Category: Dementia Care

The short answer? Yes. Of course you and your team can work to build and roll out a dementia care program without outside assistance. Here’s are 10 reasons you might want to think twice about doing that: If you’re thinking about bringing on team Dementia By Day to manage your program development, please reach out!

“What do I say when I need to leave after a visit?” Exiting post-visit can be incredibly fraught and stressful for family care partners: they know that ducking out without a “goodbye” feels cruel, but standing around arguing about why they’re leaving is losing battle. Try this approach, instead.

“What do I do when they’re accusing me of something I didn’t do?” We hear this question often. Care partners don’t want to take on the accusation, but they know that arguing about it doesn’t help, either!  Try this approach, instead.

Working in dementia care, we have heard many theories as to what people living with dementia prefer to spend their time doing (or not doing).  “All she wants to do is watch TV all day.” “She never wants to come to the beauty salon.” “Every time I ask her if she wants to participate in a craft, she says no.” Nine times out of ten, modifying how we approach the person living with dementia to engage them will get us better results in guiding them to actually participate in an activity. Oftentimes, it’s not that they don’t want to do anything. They may have trouble saying yes to things, or they may not understand what they’re being asked to participate in.  The #1 approach we suggest to engage someone living with dementia in an activity is to ask: “Can you help me?”   Most people like to feel purposeful, so when they are asked to help with something, they are far more likely to respond positively than if they were asked “Do you want to do XYZ?”  Asking for help works for structured activities like a game, or a task like folding or sorting (think: towels and socks). It even works for Activities of Daily Living. As you see in the comic, the professional caregiver asks her client living with dementia for help washing his face. When it comes to structured activities, we always suggest offering people with dementia something purposeful to do.   Although “fidget toys” and “sensory boxes” seem to be gaining more popularity by the day in dementia care, we are not big fans of them at Dementia By Day. In reality, everything is a sensory experience. Why not make their sensory experiences purposeful? Everyone likes to feel a sense of purpose. That’s why we suggest folding and sorting activities that can be easily introduced by asking for help. This might sound like, “Can you help me fold the laundry?” “Can you help me sort this silverware? Thanks so much, I’m really busy today!” The one exception we would like to highlight is that fidget blankets can be helpful for folks who are very progressed in their disease process, especially if they spend the majority of their time in a wheelchair. Please also note that people with Alzheimer’s disease, specifically, often lose their sense of smell over time, so “sensory” activities that rely primarily on the olfactory sense won’t be very enriching for those folks, anyway. Another dementia communication tip we fit into this comic is using choice architecture when asking a question. After taking one of our courses, the caregiver asks the person living with dementia if he would like a sandwich or a salad, rather than simply asking if he’s hungry or if he would like something to eat. Open-ended questions can be tough for people living with dementia to answer. Giving them two things to choose from is more likely to result in a positive outcome. Of course, we can’t actually hear the conversations happening in the comic, but it’s also worth noting that the tone we use when speaking to a person living with dementia makes a huge difference. Approaching them with kindness, confidence, and good energy will get you further than outward frustration or apprehension. A simple, “Come with me!” in the right tone can go a long way. At first, can feel a little strange to ask for help with something you don’t actually need help with. Give it a try, though, and you will see that— just as we demonstrated in the comic— “Can you help me?” is an almost magical phrase in dementia care.

After spending your whole life with your parent or family member, or spending some of the most important chapters of your life with your spouse, could there be anything more painful than feeling that they have completely forgotten who you are? Many people are under the misapprehension that this is what happens when their loved one has dementia. The truth is, despite working in the dementia care space for over 10 years and meeting countless individuals with dementia, we have very rarely ever seen someone with dementia who absolutely does not recognize a loved one who holds an important piece of their heart. When your loved one with dementia doesn’t quite recognize you, or they call you by the wrong name, they are most likely experiencing Timeline Confusion™.   It’s not that they don’t know you. It’s not that they don’t love you. They’re just having trouble placing you on their timeline. People living with dementia experiencing Timeline Confusion™ are experiencing time generally in a non-linear fashion, not just with regard to their interpersonal relationships. This means that they may believe that they are a young parent or that they are in the prime of their career, for example. Where someone living with dementia is on their timeline can vary from day to day, but it’s common for someone to stick to the same timeline narratives. When it comes to interpersonal relationships and Timeline Confusion™, please remember that— just as we demonstrate in the above comic— your loved one recognizes you as someone who is familiar to them— someone they care about— they are just having trouble working out who exactly you are on their timeline.  In the comic, you will also notice that we often use a graphic like the one above to explain the discrepancy between our reality and a typical reality of somebody living with dementia who is experiencing Timeline Confusion™. If your loved one with dementia calls you by a different name, don’t correct them. Just go with it! You and they will have a much easier time together if you can learn to accept and Embrace Their Reality™. Yes, in order to understand Timeline Confusion™ and be able to effectively adapt to it, you first have to understand Embracing Their Reality™. Not everyone with dementia experiences Timeline Confusion™, but it is very common. Other hallucinations and delusions apart from Timeline Confusion™ are also really common, which is why it is absolutely necessary for all caregivers, family members, and friends to learn about and understand Embracing Their Reality™.

