A Day in the Life at Memory Care
Leading up to Memory Care
Jim had lived alone for many years after his wife passed away. He had three children who lived less than 10 miles from him. They had their families, and Jim was involved with all of them and his grandchildren. The family would frequently get together for holidays and special events. He was at the homes of his children several times a week for dinner.
Jim, while in his mid-eighties, had bouts of forgetfulness and was diagnosed with early dementia, but Rachel, who was his youngest daughter usually was available to drive him to do shopping and errands. Rachel would also drive him to his medical appointments. Rachel had more flexibility in her schedule than her other two sisters, Carol and Lynn. Carol and Lynn both worked full time and Rachel had younger children and worked part time.
Jim had a serious fall down some stairs in his home and was hospitalized, then went to rehab to help him recover. It was a nasty fall and he could not live on his own anymore. Carol and Lynn wanted to explore options for assisted living, but Rachel was adamant that he come live with her. Carol and Lynn did not want to see this happen fearing that caring for their father might be too much for Rachel and her husband who were raising two young children under the age of 5. After much debate and discussion, Jim went to live with Rachel after his discharge from rehab. Rachel, who did not have a large home, could convert their dining room into a bedroom for Jim.
An Over-worked Care Giver
When Jim came to live with Rachel, his needs were more than expected. Prior to his fall, he had mild dementia. Now there was a significant noticeable decline in his memory and abilities. Rachel managed the best she could, but Jim needed cueing and reminders for everything. Jim was also up at all hours of the night. It was disruptive, as Jim always had the TV on very loud. Rachel, her husband, and children needed to sleep. The turning point came when, late one evening, Rachel heard the front door open. When she went downstairs, the door was wide open and Jim was not in the house. Rachel ran out to find Jim walking down the road in his pajama pants, t-shirt and no shoes. It was only 42 degrees outside. When Rachel caught up to him, Jim said he was going home. He was very confused and argumentative about going back with Rachel. All of this behavior was new for Jim. He was never confrontational with Rachel. Rachel didn’t know what to do, but after some pleading and re-directing, she was able to walk him back to the house. The day before, Jim went out the front door, but Rachel thought nothing about it as she was there and thought Jim just wanted some fresh air. She called to him and he came in.
Rachel realized at that moment, her dad’s care needs and dementia had surpassed what she could do at home for him. The past three months had taken a huge toll on her and her family. Trying to care for Jim had also caused much tension between Rachel and her husband and Rachel and her sisters. That night, Rachel called her sisters to explain what had happened and to share that she needed help. Carol and Lynn wasted no time in visiting assisted living communities that had memory care. Jim now needed a secure memory care community.
After looking at several in the area, they agreed that there was one community that was close to all of their homes. It was a stand -alone memory care community. It was secure and very homelike. The staff at the memory care community could come to Rachel’s home and assess Jim. After securing his medical records, they were able to take Jim into the community as a resident the very next day.
Bringing Jim to the community was difficult for Rachel, but she felt comfortable with her tour and how they could help him. She saw people engaged in programming that helped them keep or regain their independence. The residents were participating in far more activities than Rachel could ever provide at home. Rachel had been so exhausted trying to care for all of her dad’s needs and the needs of her family that she realized that they had no time to do any fun things together. They were just barely existing. The families they could speak with at the memory care community spoke very highly of their experiences at the community. The staff were so caring. Rachel and her sisters felt this was a better place for Jim to be, but also it would be better for Rachel and her family. The daughters brought things like bedding and photos, along with Jim’s chair for his room. They wanted Jim’s room to be familiar and comfortable for him.
After going over Jim’s care plan with the family, the staff asked if the family would not visit Jim for 72 hours. They felt Jim would need that time to acclimate to his new surroundings in his new home. Jim was agitated and even more so when he saw his daughters leave. Leaving their dad was one of the hardest things they had ever done. Twice a day, though, for the next 72 hours, the staff from the community would call and let them know how Jim was doing. Sometimes they would send photos. These calls and photos were so important to Rachel, Carol, and Lynn. They were grateful for them.
On the fourth day, they could come visit. When they saw Jim, he was looking well -groomed and dressed for the day. He was sitting in a circle with other residents, and the activity director was reviewing current events and encouraging a discussion among them. Before they got there, Jim was able to get up when he woke up naturally and caregivers were there to help him get ready for the day. They helped Jim with his rest room needs, showering, grooming, dressing and make sure he had his medications. The caregivers were learning his preferences and were tailoring his care plan to his natural rhythms. The entire staff were focused on really getting to know Jim. His daughters could see that and they felt very good about it. At meal time, the cook and dietary staff wanted to make sure Jim was eating well and liked what he was served. During the four days Jim was there, the staff made sure they introduced him to other residents and made connections with residents that had common likes and interests as Jim.
On the first day after Rachel, Carol and Lynn has left, Jim was very upset and agitated. The staff, very gently, could calm Jim down. They brought him to a room that had aroma and music therapies for Jim to take in. It was a sensory room with soft lighting and textures that was highly effective at minimizing the agitation some residents with dementia or Alzheimer’s have. After that, Jim was feeling more like himself. The first- and second-nights that Jim was in the community, he was up most of the night. It was okay though because there were other residents who were up as well and caregivers were ready to interact with them and have them take part in a structured quiet activity or have a snack before returning to bed again. In a community that specializes in memory care, the community adapts to the resident. They do not expect a resident with declining cognitive function to adapt to the community. Over time, there would be a shift in Jim’s sleep habits that followed more of a normal schedule.
It thrilled Jim to see his daughters, and he wanted to show them around the community. He would stop and introduce some of the residents he could remember. The residents he couldn’t remember, Jim let the girls say hello and ask their names. He was excited that therapy dogs were coming into the community later that day, after lunch. Jim could show them some of the creative projects he had worked on. One of his favorite things to show off was his music play list that Alexa could play for him with his voice command. The staff worked on learning some of Jim’s favorite music to create his very own list that he loved to listen to. Jim’s daughters had tears in their eyes when they realized that none of them could not provide the quality-of-life Jim was living. The staff at the community filled Jim’s life with variety every day, but it had the most important components of routine that were key in dementia care. There were components of the day that were predictable, and the residents always knew what to expect. Routine creates calm in the community. From morning thru night, help was always present and the morning, afternoon and evening care routines are the same. The morning, afternoon and evening activities and events are different, but usually at the same time. These parts of the day offer new experiences and joyful moments every day that give all the residents and staff something to look forward to.
Rachel, Carol and Lynn always felt welcome at the community and definitely felt better knowing their dad had an entire team caring for him. As his needs changed, the staff were well equipped and trained to help Jim live to his fullest potential while helping him find his new normal. There was also a bi-weekly support group for families that was very helpful for Jim’s daughters as they needed help to process the sadness they felt as changes were happening to their dad as his illness progressed and he remembered less and less. The friendships they made with other families and the staff became more like an extended family. They felt grateful that people that truly cared and understood surrounded them and knew firsthand how difficult this journey was.