Home is where the heart is
Hello again! Long time no blog! I have been working on some very exciting things. I have such a strong passion for helping people living with Dementia. I have brainstormed things over the years of how to help more people than I currently am. All of my experience up to this point has helped me make a big decision! I will announce it soon but get ready! It is exciting! I’m telling you- I literally dream about this stuff!
Anyway, onto the blogging! The past few weeks at work have been challenging- but I like a challenge! I direct a dementia neighborhood within a larger community and within that neighborhood, there is the capacity for 25 residents and there is a waiting list. This just goes to show that there are more people in need of dementia care. But, how do you know what environment is right for your loved one?
I have a wonderful woman, Mary*, who lives in my community and she loves to walk. Aside from the dementia, she is physically healthy. She walks up and down our long hallway and to the bedrooms that are at the ends of each hallway where she will pick items up and relocate them to another bedroom, usually hiding them. She had lived there for a year but her behavior didn’t become a major issue until a few things happened.
- Residents who were able to lock their doors lost the ability to do so (per state regulations we must keep them unlocked).
- More residents moved in and they interpreted her as an intruder which increased their problematic behaviors and/or anxiety
- She stopped sitting down to eat meals and was losing even more weight
- Residents who were triggered by her behavior acted out with physical and verbal aggression.
You may remember from my post “Let’s talk about sex, Baby!” that we discussed problem behaviors. Here is a quick recap:
“Is it harmful to the person performing the behavior? Is it harmful to someone else (Physically or Mentally/Psychologically/Emotionally)?”
So with that said, yes this behavior is a problem! It is harmful to both Mary and others. So what can be done in this type of situation? This is still a work in progress but if you find that this is a similar situation to what you’re going through, here are some things you should know.
There are a few different options for someone with dementia.We will discuss three of them.
- A dementia unit within an assisted living community.
- Private duty
- A group home
Assisted living communities typically have a dementia neighborhood. The state regulations vary state by state but they are locked and for people who have dementia. The activities are typically geared for those with dementia and focus more on group activities.
Although the group interaction, socialization, and specially trained staff are great, there are still a lot of design flaws. When designing a community it is tough to accommodate everyone. Things that have to be considered are where windows are placed. For instance, from the street, windows may look better on the front of the building but having so many windows in that area of the community could result in glare during meal times. That’s not something you want in a dementia community. Designs are constantly improving but I am sure you can imagine how hard it is when you have to consider when the sun rises and sets and from which direction.
For Mary, it seems that these long hallways are a trigger for her as she goes back and forth non-stop. The group activities aren’t appealing to her but what we have found is that she enjoys sitting with very small groups or one person. Which brings me to…
Hiring a Private Duty Aide can be helpful. It can become costly but there are companies who work to identify patterns in a person’s behaviors so that we may know how to better manage it. One of my favorite companies here in Northern Virginia is Stay Well Home Health Care. The main reason is that the owner is very interested in his clients. Smaller companies like this are great because the owner is more present. When the company becomes too large, the owner’s vision can become lost in those running the business. I wish the owner of Stay Well could be cloned!
Private duty can be great for helping to identify patterns and provide one-on-one care that residents aren’t able to receive among 25 residents. However, it can become costly. So it usually isn’t a permanent fix unless the person has the funds. Additionally, if you have the ability to stay in your home, private duty can support that.
Private duty could be great for someone like Mary while different medications are tried, or a pattern is hopefully identified. If there isn’t a pattern and the medication isn’t effective, I may suggest something like…
A Group Home
A group home is similar to an assisted living community except that there are usually no more than 10 residents in a home. This is great for someone who doesn’t do well with larger groups. This is managed by a director and regulated by the state. They are usually located in larger homes so it truly feels like a home.
This is beneficial for those who are intimidated by groups or are triggered by larger areas. For Mary, the small group setting may be perfect. They are usually less expensive than an assisted living community and much less than private duty. Be careful as some are not designed for people with dementia (doors that are not locked from the inside, staff that is not appropriately trained, etc.).
As you can see, there are many different environments that are right for a person with dementia. Everyone is unique and each method is determined by the person’s needs and their financial situation. If you would like more information on how to choose a place that is best for your parent, contact me and I will do my best to provide a little insight! Choosing the best option can help make your life more enjoyable and your time with your loved one more meaningful.
*Names have been changed to protect identity.