate what full memory care is and what people are willing to pay for such care. Both change over time. We have been here over three years. [We have outlived most of the people we started with.]

1.    We are secure. Margaret has not wondered out in over a year.

2.    We are about as safe here as at our last house. Acceptable falls are part of memory care.

3.    A two-hour watch is adequate for accident and incontinence checks.

4.    Allowing Margaret to roam in her wheelchair gives her happiness.

5.    Being positive with caregivers and events creates helpful bonds.

I have again met with Home Instead; if we need help between normal aging and Hospice. Several skilled and experienced caregivers have left to work in Hospice and other home health agencies.

Selecting a memory care facility is much like selecting a school or college. If you feel it will work and have the money: go with it. There is no guarantee that marketing knows what really takes place. Is camera monitoring used for safety and training? Is personal family sharing allowed?

My monarch butterfly Arlo video clip camera gives me a few minutes of the start and the end of the day; how Margaret interacts with her caregivers. Those interactions are memory care. [I can view them free for seven days If the Internet is up.]