Redefining Memory Care: Our Doors Are Open
|"After working for 25 years in long term care, I have come to realize that the care of those living with dementia is best delivered in an inclusive environment. While Elders’ safety is of utmost importance, they don’t have to be isolated to insure that safety."|
-Lanette Williams, Executive Director
In 1996, SentryCare opened the first Assisted Living home in Mississippi dedicated strictly to the care of those living with dementia. In 2007, a similar wing was opened after it was rebuilt from Hurricane Katrina. Later in 2009, a third home was dedicated to the same type of care. During that time frame we believed it was logical for those Elders living with dementia to live in the same area. Dedicated staff was specially trained to meet their needs, and they were kept in a safe and secure environment. It all sounded good.
In his book Dementia Beyond Drugs, Al Power, MD made the case for a "less is more" approach when prescribing drugs for Elders living with dementia. In particular, he noted from his medical practice that most "behaviors" which lead to a request for a drug stemmed from an unmet need. He also challenged providers to examine why those living with dementia should be segregated from the rest of society banished to live in memory care units. Disability groups, the Americans with Disabilities Act, and even the World Health Organization advocate for inclusion of those who live with dementia, rather than isolation.
|"It pleases me to see those living with dementia and needing more help well cared for...I don't feel afraid for my own future needs."|
"As I relate to care partners caring for elders with greater needs...those same elders and care partners know me as well."
"It’s good to know that if I need more care I won’t have to move to another neighborhood, even if my memory fades."
-Elders of Peach Tree Village
As a group of caring professionals, we struggled with his concept. While rationalizing our segregation of these Elders we did not want to be part of violating one's basic human rights. Additionally, questions arose about having introduced a restraint into what had been a restraint free environment. As we began talking to the Elders, they agreed - they wouldn't want to be segregated from the rest of the Village if they lived with dementia.
Finally, after a challenge Dr. Power made at the 2015 Eden Alternative conference, we decided to remove the doors. However, we had to first cover all the bases to provide a safe environment for those living with dementia. The main entrances were secured with locked devices to protect those who may want to explore beyond a safe perimeter while remaining open for other Elders and visitors. (Interestingly, in the process we realized that as we were increasing security for those who live with dementia, all who lived and worked in the village would benefit from a more secure environment.) As well, this move necessitated the training of all staff care partners (including the kitchen team) in dementia care rather than just those who worked in the dementia care neighborhoods. This information better prepared them to be even more patient and understanding with all Elders.
Our Doors Are Open!
Once we opened the doors, the results were amazing!
- Elders who had attempted to leave the memory care neighborhood were content when enabled to walk around the entire Village.
- Staff from all neighborhoods became more aware of the needs of those living with dementia and more empathetic in general.
- Elders were more understanding of the needs of those who had been living behind closed doors.
- Families all seemed to appreciate the more humane way of dealing with those who live with dementia.
- The overall feel of the Village was more relaxed and homelike.
We are very proud of our position to enable those who live with dementia to live among the rest of the community with as few drugs as possible. All of our Staff Care Partners have learned how to assist Elders living with dementia, and we believe that we have improved the quality of life for all Elders, Staff and Families with whom we are honored to serve. We continue to strive to live out our mission: "To Promote Well Being".