I get asked this question a lot. And the answer is yes, without a doubt, yes. It certainly is sad when a client passes away. We have many long-standing clients whom we have served for years. We have seen them through major life transformations, journeyed with them as their health and abilities fluctuate, and have been at their side in their final moments.
These are people for whom we have provided intimate personal care. These are people who entrusted us with even more than their physical needs; we are often their listening ear, the ones who reassure them when they voice fears or concerns, the ones who acknowledge and validate their current reality.
Our clients are more than clients. They are an extended family with whom we share deeply meaningful moments. So the answer is absolutely yes—when a client passes away it certainly does impact us.
The next question that usually follows is: “how do you keep doing it? If losing clients is tough, how do you not get depressed by it all?”
That is a tougher question to answer, but finding the answer to this question makes all the difference in the world. It is always important to step back and consider the impact that we have made in the client’s life and the lives of their family.
Impact in the Client’s Life
We had a long-term client who passed away just last week. Over ten months ago, she was deemed palliative and initially was told she may only have a few weeks left to live. She proved everyone wrong! Every day our fabulous caregivers arrived to spend quality time together, with hopes of drawing out her charming smile. Many have suggested that she lived for our daily visits; it is possible that the companionship of our team contributed to her surviving months longer than doctors predicted.
We impact our client’s lives each and every day. We arrive at each client visit with the viewpoint of: “how can I make today a better day for this client?” We have countless heartwarming moments that will make you laugh or cry—or both! We share these Heartfelt Moments so others can feel the joy and deep meaning that we experience. We aim to make every day special for clients—whether it’s our first visit with them, or it’s within their final days.
Impact in the Family’s Lives
Recently, we were asked to provide palliative care to a client who had stage four cancer that was rapidly progressing. Although we did not have years of history with this client, we quickly grew to love her too. It was her family’s wish that she remain in her apartment until the very end—they desperately did not want their mother to pass away in hospital. Our attendant care granted this family their final wish for their mother. She passed away in her own bed, at peace, with someone holding her hand.
We cannot doubt that the family was impacted. The family had peace of mind knowing that someone was with their mother around the clock at times that they could not be present. They knew she had the tender and loving care that she deserved. They were granted their wish to have their mother pass away in her own bed at home.
In moments when we are tempted to feel sad and depressed because clients have passed away, I stop to consider—what impact did we make? If we were brought in specifically to provide palliative care to someone in need, and we successfully enabled them to remain at home and experience the passing they had envisioned, what more could I ask? When I realize that without our care, the family’s wish and the client’s wishes might not have been granted, then I realize that it would be selfish of me NOT to provide the care and support that they request.
When I recognize that our clients received a higher quality of life for the final months or years of their life, I realize that it is all worth it. I am a better person for each of the clients I have met. They each leave a lasting touch. What a blessing that I get to meet so many incredible people who touch my life, and who have entrusted me with the great honour of impacting their lives too.
So is it tough to lose clients? Yes, it most certainly is. Is it depressing though? I would say no, it is not depressing. Instead, it is a blessing to have been invited into the client’s life at such an important time. I am honoured, I am blessed, and I am touched.
When families are seeking companionship for their loved ones—especially within retirement homes or long term care centres—some families are surprised that the minimum companionship visit is three hours. The reason we have minimums is to fulfill our mission and philosophy of care. Within the context of long term care, there is another element that is also crucial and that is providing your loved one with one-on-one undivided attention.
One-on-One Undivided Attention
One of the reasons that companionship services are so beneficial within long term care homes is your loved one receives one-on-one undivided attention. Of course, there are wonderful staff members in the long term care home who are providing various types of care and assistance, but their attention is not undivided. They are typically rushing off to attend to the next resident because there are so many people who are in need, all at the same time. Your loved one can feel this. They can feel the sense that someone is hurrying along, or watching the clock, or checking a pager or other device. While completely unintended, your loved one might not feel important at that moment.
