The journey with dementia: Assisted living and memory care (podcast transcript)

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The Journey with Dementia: Assisted Living and Memory Care quote graphic Maresa Henry, Spring ArborAs our loved ones get older, we want to be there for them in their golden years. We want to give them the greatest care, a safe environment to live in, and the proper treatment if they become ill. However, most American families with older relatives find it difficult to provide them with the finest care possible. Different family members have other responsibilities, so they cannot simultaneously provide all to their loved ones while going about their daily lives.

One of the possibilities is to use assisted living services. Assisted living is a form of accommodation for seniors who require varying degrees of medical and personal assistance. Memory care programs are available in several Assisted Living Facilities for dementia patients. They provide safety features for dementia patients since frequent behaviors including wandering, violence, and falls expose these patients to risk.

In this podcast, Perry Limes interviewed Maresa Henry, executive director at Spring Arbor Senior Living Severna Park. They discuss the benefits of getting the services of assisted living for seniors when to get the services, what are the programs offered especially for seniors with dementia, and the experiences and moments in these kinds of communities.

Click here to listen to Episode 5 of Season 1 of  “Life, Death and What Matters In Between”

Transcript

Perry Limes: Good afternoon and welcome back to Life, Death, and What Matters in between. I’m your host, Perry Limes, and I am joined today by Maresa Henry Executive Director of Spring Arbor, Severna Park. And today’s program will be the journey with dementia, the assisted living facilities, and memory care. Before we get started, we want to talk about your role in this journey. I like to remind our audience, you know, in every episode, we talk about our composite patient. His name is Joe, a 66-year-old African American who’s been dealing with dementia for a couple of years. And his wife of 40 years, Veronica, who is his primary caregiver. In this stage of Joe’s journey with dementia, it is becoming harder for Veronica to take care of him. She’s exhausted and concerned about leaving Joe alone and his safety, but she’s not sure what her options are. So let’s get into it. First of all, Maresa, tell us a little bit about yourself and how you came to be in this great role of executive director.

Maresa Henry: Okay, thanks, Perry. Well, first, I really appreciate you asking me to join this. This is a subject near and dear to my heart, obviously. So I always tell my family I have a story. My father’s mother had Alzheimer’s, and when I was 12 years old, my mother quit her full-time job and she moved in with us and my mom became her full-time caregiver. And as a 12-year-old, that was a really difficult thing to process and understand. And ten years later, when my grandmother passed away, it was difficult to see the impact that had on my own mother being her only primary caregiver. So I feel like I was put on this path to help families know that there are other options and other resources so that they can not only take better care of themselves but really give the best care to their loved ones. So I’ve worked through long-term care and now assisted living and every family member I meet. It has been a joy to help them find the answers to their journey.

Perry Limes: Oh, that’s such an amazing thank you so much for sharing that with us Maresa. With that, I think sometimes our viewers don’t really understand all of the segments of healthcare and assisted living, especially with the rise of the baby boomers, which is becoming more and more prevalent in our society. Could you just briefly explain to us what assisted living is? And in essence, you know, Ms. Veronica, our patient’s wife, you know what, how you would kind of describe this to her moving forward.

Maresa Henry: Okay. So definitely, especially even in just the last 5 to 10 years, assisted living has really evolved. I think 30 years ago, it was designed to be more of a hospitality service versus health care, and it has definitely transitioned into a healthcare setting and industry. Assisted living is what it sounds like. We’re there to assist our residents with their activities of daily living, medication management, helping with their bathing, and dressing as needed. But we also want to foster as much independence as we can for those residents. We don’t want to take anything away from them that they can still do on their own. And I think that’s the part people don’t see or understand on the outside, is that we’re not there to take your car keys and tell you no more fun. You know, we still have residents that do drive. I don’t park near their car, but they do still drive, you know. So it’s really just a safe place for residents to know that help is less than 5 minutes away, but also to have their privacy and independence and also be healthy and safe.

Perry Limes: That’s excellent. You know, it’s interesting, in my health care experience, I learned early on in post-acute that you do not call the resident’s patients. And I think that’s done with purpose because this is where they live. This is their home, and they don’t see themselves as patients despite them getting, you know, interventional care intermittently. Correct?

Maresa Henry: Very true. Very true. And again, I think that the label of resident again helps foster that independence. This is your home. You still get to make decisions. You still get to be in charge of your life. We’re just here to support you where you need us.

Perry Limes: That’s awesome. So how does someone know when it’s time for assisted living Maresa?