At Dementia By Day, we strive to innovate, to make our teachings around dementia care and dementia-friendly communication digestible in order to reach the people who need this education the most. Especially in today’s algorithm-driven climate, despite being a brand that has had an online presence in our niche for over 10 years, we indeed do reach new people all the time. Most people don’t think about dementia until it affects them personally. Every day, suddenly finding the “caregiver” label thrust upon them, people stumble upon our content for the first time while searching for answers to questions they never guessed they would have to ask. If this sounds like you, welcome. You’ve come to the right place. After celebrating the one year anniversary of our short film, Embracing Their Reality, our founder and CEO Rachel Wonderlin had the cool idea that we should develop a web comic on that same subject, the core tenet of our dementia communication framework. We commissioned the talented artist Brett E. Wagner to bring to life the story you see here. This time, we chose to illustrate (literally) the concept of Embracing Their Reality™ with the story of a mother and daughter. As you can see, the mother has a delusion— a fixed, false belief— that her mother is still alive, so she keeps asking about her. She is experiencing Timeline Confusion™. Essentially, she is experiencing time differently and believes that, where she is on her life timeline, her mom is still alive.  (Keep your eye out for our next web comic, as we will be tackling that subject next).    This is a common scenario for caregivers, in which the person living with dementia has a hallucination or delusion that is difficult for the caregiver to know how to respond to. So, what is a caregiver to do? Trying to prove that our reality is the truth and impose it on the person living with dementia, by arguing or through extreme measures, never goes well. Though to some it may seem over-the-top and unrealistic, we have actually met people who have taken their loved ones to the cemetery to try and prove that the person they ask about on repeat is indeed deceased.  In the web comic, the daughter learns that she needs to ask her mother key questions to find out where her Reality is, in order to then Embrace it. By asking, “Where do you think she is?” the daughter gains insight into her mom’s delusion, and is able to solve the emotional problem her mom is experiencing. The emotional problem is that Mom feels stressed because she does not know where her mother is.  The daughter gives her mom the opportunity to think about a likely place her own mother might be, and when Mom answers that she believes Grandma is at the store, the daughter now has a good answer she can share with her mother next time she asks the same question. We encourage everyone who interacts with people living with dementia to Embrace Their Reality™. It can feel awkward at first. We often compare it to learning a new language. Once you get the hang of it, though, it is very rewarding, and makes for less stress for everyone involved.

“Our company serves people with memory impairment.” “We offer memory care for people with Alzheimer’s and dementia.” “We provide specialized care for clients with dementia.” Do these sentences look familiar? They certainly do to us. These phrases are usually followed by stock photos of smiling older adults being assisted by smiling younger adults. There is frequently some vague language about an “excellent dining program” and “round-the-clock care” provided by “staff trained in dementia care.” We see the same language and same stock photos on just about every senior care company’s website. For us, it’s an immediate indication that the company who designed the website doesn’t actually have a specific dementia care program.   Here are our red flags: “Memory impairment” doesn’t even remotely cover the symptoms and causes of dementia. Alzheimer’s IS the most common cause of dementia, so saying, “Alzheimer’s and dementia” is a misnomer.  “We offer memory care” tells us that there isn’t a branded, named dementia care program—if there was, the company certainly would’ve said that. What does “specialized care” mean? There’s no mention of what happens for the company’s clients or residents that really makes it different from any other type of care. We work with our clients to design branded dementia care programs. In other words, we don’t provide cookie-cutter solutions. While we have dementia care education that everyone utilizes (Dementia By Day School) and we have intellectual property that we bring to all of our clients (think Embracing Their Reality®, Creativity Boxes, our favorite Life Stations, etc.,) we work together to design a dementia care program that meets their needs.   During our initial conversations through Evaluate & Escalate, we find out what is important to your company. We talk through challenges and successes your team has had and what makes you stand out in the industry.   THAT is what we build a plan around.   We also don’t believe in “train the trainer” methodologies for our dementia care education. Why? We’ve found that there’s a “whisper down the lane” or “game of telephone” energy to train-the-trainer: People end up with different interpretations and information when more than one person is teaching. That’s why we love what we’ve built on Dementia By Day School. The entire team gets access to the same clear messaging about dementia care.   While the C-Suite is working with us to design a dementia care program, the whole team (everyone at every location!) is going through our dementia education platform. Learn more about what’s included in program development here.   Here’s a great example of a dementia care program we built: BLOOM by Bethesda.   BLOOM was chosen as the name of their dementia care program because many of their communities have the word “garden” in their names. Additionally, as a faith-based organization, it was agreed that gardening is a very prayerful activity, and that it encourages spirituality through engagement with the earth. Thus, BLOOM was born, and gardening became foundational to the dementia care program and the resident’s day-to-day life. This stellar execution was possible because meeting attendance was off-the-charts with this leadership team.   They were totally united and invested in revolutionizing their dementia care, and this was ultimately reflected in the outcome at each building upon rollout.   When you have a branded dementia care program, you: Make it clear to your team that dementia care is something worth taking seriously.  Make it easier to hire the right people for the right roles. Show families that you understand their needs. Are better able to provide care for your residents or clients. Are better able to provide programming and activities for residents or clients. Stand out against competitors in the industry and the area. Ready to learn how Dementia By Day can help your organization? Get in touch today.