Our companionship services are an antidote to the rushing around and unfocused attention they’re receiving. Our caregivers slow right down and sit with your loved one. They’ll exude a sense of peace and calm that says “I’m here for you, and I’m not rushing anywhere else.” Because they have the luxury of time (at least three hours), they are not watching the clock, they are not rushing off to attend to other residents. They are focused entirely on your loved one giving much-needed undivided attention for hours on end.
We have served many clients in long term care who are in the very late stages of dementia. In many cases, these clients have very little verbal communication left. Many would say that they are past being able to recognize faces, and certainly beyond knowing names.
We served one such lady at a long term care home in Kitchener. She was non-verbal and most of the time her head hung low. She rarely made eye contact and only groaned occasionally. When family enlisted our help, many others wondered why they even bothered having a caregiver visit. Others assumed this woman could not benefit from a companionship visit since she couldn’t converse.
We paired this woman with a caregiver who had a particular knack for connecting with people who are non-verbal. The caregiver spent hours with this woman, slowly getting to know her and understand her body language. She developed trust and rapport with this woman. Before long, the elderly woman was responding to the caregiver’s voice.
The woman could be sitting in her wheelchair, slumped over with her head drooping, but at the sound of the caregiver’s voice, she would suddenly open her eyes and lift her head. When the caregiver was within sight her eyes would sparkle. She knew that the caregiver was there to see her personally. That caregiver wasn’t there to help everyone; she wasn’t there to do activities with or entertain the whole crowd. She was there for the sole purpose of being with this particular woman, and the woman knew that and responded to that individual attention.
This woman—who many might have disregarded as being unresponsive or too progressed with dementia to bother providing companionship—clearly benefitted hugely. We’ll never know how much she comprehended the caregiver’s one-sided conversation, but we know that she comprehended the feelings elicited by the caregiver. The woman felt noticed and appreciated, she felt valued and she recognized that the caregiver was there for her alone.
That is why we provide companionship to clients regardless of their physical or mental diagnoses or conditions. Making that woman’s day, providing her with a sense of joy and moments of contentment and fulfilment are what it’s all about. Would you like to have the same for your loved one?
In the world of homecare, terms like ‘minimum’, ‘maximum’, and ‘eligibility’ frequently arise.
When arranging publicly-funded homecare through the LHIN, the first concern will be eligibility—is your loved one eligible for LHIN homecare? If they are, the next question will be “for how much homecare?” Publicly-funded homecare is all about eligibility and maximums—the maximum amount of service that can be provided based on eligibility.
Privatehomecare is exactly the opposite. There are no eligibility criteria, and there is no maximum amount of service. We gladly provide as much service as a client needs or wants. In fact, to ensure that clients truly are well-served, we have minimum service provisions rather than maximums.
Why do we have minimum service provisions?
Here at Warm Embrace Elder Care, we have service minimums as a way of ensuring that we always provide service in line with our philosophy of care. Here are a few important ways that minimum service provisions contribute to the fulfillment of our mission and our philosophy of care:
Our philosophy of care is about promoting abilities and never doing for a client what he or she can manage independently. It takes significantly longer to support someone in doing a task slowly, at their ability level, than having caregivers just rush through a task on a client’s behalf. What is best for the client though? If caregivers always just do the task because it’s faster, eventually, the client will lose the ability to manage that task independently. Promoting abilities—even though it may take much longer and requires more support—is better for clients, so we allow enough time to support independence and not just do tasks ourselves.
Part of dignified care is ensuring that we match each client’s individual pace. Being rushed through your daily routine, especially with something as intimate as personal care, can feel very dehumanizing. Our clients deserve the dignity of taking time and lingering over their personal routines and not being rushed by an artificial deadline imposed by a one-hour visit.
