The Culture of Care
The signs of a good nursing home include treating the underlying medical problems, relieving pain, and doing everything possible for the residents to feel comfortable and at peace. Psychoactive drugs should always be the last resort for treating the symptoms of dementia and there are many steps a care facility can take before resorting to medication.
Enlightened care providers are increasingly turning to “comfort care” to enhance the quality of life for their residents. This approach, as its name suggests, focuses on keeping the residents comfortable using a nurturing, individualized approach looking at the emotional, social, and spiritual needs of their residents, as well as the medical ones. The goal is to keep residents comfortable, thereby avoiding unnecessary drugs. This can be done through a variety of means:
- knowing the residents well enough that basic needs are never a major issue, and needs can be anticipated
- embracing a philosophy of individualized care
- adjusting the manner and pace of interacting with the residents to be more suitable for the needs of those living with dementia
- recognizing and treating pain aggressively
- treating family and friends as the true partners in care that they are
The simplest of issues may trigger conflict: an incompatible roommate, room temperature issues, unenjoyable music choices, a loud television. Someone living with dementia may not be able to effectively communicate what is bothering them and it is up to the care providers to be patient and understanding in discovering the root of the issue. Common symptoms of dementia, such as restlessness, pacing, and repeated questions, should be both anticipated and accepted.
Individualized care and more attention are some of the best substitutes for drugs. As your loved one’s advocate, insist on a customized care plan which takes into account personal sleeping and eating schedules, bathing methods, and other services which will keep your loved one happy and comfortable. A facility which takes the time to really learn about their residents, their history and life’s journey, will be more likely to meet these needs effectlively.
Nursing homes can also stop unnecessary drugging by improving staff training on how to respond to symptoms of dementia. Talk to the facility where your loved one lives and ask if they have the local Alzheimer’s Association chapter conduct training for their staff. There are also certified coaches in Teepa Snow’s “Positive Approach to Care” who can provide valuable training for both independent and facility-based care partners. If on-going training is not part of their protocol, urge them to make it so.
It takes a village to be a care partner to someone living with dementia. Finding a residential facility able and willing to truly be part of that village will help ensure there is no unnecessary medicating and that your loved one will have the best life possible until the very end.
For further reading:
Encouraging Comfort Care: A Guide for Families of People with Dementia Living in Care Facilities