Maresa Henry: I think that you know, for each individual, you really have to consider who they are as a person because not everybody is ready to jump into a community living lifestyle. But with that said, it is really important to pay attention to medical needs or cognitive decline. Obviously, if there’s a risk of that person falling or mismanaging medications at home, that can be very risky. Um, those are some key indicators that it might be time to look at assisted living. Also, something that we see even within our own community from assisted living to memory care, is if we start to see people withdraw or isolate themselves socially. Um, you know, that’s typically an indicator that somehow they feel they can’t participate any longer with the group that they’re around. So, you know, if mom or dad were normally really socially outgoing every Friday, they played bridge with their friends and now they’re not interested in doing that anymore. That’s kind of a sign that everybody needs to pay attention to. Um, you know, in seven years of assisted living, there’s only been one time that I had a resident who was really excited about moving in. Um, this is a big step, and it’s a difficult step. So what I’m saying is, in this journey, no one’s ever, like, excited to sign up for assisted living. But what they find is once they’ve made that move and they’ve acclimated to the community, they love it and they thrive. They’re in a manageable space. They know that they’re safe. They know that they’re cared for. They can come and go. They can have visitors. So it becomes their new home.

Perry Limes: And so now you have had the pleasure to be to your community. And it’s an amazing property. And you’re right, it does have a very homely feel to it, but it seems like assisted living things go from, you know, big as these, as they look almost like hotels to small homes. What are some of the services that are provided in assisted living for families?

Maresa Henry: So what we offer at Spring Arbor is 24-hour nursing care. I think that’s one of the most important features that families need to know about. And when I say nursing care, we have OPNs 24 hours in the building. So if a resident does fall or is showing signs of a UTI or has something going on, that nurse can call the physician and get orders and execute those orders on the other end. So we’re not sending people to the E.R. every other day. And we all know the last place any of us like to spend time is in the E.R.

Perry Limes: Absolutely.

Maresa Henry: So those nurses are able to administer medications and, of course, manage symptoms for the residents. And then we also offer our resident care assistants who are able to help with things like bathing, dressing, hygiene, and personal care type things. And again, as much or as little as that person needs, we really want to cater that service to what they want, what they need. So it might be that we’re just helping someone step into a shower, or it might be that we’re washing their hair all the way to their toes. We individualize the care for those people. Also, what we offer is programming. So we have activities throughout the day for all different interests. So we have everything from painting and pottery to happy hour. We have volunteers from churches that come in. So music magicians, all different types of entertainers. So we really offer a wide variety of programs for our residents to engage in. And now we also are resuming our outings. So we’re going to concerts in the park and out to eat and trying to enjoy things outside of the community, just as if we would in our own home. So we do offer those transportation services as well, or those are probably the main things that families are looking at.

Perry Limes: Awesome. Now I think with all things here in this country, costs are always a factor. And I know at that age, you know, they’re paying for medical interventions and prescriptions and so many other things. How does cost factor into that decision-making?

Maresa Henry: I know for us, often cost makes this feel prohibitive for a lot of families and future residents. But we are able to work with them and offer resources that will help fund their stay with us. I know different companies partner with different companies. But we do have several resources that we offer to our families that can help fund their stay with us.

Perry Limes: Awesome. So, Maresa, since we’re on the journey of dementia, I know at your facility you have a memory care program. Can you describe what that program is and what some of the features are?

Maresa Henry: Sure. So I take a lot of pride in our memory care. I shared at the start of this that I had a grandmother with Alzheimer’s, but I also had two other grandparents with dementia. So this is definitely a subject near and dear to me. So we have an open floor plan for our memory care. It is secure, but it’s almost like a continuous circle. So there are no dead ends, you can’t get lost. A lot of people with cognitive impairment like to keep moving. They like to walk. So we’ve offered them the space where they can move freely and not feel confined. There’s also a beautiful outdoor space where we have raised flower beds and we do gardening with our residents and spend time outside. In addition to that, we offer both private and semi-private apartments, depending on the situation. I’ve actually found some residents do better with a roommate. It can be beneficial to have that person there to make them feel comfortable and safe. We do a lot of sensory-based programming, so we have things from art from the heart, where people can express themselves through painting or drawing, and coloring even if we’ve done some work with clay. We do hearts and harmony. Music is timeless and even there are, as you know, period, many, many, many studies that show that someone even with very advanced dementia, can identify and still sing along with some of their favorite songs. So we do have a lot of music programs, and then we do other things again, going back to that personalized care. We have a program called Royal Treatment where we like to spend some extra time really giving that person, you know, hand massages, styling their hair, giving the man a nice shave, you know, really making them feel special at that moment. So those are a few of the signature programs that we offer.

Perry Limes: That’s amazing. And it’s great for the visual of the circular. I can see individuals getting confused and where they’re at, but if you kind of wind up in the same spot when you’re walking, it’s that’s great.

Maresa Henry: Yeah. And also, just to add to that, we did add murals. So as they’re going, it’s like a walk in the park, all these beautiful trees, and flowers. It really is a beautiful space.

Perry Limes: It’s amazing. So a couple of things. Do you have to have a specific diagnosis in order to be, you know, too, I guess, reside in the memory program? Or is it a specialty or is it a separate part of the ALF as opposed. Yes. Okay. Cause you did say it was a locked unit, correct? Okay.