Companionship is an essential element of our service. Our clients and caregivers establish a special bond, and this bond is developed by sharing quality time together. If caregivers simply rush in the door hurrying to complete a specified task in less than an hour and rush back out the door, it is difficult for rapport to develop. Slowing down and getting to know each other as human beings first, before jumping into tasks or personal care, puts the focus where it should be—on the people first and not on the tasks alone.
When a caregiver is paired with your loved one, that caregiver is prepared to assist in numerous ways. Caregivers are able to help with numerous tasks in the time they are present—they might do some laundry, wash dishes, make dinner, help your loved one to shower and get dressed, and then run errands. The benefit of this model is that you don’t need a separate person for each task—you don’t need a driver who only does errands, and someone else who only assists with personal care, and someone else who only does laundry, etc. It’s a more comprehensive approach where all the different elements of daily life can be seamlessly woven together—the same as you weave numerous elements throughout your day. Because we’re aiming to assist with so many different elements of daily living it takes more than an hour or two to effectively assist with each.
Living and serving by our mission and our philosophy of care is what makes our service exceptional. Minimum service is the first step to abiding by our mission. Beyond the minimum, the sky is the limit! Clients don’t need to worry about exceeding the maximum or being capped at a certain level. Instead of feeling limited by caps, maximums or restraints, clients can know that we’ll be there to assist as needed.
You have a resident, Henry, who insists on “going home”. Henry is adamant that he is “getting out of here” and that you can’t stop him. As the afternoon progresses, he becomes increasingly agitated and more insistent. Henry’s agitation is contagious; other residents are upset that he is upset.
Of course, logic won’t be helpful at this point. Reminding Henry that this is his home and he has lived here for months now is not effective. In fact, the more you try to reason with him and explain that this is his home, the more upset he becomes and the more he wants to leave.
“Going home” is not about the location. It’s moreabout the feeling Henry is experiencing. Henry is trying to communicate how he feels. He wants to go home because home is a place that represents feeling safe and secure, feeling in charge, feeling productive and knowing what to do. He wants to “get out of here” because he isn’t feeling safe, in charge or productive. He’s not sure what to do, so he figures he should go home where everything will make more sense.
Answering Henry’s emotional plea with logical answers won’t work. Explaining how long he’s lived there or which city he’s in, or the fact that he chose this home when he toured with his son—none of these explanations will be helpful. Instead, he needs someone to address his emotional needs.
The challenging part is that it takes a lot of time, a lot of patience, and a lot of one-on-one focused attention to effectively help Henry. It may take more individual time than your staffing allows, and other residents may have more pressing needs. This is where Warm Embrace comes in. Our caregivers provide one-on-one support to help redirect Henry when he wants to go home.
Better yet, our caregivers proactively address Henry’s needs. Since we know that Henry is more likely to want to go home as the afternoon progresses, we schedule an afternoon visit that starts before he typically becomes agitated. We keep Henry engaged in activities and provide positive reinforcement that confirms for Henry that he’s in the right place and he belongs. When Henry is busy working on a puzzle with his caregiver, or he’s in the courtyard enjoying the sunshine, or he’s joining in the sing-a-long in a chapel, he is less likely to focus on going home.
One-on-one companionship meets Henry’s needs in a non-pharmacological way. We can help to reduce his agitation and no medication is required. Other residents are also relieved when Henry is content and not agitated. Your staff is then free to attend to the needs of all the other residents in their care, knowing that Henry is in good hands.
Which of your residents would benefit from the same support as Henry?
You’re always encouraged when your residents have visitors. It brightens their spirits and gives them something to look forward to.
You have a fairly new resident who moved in last month and her daughter has been visiting daily. Initially, you thought it was to help ease the transition, but after a month, the daily routine is still in place. You’ve noticed that the daughter is looking increasingly strained herself. While the mother certainly seems to appreciate the daily visits, it seems to be taking a toll on the daughter.
This daughter needs a Warm Embrace caregiver! She needs a reliable visitor who will befriend her mother and visit consistently on set days of the week. We certainly can’t replace family, but we can supplement family visits. Maintaining a daily visiting routine is not sustainable for most families, and this daughter could be relieved to know that a reliable caregiver will cover set days of the week.
