Memory Care

Design

Friendly, Familiar & Safe

After five years of research, our community was created exclusively for persons living with Alzheimer’s disease and related dementias. Residents can feel safe and secure, but still feel a sense of home which enables them to stay oriented and as independent as possible. Some aspects may seem unusual to you, but they are beneficial for your loved one.

 

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Technology & Dementia Care - Why Newer Isn't Necessarily Better

Learn how reliance on alarms can lead to less one on one or group time with residents and less chances for staff to develop skills as a caregivers.

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Technology & Dementia Care - Why Newer Isn't Necessarily Better

Tam Cummings, Gerontologist

 

I noticed another of the "techno" buildings is opening I encourage families to avoid this type of care. The selling feature of these buildings is based on the alarm systems in place in each room, bed, hallway, ect. Families are assured these buzzers alert staff to problems or issues with their loved ones, such as incontinence or falls, theoretically allowing for a higher level of care.

The reality is that the care received by residents in these buildings is actually quite the opposite. Research on the response times and training in dementia care these staff members receive is rather frightening. Results indicate the "caregiving" staffs in techno buildings develop a dangerous habit of relying on the alarms to alert them to the needs of the residents, rather than on positive nursing/caring standards. Because they are not checking on the residents face to face, the staffs congregate away from the residents and wait for the alarms to indicate care is required.

As a result, the techno staff members spend less one on one or group time with residents, and fail to develop their skills as a caregivers. This lessening of social interaction leads to poorer quality of care and a more rapid decline of the residents. Rather than interactive care geared towards keeping residents socially alert and physically as active as possible, the residents have reduced social interaction and staff members have a tendency to view the residents in a less positive light. A person with dementia ceases to be seen as a declining older adult and becomes that "old woman whose alarm goes off three times a night." Depending on alarms to alert them to the care needs of the residents, these staff members are not responsive to the resident's needs, stories, history, or the requirement of human interaction critical to quality care.

The staff members tend to isolate themselves from the residents, expecting the alarm systems will "tell" them when care is required. As  you are aware, but families new to dementia may not be, care for the dementia population requires so much more. Caregivers in memory communities are responsible for observing so many changes in our residents, responses that cannot be detected by mechanical devices. Their training to be aware of the persistent deterioration of the dementia process in residents cannot be countered by electronic "smart" systems measuring moisture or movement or lack thereof in an environment.

For example, aggressive or lethargic behaviors, possibly indicative of delirium stemming from UTIs, fractures, infections, etc., cannot be detected by a moisture alarm on a bed or chair. Only a trained care professional, alert to the subtle start of infection, can spot a care issue of vital importance in dementia.

Response time studies of staff in techno buildings are also judged to be much different than a traditional memory care community. Research indicates that rather than staff taking the initiative to check on residents, the expectation is that unless an alarm goes off, the resident doesn't require care. The constant ringing of alarms also dulls the staffs' response time to the residents, as the buzzers tent to become more of a white noise and therefore sometime to be ignored. As a result, ADLs such as grooming, toileting and eating for these residents are adversely affected.

Another area of concern is the decline of social skills. Because the staffs in techno buildings are not following a social-medical model of care, residents are more likely to decline more rapidly. We recognize dementia in any form is a terminal disease. But we also believe in the "use it until it's lost" model of care, not the "ignore it until an alarm goes off" model. Residents involved in social settings and activities continue to decline certainly, but the decline is more humane and often somewhat slower.

The demonstration and enforcement of routine social skills are a key element of care in memory communities, but sadly the techno buildings lose this valuable tool. The alarm systems simply encourage less interaction, less touch, less human care and contact. Another reason to be concerned about the lack of care in these buildings is touch. This is because our elderly population is the least likely group to receive human touch. Generally because an aged person may have lost his or her spouse and the children are no longer at home, etc., there are less opportunities to be hugged or touched. For persons with a dementia, the possibility of being touched is even lower, unless he or she resides in a traditional memory community. As I have already pointed out, the lack of interaction between caregiving staff and residents underscores another critical level of care being overlooked. 

 

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We offer support, education and information for caregivers and family members. If you have questions about Alzheimer's or a related dementia and the types of care available contact an Arden Courts near you.

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Goldilocks and Memory Care

Learn why it is important to choose a community based on the needs of your loved one living with Alzheimer's or a related dementia's and not on how similar it is to their current living arrangement.

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Goldilocks and Memory Care

You realize that your loved one may need a new living arrangement. You are no longer able to plug all the holes that dementia has left. Whether you are an adult child, a spouse, a good friend---you are seeing that her needs exceed your capabilities. You have resisted, finding creative stopgap solutions that work for a time and then fail. You set out to find a place that can help. It is this search that requires an objectivity difficult to access. Somehow as you visit assisted living facilities or memory care communities you forget the reality of your loved one’s needs. You see a lovely apartment, compare it to her current house and your mind says, this is good, she will like this. But what you are forgetting is why she needs to move. You are forgetting how she only uses three rooms of her home, and two of those are used ineffectively. She no longer can use even the microwave. You are forgetting how she fell in her own bathroom. You are forgetting that even when you gave her a life alert pendant, she could not remember to use it. 

What is important to know before shopping is what has been shown to be negative for individuals placed in a setting that is not designed, trained and staffed for dementia care. Research shows that individuals with dementia who are mainstreamed in assisted living will experience stigma. 

One family reports moving their dad to Arden Courts after a regular assisted living, "Dad was unable to find the dining room. He ended up isolated, living on cookies and soda. When we asked him why, he said 'those people are too smart for me'."

This same father was sent out for psychological evaluation based on behaviors from his dehydration. The general assisted living did not have staff trained in dementia, dehydration, and the negative impact of isolation. "We picked the apartment over Arden Courts because we felt Dad needed a small kitchen and private bathroom. It took us several hospitalizations before we moved Dad to Arden Courts. Now we realize how much was lost in choosing what we wanted for him instead of what he needed. We feel like Goldilocks, we tried others, but Arden Courts is just right."

The Goldilocks Effect of Arden Courts comes from:

  • A fail-proof design, allowing your loved one the personal space that is ideal for an individual living with dementia as well as the freedom to wander safely and contentedly
  • A higher staffing ratio that is dementia-trained eliminating isolation
  • A higher ratio of medical oversight decreasing hospitalization
  • A state-of-the art program for engagement at all stages of memory loss

Your best defense is a good offense is a saying that applies to memory care.  Take advantage of educational resources like Arden Courts’ seminars, resource library, and support network.  Choose care that is just right for your loved one living with dementia.

 

By-line: Cate McCarty, PhD, ADC has been collaborating with Arden Courts in a variety of roles since the late 90’s.  Her background in nursing, activities and admissions has given her a passionate commitment to quality of life for the individual and family with dementia.

References
 Dobbs, D., Eckert, K., Rubinstein, B., Keimig, L., Clark, L., et al.  (2008).  An Ethnographic study of stigma and ageism in residential care or assisted living, The Gerontologist, 48(4):  517-526.

 

 

 

 

 

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