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MEMORY CARE


Memory Care During Pandemic


Calls for Extra Attention for All By Sara Wildberger


during COVID-19. Subtle changes in routine such as not


S


being able to sit in their accustomed place for dining, and big changes such as not see- ing loved ones in person call for continual patience, reassurance, and support—for residents, but also for their families. “COVID has basically caused all of us to


have a loss of control…and it's very normal for the brain to react with a kind of fight-or- flight. We get anxious, we have moments of sadness, if not full out depression. We can get irritable, we can lose patience, we have sleep disruption,” says Paul D. Nussbaum, PhD, ABPP. He’s an adjunct professor of neurological surgery at University of Pitts- burgh School of Medicine and president of the Brain Health Center—which offers many resources, at Brainhealthctr.com. And memory care residents can lack the coping mechanisms the rest of us count on.


HELPFUL IDEAS


• Turn the constant handwashing required into a kind of game or interactive opportunity. A gentle hand massage with lotion can help protect the skin and reduce stress.


• Set up a hot line for families of residents. • Be extra-careful about hydration and set reminders to offer water. • Offer favorite foods and sit and talk with residents to help improve appetites. • Use colorful, fun masks (over surgical or N95 masks if needed). • If residents don’t understand mask use, telling them it’s “cold and flu season” has helped. • Use lightweight tape or ribbon across areas to signal “no entry”.


Argentum members can download a free webinar packed with more information and best practices, led by Argentum COO Maribeth Bersani and featuring Doug Pace of the Alzheimer’s Association; Beverly Sanborn, Belmont Village vice president of memory programs; and Christine Stempel, RN, director of quality and education at HHHunt: argentum.org/covid19webinars


40 SENIOR LIVING EXECUTIVE JULY/AUGUST 2020


low down. That’s the essence of the advice experts—including veteran direct caregivers—for memory care


“Some residents don’t understand why


they can’t see their loved ones or that their loved ones can’t be with them. We try to re- assure them,” says Shirley Copper, a resident wellness associate at Candle Light Cove, an IntegraCare community in Maryland. She has about 30 years’ experience and has been at Candle Light Cove since 2004. Video technology has helped enormously,


Copper says, for residents and families alike. “Even before coronavirus, they had been Sky- ping, so some of them are used to that,” says Copper. “Just today, one gentleman who had a birthday had his family FaceTiming him, and he said: ‘They’re taking good care of me.’ It was reassuring for the family to hear that.” Approaches to memory care emphasize interaction, exercise, and as much indepen- dence as possible—these all support good health physically and cognitively—but these may compromise protection now. Associates at all levels are finding innovative ways to keep up both sides of their mission. Copper says keeping a routine that starts with exercise


in the morning, every morning, is helping. Nussbaum notes that different types and


levels of cognitive impairment make a big difference. “I'm less concerned as a neuro- psychologist about implications for the per- son with Alzheimer's because … they may ask a question, but the staff will notice that the person will kind of move on or forget about it within several seconds. And there's anatomical reasons for that.” Copper affirms this, and says it surprised her


at first. “They’re not upset…they may ask, why do you have these masks on? But there’s not even too much of that. They go with the flow.” Residents with other types of cognitive im-


pairment may be more likely to react with be- haviors such as agitation and sleep disruption. Wherever a resident is in their journey, “their behavior will be the signal to what they're experiencing, because maybe they can't tell you,” Nussbaum says. “It's probably because of all the change that they're experiencing, because they can feel anxiety too.” This careful kind of attunement makes


extra staff support essential. Nussbaum rec- ommends simple timeouts for staff check- ins or get-togethers—even five minutes can help—not only to share resident informa- tion, but to check in with each other. Supporting residents’ families has reached


another level, too. Nussbaum recommends: “Think about not necessarily giving answers or logistics or facts first, but just listening: Permitting the family an opportunity to say, here's where I am with this.” “What they say might not make sense. It


may not fit with what the facts are. Put that to the side, and just be with people on the emotional level first,” Nussbaum says. “And then from there, that building of trust and faith can then lead to saying, ‘Let's get back to why you called us in the first place.’”


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