We can protect the daughter from burnout by alleviating her before she hits a breaking point with an unsustainable routine. If she reaches the point of burnout, there’s a risk she will no longer be able to visit at all. If she stretches herself too thin, she may become susceptible to illness herself, catching every cold or flu that circulates. If she becomes contagiously ill, she won’t be able to visit and then her mother will be left with no visitor at all.
Our wonderful caregivers create balance. We can supplement family visits by coordinating to match each family’s routine and schedule. Perhaps the daughter would like to maintain visits three days a week; we can provide a caregiver to visit on the other four days of the week. When the daughter would like to go on holidays, we can provide additional visits to cover the days when she would usually have visited.
By recommending a Warm Embrace caregiver for this new resident, you are supporting this family when they need it most. Which residents—or family members—do you see who are most in need right now?
Homecare can be defined pretty broadly and mean different things to different people. To some, it might mean dropping in to check on someone for 5 or 10 mins, for someone else it could be 24/7 care in someone’s home. It could be just about anything in between!
To ensure that our clients receive the best possible service, we have placed parameters around the type of service we can offer to ensure top quality. Here at Warm Embrace, the minimum visit length we offer is three hours. We have set this minimum to ensure that we are fulfilling our mission and our philosophy of care.
Within the context of homecare, where an elderly client is living in their own home, apartment or condo, there are some additional reasons why the three-hour minimum is necessary.
Have you ever dropped by your elderly parents’ home with the intent of staying for a half hour visit? How did that turn out? I’m willing to bet that you stayed much longer than just 30 minutes! Why is that?
I’m guessing that by the time you got in the door and settled, got caught up with some friendly chit-chat and had a coffee, you were already at the 30-minute mark. Just as you were thinking you would head out the door, your mother mentioned a new symptom that’s bothering her. You discussed that and tried to track down whether a doctor’s appointment had been made since your mother couldn’t remember. Then your father mentioned that the microwave wasn’t working properly so they weren’t sure what they were going to have for dinner. The next thing you know, you’re busy making dinner for them and your quick 30-minute drop-in lasted a few hours.
Of course, your parents tend to stock-pile all the issues until you arrive. Then it takes longer to address everything. The same is true for our visits. Clients may save up the dishes and the housekeeping and laundry pile up. The items you plan in advance that you figure might take an hour or so end up taking much longer when the list keeps growing!
It’s not just about tasks; it’s also about pacing.
If you personally have a doctor’s appointment at 11 am, how much time do you allow yourself to get showered, dressed, ready and out the door? Now, what if your parents have a doctor’s appointment at 11 am? It takes a lot more time since every step in the process needs to be adjusted to allow the extra time they may require or prefer.
It likely takes much longer for them to manage to get in and out of the shower. Selecting an outfit and dressing likely takes longer, as does personal grooming and other morning routines. Physically getting into and out of the car may take longer, and your parents may prefer to be at the appointment 20 minutes early instead of arriving just on time. . .despite the fact that the doctor is always behind schedule and you know you’ll end up waiting anyway!
Out of respect for your parents, we allow significant time for outings to ensure that we can match their preferred pace, not our preferred pace. We know that each stage will take much longer and that we need to allow lots of extra time should something unexpected arise. If we’re just getting your parents settled in the car and your mother suddenly needs the washroom once more before leaving, we need to have allowed lots of extra time to deal with the (somewhat) unexpected. For your parents’ sake, we would never attempt to accomplish an outing in only an hour long shift. Part of providing dignified care is allowing sufficient time for outings and errands and matching your parents’ pace, not necessarily just focusing on fastest efficiency. It takes time to do things well and the minimum time we need to ensure top quality is three hours.
Granting your parents the dignity of matching their preferred pace, ensuring that we have extra time built in for the unexpected, and knowing that they may have a stockpiled list ready for our arrival are all part of how we plan in advance to meet your parents’ needs.