At Dementia By Day, we work primarily with senior living companies who want to elevate their dementia care communities and brands. Although that all sounds pretty niche, we actually work with a wide variety of different types of clients: clients with 1 building, clients with 25 or more buildings, home care companies with one or more franchisees, third-party providers who need a dementia care expert, and more. Learn more about us here. We always want our clients to come out of a project feeling successful and happy with the work we’ve done together. The challenge for us, though, is that we can’t completely control the outcome for our clients. In a lot of ways, it’s up to the client to do their “homework” and—more than anything else—continue to communicate with us throughout the project.  Here’s when it works:  1. The entire team cares about the project and engages positively in meetings. Bonus: Everyone turns on their cameras for meetings! If the only person who is invested in improving the company’s dementia care program is the CEO, it’s going to be a challenge for us to make any substantive changes at the organization. Imagine that the CEO moves onto another organization, or, more likely, imagine that when we begin to roll out a program, we get a lot of pushback from other team members. The positive energy and meeting attendance also includes the clients’ buildings during the rollout process. Do they come to meetings? Do they do their homework? Are they happy to see us over Zoom, or are they annoyed that we’re trying to make changes to how they do things?  2. The team communicates with us in between meetings via email and does their homework. Bonus: We are kept abreast of big changes! Whether it’s going through a Dementia By Day School course or a more conceptual task, if team members aren’t doing their homework between meetings, the project is going to stall out— quickly. We want to get everything done in the time period we’re working together, but that isn’t going to happen if we send a few logos for the team to review and no one replies to us for a week. The more time we have to spend following up with a client, the more this time is going to cut into the actual meat and potatoes of the project. We also appreciate when we’re kept abreast of big changes at the organization. As an example, if the team is hiring a new COO, we’d love to meet them when they come aboard—not three months later when we hear, suddenly, that there is a new COO. 3. The point person at each building (if this is senior living, not home care) is a Dementia Care Director or Dementia Care Coordinator—not an activities team member. Bonus: We’d love to help you create the job description and hire for these roles if you don’t already have them! We need a key point person at each building during the rollout, and we have seen time and time again that this individual should be a Dementia Care Director. Why? The Dementia Care Director is in charge of every non-clinical thing that happens in dementia care. They’re typically someone who is knowledgeable and in a supervisory role. They are typically someone who has a background in dementia care. When the key point person is an activities team member, they are often pulled from meetings to run activities in other parts of the building. Perhaps they’re driving residents to appointments or working in Assisted Living for the day. They typically don’t have the authority to make big changes or decisions, and the care staff often disregard what they say. 4. We get paid on time and we don’t need to track down multiple contacts to try and get paid each month. Bonus: You’re offering direct deposit! We know this seems like an “us” problem, but trust us on this: Not getting paid quickly can stall our timeline. When we have a client who doesn’t pay us on time, it means that we have to start putting walls around our content and the time we’re spending with that client. It means we spend extra time and energy following up with the client. It means we’re spending less time doing the valuable work we both want done. Besides that, it’s painful to have to ask a client for payment each month and it doesn’t foster a good relationship between us and the client. 5. People stay with the company and the company culture is generally positive. Let’s face it: Senior care has high turnover rates, particularly among care staff. We know this and we expect there will be turnover. That said, if there is consistently above-average turnover (in management, in particular) it will begin to affect the project’s workflow. If we’re rolling the project out with a building, and suddenly their Director is gone, we have to pause and restart once a new team member joins and takes that role. All of our super successful clients have these five things in common. There are plenty of other attributes that we love about our favorite clients, but these five items are incredibly impactful when it comes to rolling out a dementia care program.  Are you interested in working with us and want to learn more about what we do and who we’ve worked with? Check out our Work With Us page here.