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Bill: This is the Alden Network Podcast, Healthcare Solutions for Seniors. Today, Dr. Jennifer Stelter, a psychologist and the Director of Clinical Programs at The Alden Network explains what memory care is, what sets a memory care community apart from other senior living communities and answers many questions when it comes to a loved one who may be suffering from dementia, Parkinson’s, Alzheimer’s or other memory issues.

Dr. Stelter: The term “memory care” is used now so often in our industry. The way that I like to define it in the role that I'm in and running operations for The Alden Network is really a way of working with individuals who have dementia with a holistic approach, really trying to engage them in a meaningful way from a cognitive, physical, mental and spiritual perspective. I think we've evolved so much within our industry through wonderful research, especially through The Alzheimer’s Association who the Alden Network partners with a multitude of areas, that the memory care communities really focus on it being what I like to call dementia friendly – from the way that the environment is designed, and what I mean by that is the use of colors, the space, how things contrast for navigation. What also is important is the décor. The décor and the environment are user-friendly. Just like you and I, we have things throughout our house that we use on a daily basis, and so people who move into a "dementia-friendly environment,” they can utilize every space and every knick-knack in that facility as if it is their home.  

Bill: What other differences do you find in a memory care community?

Dr. Stelter: The other piece of this in memory care communities is they focus highly on the structure of day and programming to engage patients in a meaningful way. It's programming that's tailored towards people with dementia. A big piece of that programming is looking at stimulating a patient with dementia from all five senses. That's really what a memory care community looks like different than any other type of long-term care environment.

Bill: What are the signs that it might be time to seek help from a memory care facility?

Dr. Stelter: The best time to consider that is when there are a few indicators going on that you may be concerned about for your loved one. One is safety. If you are constantly worrying about your loved one maybe because you placed phone calls to them and they're not answering your calls or you're rushing over there and fear that something happened to them, that should really be at your forefront. With the disease process, what happens is people with dementia will lose the ability to be able to anticipate risks. Their inhibition decreases and they have difficulty in problem-solving. Because of those along with short-term memory loss, they will have difficulties anticipating what would put them at a safety risk, meaning when cooking or driving or taking medications or walking up and down the stairs. Those are all things that can pose risk for us when we don't have that skillset to be able to follow through with those types of things.

The other area is if you’ve seen a deterioration from a physical or mental perspective with your loved one. If they're not taking care of themselves, showering, eating or if they're isolated, they're not socializing as much as they used. Also, it could be as if they're not taking their meds as prescribed. If they're taking too much medication or they're not taking their medication at all. Another area could be finances if for some reason they aren't paying bills or they paid their bills too many times. Burnout. If you yourself are feeling burned out, that does happen quite readily, and so we want to encourage that you take care of yourself in order to take care of your loved one.  

Bill: How should a family evaluate a memory care facility?

Dr. Stelter: I think first when you're looking for a place for your loved one is when you go into the facility, I would say tour at various times. I say tour during the morning hours, the afternoon, evening, also during a dining experience. I think that's important and that sounds like overkill, but you do want to get an idea of what your loved one would be involved in throughout the day because they're living there now, so you'd want to get an idea of what that looks like from all perspectives. I would say also what you'd want to look for is what does the environment look like. First of course, is it clean? Is it kept up well? But also, does it have that dementia friendly feel? Do they have the use of contrasting colors? That way, your loved one can navigate safely. How are their particular rooms or apartments decorated? Does it look home like? Does it look warm? I think that's important.

I would also talk with them about who is encompassed in their treatment team. What kind of professionals do they have involved and would be involved in your loved one’s care? How are those professionals trained? Dementia training is a need. It’s a necessity, I think, for individuals who work with people with dementia, and so, how much training do the staff get at that facility? Along with the treatment team, when you're there touring, look at how the staff is intervening with patients that are currently living there. Do they have a warm genuine voice? Are they patient? Are they calm? Do they encourage the residents to be independent by doing for themselves as much as they can? Those are important things to look for. Of course, cost does come into that because we have to know can your family afford this or would it be covered by insurance, so that's also important to look at as well.

Bill: When it comes time to move a loved one into a memory care facility, how should a family member communicate that to ease the transition?