Maresa Henry: Yeah. So in our particular community, we have three floors and the middle and top floors are our assisted living apartments. And our memory care is on the ground floor. You don’t necessarily have to have a specific diagnosis, but you do have to have a diagnosis of cognitive impairment. So to really be qualified, I have had situations where, you know, a husband and wife like Veronica and Joe and the wife wants to stay and we won’t allow that, you know, because that’s not healthy for the person that doesn’t have cognitive impairment. So we do have situations again where we have husbands and wives. One is on the assisted living side, one is in memory care. I tell people, you still live in the same house, you just have different bedrooms so they can visit, they can eat meals together. But at the end of the day, the loved one that has the memory impairment would stay in the memory care area. Now, of course, they can still do outings, they can go out with family, but we have a sign-in and sign-out process just to keep everyone safe.

Perry Limes: It’s awesome. So in our previous episodes, we discussed memory care, but it’s always been in a one-on-one situation. This is the first episode where we’re talking about individuals kind of intermingling, if you would, with other residents that have cognitive impairment. Do you see any benefits of that, where they kind of support each other? What does that look like?

Maresa Henry: Definitely. A couple of things come to mind. I actually just over the weekend had one of my nurses text me a picture. We transitioned one of our assisted living residents to our memory care about two weeks ago. And she and another memory care resident are both artists and they’ve connected. And there was a picture of them sharing an art book and enjoying the art together and talking about it, you know, having really lucid conversations about art. So I think that what happens is they find themselves in a space where they’re not being judged and they can be themselves. And again, we’re there to support and facilitate some of those conversations and those moments of joy for the residents and their families.

Perry Limes: That’s amazing. That is amazing. Some of our listeners might not be aware that supportive care, which we call palliative care and hospice, can be provided in assisted living. What’s been your experience with palliative care and hospice with your residents?

Maresa Henry: I am a big fan of and advocate for hospice and supportive care services. I think that often, you know, we’re in the business. We do this every day so we know what’s happening. But families, this is their first step on this journey so they don’t know what to expect. And I think that you know, helping the family bridge the gap from, you know, the start of their journey to the end of life. It’s really critical to have that partnership with Hospice and the supportive programs because it helps families make sure that their loved one is enjoying and making the most of their stays. Um, we hear the expression that it’s about quality, not quantity. We want people to have fun and laugh and dance and do all of those things. And in partnership with these programs, we’re able to do that more and more.

Perry Limes: That’s awesome. So with all said and done, are there any questions that families should ask when they’re looking for an assisted living to place their loved one in? Is there anything, any kind of pearls of wisdom that you could share with our audience for them to inquire about when they’re in that search?

Maresa Henry: Sure. I think it’s important, especially with memory care to talk to them about what training is provided to their staff. At Spring Arbor we do a virtual dementia training with all of our new hires and ongoing so that we can really put our employees in the shoes of our residents and have that experience of what it feels like to have an impairment. So I think, you know, making sure that the staff is trained appropriately to care for someone with memory care or just a senior that has, you know, vision loss or hearing loss. All of those things impact how they need to be cared for. Also in the climate, we’re in, Perry. You know, health care, we’re all having that same struggle with staffing. You know you want to understand, are the staff employees of the company or are they temp agency people? What’s the longevity of the administration that’s been with that community? You know, it’s just, I think, really important and really telling when you look into those pieces about what to expect when you walk in through the front doors as a resident.

Perry Limes: Some and you know, it’s on everybody’s mind dealing with COVID in a place where people congregate, and obviously in assisted living, you have multiple people congregating with each other. How have you handled the COVID crisis over the past couple of years and what is it looking like for you now?

Maresa Henry: It has been the most challenging three years of my life. I won’t lie to you about that. In the beginning, it was a very scary time. I closed their doors pretty early because I was determined that we were not going to have to fight that fight. And we managed to keep COVID out of our community for almost nine months without any positive cases. We did, like everyone else, have an outbreak, but it was managed pretty well and we were able to end it pretty quickly. All of our residents are now vaccinated. It is mandated and required for all of our staff to be fully vaccinated. So I think that’s going back to your last question. Also important to ask, you know, what are other communities doing? The most heartbreaking part of COVID was separating our residents from their families. Watching people try to visit one another through a window or over a tablet, that’s just not what any of us signed up for. So I felt like I went from executive director to jail warden for a period of time. So we’re happy that we opened our doors to visitors. We just require masking, but they’re able to visit common spaces again. Residents have the freedom to come and go. So I do think that with vaccinations and the progress that’s been made, we’re past the times of isolation and quarantines and we’re learning to live with COVID now, not fear it. And so going forward, I expect that you know, we’re going to be able to maintain these positive interactions and hopefully go back to having big holiday parties and making this really feel like home again for our residents.

Perry Limes: That’s awesome. And thank you again for sharing that and obviously doing your due diligence to ensure that your residents and your staff are safe during this pandemic. You know, assisted living and memory care programs can be a valuable resource for families and loved ones. Living with dementia, I’m certain that they’re the families and the residents that reside at Spring Arbor are benefiting from all that you do. And we thank you so much for being a valued partner in the community. We like to thank the John and Cathy Belcher Institute for their generous support of our community outreach and education programs.

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