Relationships are about so much more than speed and efficiency; your parents will thrive from the attention they receive from a wonderful caregiver who takes the time to appreciate them for who they are and who gets to know them on a personal level without rushing.
Mealtimes don't have to be difficult - We can help!
Wednesday, January 9, 2019
For many of your residents, meals are the favourite times of the day. They line up in the dining room half an hour early in great anticipation. It is the event to savour!
Other residents may struggle with meal time. Some require physical assistance with feeding, and some may need constant cueing and reminders to eat their meal. For those with advanced dementia, the noise and commotion of the dining room can trigger agitation and make mealtime less successful. There are so many different needs to meet at every meal and it can be tricky for dietary staff to meet all those needs simultaneously.
Some residents may benefit from their own dedicated caregiver during mealtime.
Residents such as Lucy, who often became so agitated at meal times that she wouldn’t eat anything at all. At a quick glance, it appeared that Lucy just wasn’t hungry for her dinner. But when we sat with Lucy through her meals, we discovered that much of the time, she was confused and wasn’t sure what to eat or how. It was not because she was not hungry.
When we provided Lucy with a dedicated caregiver who sat with her throughout dinner, Lucy suddenly began to thrive! The caregiver would cue Lucy saying “oh, that roast beef looks delicious, would you like a bite?” and Lucy would smile and take a bite.
A minute later, the caregiver would say “you’re a big fan of mashed potatoes, and look what we have here—your favourite! Mashed potatoes!” By the end of the dinner hour, Lucy had cleaned her entire plate. With cueing, direction and constant encouragement, Lucy ate her food and was mostly able to feed herself. By continuing to cue Lucy and not just take over by feeding her, her own dedicated caregiver promoted Lucy’s remaining abilities and independence.
Do you have any residents who would benefit from patient, one-on-one constant cueing and encouragement? Watch your residents thrive when paired with a Warm Embrace caregiver!
You’re worried about your parents and you think they could use more help. You suggested homecare, but they wouldn’t hear of it. They told you: “we’ve managed just fine on our own this long, we don’t need any help.”
What they’re really saying is that they don’t want to face change.
That’s because change is scary.
Change is scary for all of us, at some level. Each person has a different tolerance for change, and it might take a lot more change to scare some people than others. But if you introduce a drastic enough change, eventually, any of us would feel trepidation about that change.
It’s little wonder then, that for seniors in their 80’s or 90’s, the thought of even a small change can be quite scary. After eight or nine decades, they are likely pretty set in their ways. They want things done a certain way; they want to keep their environment the same. As long as everything remains the same, it feels more manageable. It might help your parents to understand that homecare is all about reducing the amount of change that your parents will experience.
Warm Embrace Caregivers are trained to match each client’s specific preferences.
Caregivers DO NOT barge into a client’s home and just take over. Caregivers DO wait to be invited in, and they ASK permission to proceed. They ask how that particular client prefers the laundry or housekeeping to be done. They cook from the client’s recipes or directions to match their particular tastes. They help to keep clients’ lives consistent.
Homecare is one of the best prevention strategies to one of the biggest possible life changes: admission to a long term care home. Moving to long term care is a HUGE change—absolutely every single element of someone’s routine is changed. From the time they get out of bed, to when they eat, and whether they wear pyjamas to breakfast—everything is adjusted to match the schedule of the long term care home.
Homecare ensures that individual clients maintain their own personal routine, they maintain their home, they maintain familiar comforts. Caregivers match clients, rather than clients matching caregivers. It reduces the amount of change they must experience.
Since homecare is completely client-focused, each client calls the shots. The client decides what they’re doing each day and how they want things done and in which order. It is very empowering for seniors to get to make all the decisions that impact their own day-to-day living. Homecare grants this level of autonomy and independence.
Help your parents to see that homecare will ensure the least amount of change and help them to maintain the lifestyle that they know and love.
