Using the stay away method for a dementia community move
When a person with dementia is moving into a new community or into another part of the community, it can be difficult for both the family and the person with dementia. One of the techniques commonly used is the “Stay Away” technique.
Staying away means that a family does not visit or make contact with the person with dementia for an extended period of time.
Why do we need to stay away?
The amygdala is the part of the brain responsible for “fight or flight” responses. It is also the reason why a person with dementia may remember things based on the emotional reaction.
In the moment, it can look like the visits from family members are helpful. While the family member is there, agitation is decreased and the person appears to be more comfortable. The visit itself is not the challenging part. It is when the person leaves and the absence is felt. The resident may have feelings of abandonment, loneliness, or confusion and be unable to communicate how they’re feeling and therefore, it is communicated through challenging or anxious behaviors.
These challenging behaviors can create problems with other residents and interfere with the resident’s ability to acclimate to their new surroundings, form bonds with the staff, and becoming comfortable in their new environment.
How to use the Stay Away Method
This can be a challenging process for everyone involved: The resident, the family, and the community. Everyone is learning about what one another, the processes, and a lot of this is learned through trial and error. Even if the resident is not having a lot of challenges, staying away can still be helpful. The community needs to learn the resident and get into a routine. The family may perceive this time period as needs not being met. So disconnecting for a period of time can allow the community to get into their groove with the new resident. There are some general principles to making this work:
- +/- One Week: As a rule of thumb, I recommend a week of staying away. Some residents will be fine after one day while others need more than a week.
- Choose a trusted, but less familiar, person to visit the resident. This trusted person should be someone they are use to saying goodbye too. A dementia consultant could be a great option, especially if the resident is expected to have (or has had in the past) behaviors that may be dangerous to themselves or others.
- Communicate with the trusted person and/or the staff of the community to understand how the resident is transitioning. Other times from home may be needed.
- Make sure the person has plenty of comfort items from home. Whether it’s a blanket, a hat, a picture, etc. the person will need ways to be redirected and comforted.
Initiating visits again
When it seems the resident has acclimated well, it is time to re-introduce the visits. This can be a delicate time because sometimes a visit may take us back a few steps. Be prepared to begin staying away again if the visits do not yield a positive outcome.
- Keep the visits to 30 minutes or less at first. I recommend visiting for no more than 30 minutes at a time initially because it is long enough to check in and connect but not so long that a great absence will be felt when it ends. Keep it light, positive, and set a gentle timer on your phone or watch if you need a reminder to leave after 30 minutes.
- Visit with other residents and community staff. While it may be tempting to Avoid find a quiet corner for one-on-one engagement, engaging with other residents and the staff will encourage positive interaction (and forming positive emotions) with others in their new surroundings. You won’t have to do this forever, but the first several visits following the initial stay away period, this is really important.
- Visit just before a meal. This is a good idea because you can say “goodbye” as the resident is transitioned to a meal. It can be hard to say “goodbye” and just leave, but knowing they have something else to engage in after you leave can be comforting for you and make the “goodbye” easier for the resident.
- Ask for feedback after you leave. When you leave, the resident may be OK initially but I have seen people with dementia become more agitated or upset in the hours to come. Check in with the community staff to see how the resident has responded after you leave. Not just immediately after, but for hours (and maybe days) to come.
When stay away doesn’t work.
This is not the only method we use for transitioning a person with dementia into a new community. There is no one-size fits all. In determining whether or not this will work, it is important to use person-centered techniques that explore more areas including the resident’s:
- Family dynamic
- Personal history
- Personal preferences
- And more
If this technique doesn’t work, and is employed correctly, the community may not be the right fit for the person with dementia. There are a lot of great communities out there, but that doesn’t mean that every community is right for every resident.
Prior to moving someone with dementia, it is best to consult with a dementia consultant to avoid mistakes in choosing a community. Using their recommendations, you can search for a community on your own or ask for help from a company or person who will help you find one within those guidelines. A dementia consultant will be able to help you develop the best transition technique for your loved one with dementia. If you have questions, contact Trovato Dementia Services for your free phone consultation.