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Trilogy’s BFF program, for instance, is an updated spin


on the groundbreaking Best Friends™ approach, devel- oped by Virginia Bell and David Troxel more than 20 years ago. Associates hear the name—BFF means “best friends forever” in text-speak—and grasp the concept immediate- ly. They also go through training. Every team member learns the life story of the peo-


ple they serve—their career, their hobbies, their favorite foods—and uses that knowledge to make and maintain connections in a “commitment to create a day filled with life affirming friendship and fun for the residents and help them through their journey,” Alaimo says, such as having a former teacher help put together some “lesson plans.” Trilogy had already used computer and video-based


learning as well as in-person training and coaching, along with role-play exercises, and recognition sessions with small prizes. With COVID, staff use the monthly training modules, but these have been condensed from 10 to 15 minutes to five to eight minutes long, to get to the meat of the message more quickly. Huddles are held at a social distance. Role-plays can be done at any time, in a few minutes,


as a creative break. And the prize would be ear cushions to make mask straps more comfortable. Staff also wear a photo of themselves so that residents can see what they look like without the mask.


CARE BECOMES CRITICAL Approaches that emphasize meaning and connection are more important than ever, given recent evidence of the effect of isolation and loneliness on overall health. Not having a best friend could be very harmful. The most frightening factor to come from the pandemic


wasn’t directly linked to COVID-19 at all. By the end of the summer, what the CDC calls “excess deaths,” or a higher-than-usual number of deaths showed an alarming pattern—Alzheimer’s and dementia deaths were at up to 20 percent above normal. As of the end of November, the CDC recorded deaths above the average number for Alzheimer’s and dementia at 35,788, followed by 21,136 of hypertensive illnesses and 13,213 of diabetes. It’s unknown what has caused the rise—the CDC and


others have speculated that it could be the initial toll from nursing homes of early and undiagnosed cases; an action of the virus itself; or falls or medical problems exacerbated by stress and being alone. In senior living memory care, the charge was clear: Do everything needed to keep residents safe—and do every- thing to keep the connections open and the stress down. Doing all this simultaneously is difficult, especially for care- givers who are themselves under stress. But providers have adapted in ways that may be used into the future.


STOPPING THE CYCLE


As caregivers or the environment are affected by COVID-19 stress or changes, there can be more stress among residents, which leads to more behaviors, which in turn leads to more risks, says Dr. Miranda Huffman, ad- junct clinical faculty at Meharry Medical College, in a panel discussion during the annual symposium held by National Alzheimer’s Buddies, in December. But this troubling cycle can be stopped at the beginning. A technique from the person-centered care toolbox


could help with that. At the Senior Living Virtual Execu- tive Conference, Melissa Batchelor, Ph.D., RN-BC, associ- ate professor of nursing and geriatric nursing researcher presented the C3P framework: a way of “thinking past the behavior you see” and learning what’s underlying it.


In the COVID-19 environment, more stress among residents can lead to more behaviors, which in turn leads to more risks, says Dr. Miranda Huffman of Meharry Medical College. But this troubling cycle can be stopped at the beginning.


The first P is Person: Is the person hot, cold, in pain?


The second is People: Is the problem us, the staff, and our approach? Finally, there’s Place: the environment may be noisy, visually confusing, chaotic. Another technique to reduce stress is to understand the energy changes of the day. “Those with Alzheimer's and other dementias have a fluctuating energy pattern throughout the day,” says Alaimo. “Our program helps create a schedule based on their energy levels, of both structured and unstructured activities.”


PROGRESS EVERY DAY Despite COVID-19 restrictions, memory care programs are continuing not only to adapt but to excel. In August, in fact, Discovery Senior Living’s SHINE® Memory Care program became the latest of eight providers to receive a national Certificate of Recognition from the Alzheimer’s Association, after a comprehensive review based on best practices, training, and other factors. Discovery developed the evidence-based and person-centered memory care program and created specialized training and certification in SHINE for its staff.


“This recognition is an honor for our organization and a testament to the quality of SHINE®,” said Richard J.


NOVEMBER/DECEMBER 2020 ARGENTUM.ORG 31


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