What do you get for the grandparent or senior who already has everything? The great-grandparents are even harder to shop for! What is the perfect gift for someone who is 80+? Different gifts are ideal depending upon where someone lives. Here are two gift list ideas to suit different living situations.
4 IDEAS FOR SENIORS LIVING AT HOME
If your 80+ relative is living independently at home (either a house, condo, or apartment), then the best gifts you can give them are practical items that will prolong their independence. Your loved one is likely very focused upon remaining at home for as long as possible; any gift you give that helps in achieving that goal is a good idea.
Here are some suggestions
1. Gift Certificates for property maintenance. The physically demanding activities of home maintenance are likely difficult, so provide your loved one with a gift certificate for regular home maintenance chores such as snow shovelling, grass cutting, garden upkeep, window washing, etc.
2. Homemaking and Household Assistance. Out-door house maintenance is not the only area of challenge for the elderly. Household chores can also become quite onerous. Your loved one will greatly appreciate a gift certificate for housekeeping.
3. Assistive Devices. Assistive devices can include a whole range of products to help with any variety of needs. There are specially designed items for challenges such as hearing impairment, sight impairment, weakness following a stroke, dexterity, memory loss, etc. You might be surprised at some of the items available for purchase at your local assistive devices store. Your loved one will truly appreciate this gift if they have already acknowledged challenge in a particular area.
4. Transportation. Many elderly seniors no longer have a licence and no longer drive. No access to transportation can be isolating, especially in the winter months. Providing your loved one with pre-paid driving options ensures that they will not be home-bound when the winter weather hits. Warm Embrace caregivers are pleased to drive your loved ones wherever they need to go.
4 IDEAS FOR THOSE LIVING IN NURSING HOMES
If your loved one lives in a retirement home or long-term care centre, then different gifts might be more appropriate. Their personal quarters are much smaller, so they do not have space to keep many belongings. Here are some ideas that won’t take up too much space but will still bring a smile on Christmas day.
1. Window Ornaments. Glass window ornaments are pretty to look at, and cast a cheerful glow when the sun is shining. There may not be much shelf space available for knick-knacks, but adding a personal touch to the window doesn't take up any additional space.
2.Personal Items. Residents in long-term care use their own preferred personal care items such as hand soap, lotion, toothpaste, etc. A care package of your loved one’s favourite items is always appreciated! The scent is strongly linked with memory and emotion; selecting a favourite scent can induce positive memories.
3. Blanket or Lap Quilt. Having a cozy item such as a small blanket or lap quilt is always comforting. It can be left on the bed or on a chair in your loved one’s room. If recognition of new items is difficult for your loved one, a blanket on the bed implies its purpose in a way that new clothing items do not.
4. Companionship. Providing your loved one with on-going visits is probably the best gift you could offer. Warm Embrace provides Companion Aides to long-term care centers across the region. Companion Aides visit one-on-one with residents and can take them on personal outings into the community. They provide mental and social stimulation, as well as an opportunity for physical activity. This is a gift that keeps on giving long after the holiday season!
FOR SENIORS LIVING ANYWHERE:
Triple Vitality. This gift is suitable for someone living in retirement or long-term care, as well as those still living in the community. Triple Vitality is a proactive approach that focuses on three areas of health—physical fitness, mental stimulation, and social interaction. By maintaining strength and functioning in each of these areas, people maintain independence and enjoy an increased quality of life.
If you just have questions about the above list of gift ideas, please don’t hesitate to call. We love to know that the seniors in this area will have a meaningful holiday season!
These are great ideas. Thank you so much! I also wanted to say if you have clients in need of Foot Care, Basic or Advanced (diabetics etc.) I offer this service in Listowel, Milverton, Rostock, Stratford and some in Cambridge areas. Foot Care is a great gift for the elderly as well. :)
Someone who is experiencing dementia may exhibit behaviours that we do not understand. These behaviours have been labeled ‘difficult’ or ‘disruptive’ or ‘challenging’, but is that really a fair assessment of these behaviours?