Dr. Stelter: The first thing I always say is do not announce the transition. That can really cause a lot of undue worry and stress for the person who would be moving. There could be some refusal and then it turns into continuous arguments until that day comes. Don't announce the transition. Along with that is sometimes you do have to use fibs – fibs as in you may have to tell them that you're going on a vacation – so, at the time the transition is going to occur, we're going to go on a vacation – and that’s the way to get them into the car and go to the new environment. It’s really about trying to see how they are going to accumulate in that new environment. The third thing that can make the transition a lot easier is to bring familiar items from home to the new environment, things that they recognize, things that are meaningful to them. It helps to serve as a cue so that way when they are trying to navigate through the new environment, when they see something that's theirs, they can identify with it and they're feeling more at home and safe, but also their items that really help them to keep who they are in terms of their personality and their likes and dislikes – it keeps that at their forefront.

Bill: What about immediately after the transition to a memory care facility? What visiting guidelines do you recommend?

Dr. Stelter: This is a hard conversation to have. Just please do not visit your loved ones for the first week they're there. I know that’s hard for a lot of family members because they want to know ‘is mom okay, how is she doing,’ and certainly it’s up to the staff at the facility to provide those updates. If the family is coming in constantly, then, of course, the resident who moved in is going to want to leave with them every single time. It makes each time that the family member comes in for that first week that much harder when that family member leaves to go home for the night. We ask after a week and the person is accumulated and they're comfortable, then we want you to visit as much as possible.

Bill: What about learning for the person’s likes or dislikes?

Dr. Stelter: As family, please communicate to the staff about what is your loved one's likes and dislikes. What are their preferences? What was their daily routine like? We need to know that information so we can try to replicate that structure in the new environment. That way, their loved one can get comfortable quickly and that's what's important. Get them comfortable as quickly as possible.

Bill: And Dr. Stelter explains why someone should choose The Alden Network.

Dr. Stelter: I think someone should choose The Alden Network when you are considering moving your loved one into a memory care community because our approach to memory care is really ensuring that we are meeting the patient where they're at from a cognitive, a physical, a mental and a spiritual perspective. Our approach is very holistic in nature and a lot of the strategies and approaches that we use are evidence-based. We take the time really to ensure that our staff are trained in dementia care, that they have the personalities and the compassionate to work with this type of disease process, we invest in ensuring that we have the clinical experience when it comes to designing the memory care communities from an environmental perspective and a design perspective as well as we have great nursing care to try to really combat some of the ancillary disease processes that go along with dementia. The reality is that as the disease progresses, the body does shut down and it’s more susceptible to disease processes. Nursing care, we have to have wonderful nursing care and that’s something that we provide as well.

Bill: Lastly, Dr. Stelter shares a patient’s story.

Dr. Stelter: We had a patient, we’ll say her name is Gail, she had moved into one of our short-term rehabilitation facilities for physical therapy and she also has a form of dementia. As a disease progresses, individuals with dementia have difficulties in communicating. At times, verbally or physically, they’ll make people aware that they need something and it could be what's seen as a more aggressive nature, but what they're doing is they're just communicating that they need something. Gale herself, she would act out in a physical way in order to communicate that she needed something, but unfortunately, it was disruptive to herself and it was disruptive to other individuals that were there. The team has reached out to me wanting to know what else we can do. We've tried XYZ – what else should we do? With some of the programming that we do at The Alden Network, we utilized essential oils with her. We diffuse lavender in her room during the times that she would have rest periods as well as at night and it actually had increased her sleep overall by a number of hours per day. She was getting roughly about four hours before we implemented the essential oils and then was sleeping about six to eight hours on average, which overall that helped improve her mood as well as increase her appetite, and so that helped tremendously.

The other thing that we implemented, which we use throughout our memory care community, is pet companionship. Hasbro actually developed these mechanical cats and dogs, which were developed for individuals with disabilities. She particularly liked the cat. It responds to you as you are communicating with it. If you don’t communicate with it enough, it actually will want you to communicate with it by purring and meowing at you. Where she was at in her disease process, she thought that this cat was real, but it brought her so much joy. She actually sleeps longer, she was calmer, during her sundown time previously was when we saw a lot of the verbal and physical acting out; when we implemented the cat, she actually minimally sundowned at that point. Her demeanor was like night and day. Before we implemented the programming strategies to after we implemented them, it was unbelievable to see her transformation. She is still currently living with us and we know that her quality of life has significantly improved. The family has been undoubtedly grateful for the things that we've been able to do with their loved one and they're just so excited to see a smile on her face every day when they go visit her.

Bill: We thank Dr. Jennifer Stelter for her time today. The Alden Network has nearly 30 short-term rehabilitation and post-acute care centers throughout Chicagoland and southern Wisconsin. For more information, visit thealdennetwork.com. That’s thealdennetwork.com. This is The Alden Network Podcast, Healthcare Solutions for Seniors. Thanks for listening.