A Good Enough Daughter
As a professional in the field of aging, Sara had seen it all—until her own mother broke her hip at the age of 88 and became profoundly confused, unable to live in her own home. Join Sara on her journey through the strangeness that is dementia while trying to make sense of it all and finding humor in the details. [Editor's note: Sara no longer contributes to Silver Planet, but we have made her archived blog entries available as a service to our readers.]
The Three Plagues of Long-term Care: Loneliness, Helplessness, and Boredom
“Because three hots and a cot” is just not good enough
I want to throw my purse at long-term care facility administrators who say, because of financial restraints, that they cannot intentionally and successfully address what Dr. Bill Thomas calls the “three plagues” of long-term care: loneliness, helplessness, and boredom. Their thinking goes, if facilities would only take in more money, there would be enough resources to deal with those problems. Claptrap. It’s not about money—it’s about culture and priorities.
Last week I attended a forum at Pacific Lutheran University in Tacoma, Washington. Dr. Terry Miller, dean of the School of Nursing at PLU, is leading a small but mighty army of nurses and social workers on a mission to transform the culture of long-term care. Dr. Miller and his team of extraordinary thinkers are not alone in their campaign; they’ve wisely assembled a local coalition of like-minded professionals in the Tacoma area to help carry the message forward.
At the Tacoma forum I watched a video: Gladys Wilson and Naomi Feil (available on YouTube). Ms. Feil is the person who developed Validation Therapy, a practice and orientation in caring for those living with dementia; Ms. Wilson is a resident at a nursing home. The basic principle of the therapy is to communicate respect for the resident’s (client’s or patient’s, depending on the setting) opinions and acknowledge that they are heard. The video is very powerful and successfully demonstrates that human connection is possible even in the face of significant cognitive disfunction.
On October 8, in Seattle, at the National Adult Day Services Association conference, Dr. Anne Basting of the University of Wisconsin will give a presentation on an activity program called TimeSlips, described by Dr. Basting as “a group process that opens storytelling to people with cognitive challenges by replacing the pressure to remember with the encouragement to imagine.”
A few years ago, my friend Julie introduced me to the concept of GENTLECARE, developed by Moyra Jones. Ms. Jones believes that the environment needs to change to accommodate the person living with dementia, not the other way around. Her approach requires the facility to adapt, rather than require the person with dementia to perform in ways no longer possible.
There must be dozens of programs and approaches available to residential facilities that go beyond handholding and manicures. We must ask facility administrators this question: “What programs do you have in place to alleviate residents' boredom, helplessness, and loneliness?” The question will probably take them by surprise.
By Sara Myers
A Good Enough Daughter Blog
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