In caring for people with dementia, the focus often ends up being on the disease itself, rather than on the person who is experiencing the disease. Thus, their behaviours are often automatically assumed to be associated with the disease.
Sharon Stap, a Psychogeriatric Resource Consultant, contrasts older understandings of dementia with more updated approaches. In the past, it was understood that dementia was altering someone’s brain, resulting in different behaviour. All behaviour was assumed to be a result of the disease.
The newer understanding of dementia is that the changes in someone’s brain results in a different perception of the world around them, creating anxiety, fear and other emotions which then lead to different behaviours. Understanding that someone with dementia is experiencing a change in perception which causes behaviour should fundamentally alter how we interact with those who have dementia.
Dr. Sherry Dupuis, former director of MAREP (the Murray Alzheimer Research Education Project), feels that we need to reframe our view of these behaviours. Instead of merely seeing the ‘challenge’ or ‘difficulty’ that these behaviours cause for us, or assuming that all behaviour is attributed to disease, we need to reframe these behaviours as a form of communication. Dr. Dupuis views behaviours as a form of personal expression, a unique way of communicating needs. We should then seek to understand the meaning behind the personal expression.
We must remember that people who have dementia were all unique individuals prior to the onset of their illness. They continue to be unique individuals with different personalities, communication styles, interests, life histories, etc. Dr. Dupuis charges us to never lose sight of the fact that a person with dementia is first and foremost a person who requires love, care, and understanding, not just a disease or a ‘case’ that needs to be managed.
One of the greatest gifts that we can offer to someone with dementia is the gift of truly relating to that person—validating their personal experiences and feelings. Someone with dementia is experiencing the world around them differently than they previously experienced the world, and differently than you might be experiencing the world around you.
This experience may be frightening, overwhelming, or worrisome, and the feelings that are generated and their emotional response is fully valid. We cannot be dismissive of someone’s feelings or emotional responses just because we do not deem a situation to be frightening to ourselves. The kindest thing we can do is try to understand the emotional response and validate the feelings that someone else is experiencing. Only then can we attempt to change someone’s experience into something more positive.
If someone is distressed or having a negative experience, distraction can be helpful, but it is not the first step in the process. Stap emphasizes that you cannot jump immediately to distraction, otherwise you risk being dismissive of someone’s feelings. Stap proposes a four-step process where distraction is the final step, not the first option.
The Four Steps:
1. Show you care
2. Show you want to help
For example, Agnes has dementia, and she is upset and focused on wanting to return home. The first step is to acknowledge how Agnes is feeling. You might say: “You need to get home, Agnes? I can understand why you’re so upset.” Attempting to inform Agnes that she is already at home—known as reality orientation—is not helpful and only causes more distress; Dupuis and Stap agree that there is rarely, if ever, a good time for reality orientation.
After acknowledging and validating Agnes’ feelings, you want to show that you want to help. You might suggest: “let’s go see if we can find someone who can help us, Agnes”. While on the hunt for someone who can help, you have the opportunity to redirect, the third step. You could say, “I’m tired. Before we look for someone else who can help, do you mind if we rest here by the piano?”. After this, you have the opportunity for distraction, the fourth step. You could then say: “You play the piano, don’t you, Agnes? Would you play me a tune?”
If you had jumped immediately to distraction via the piano when Agnes first approached you, she likely would have felt even more frustrated that her needs were not being addressed. Acknowledging Agnes’ feelings and needs, then assisting her to focus on something that is more comforting, allows for a positive experience overall.
Interpreting all behaviour as a form of personal expression shifts the focus off of the disease of dementia, and refocuses attention on the individual person. Suddenly, behaviours are imbued with meaning and purpose, a form of communication. It is then our responsibility to enable the best possible form of communication and understanding, setting people up for success, regardless of dementia or other illnesses.