Our journey into the world of Alzheimer’s disease has led us from home care to assisted living, adult foster care, a nursing home for more than a year, and back to adult foster care under direct ownership. Most importantly, these learning years have led to a vision of developing a special model of care for persons with dementia. Our model is a psychological-social model based on the concept of Personhood. Our purpose is to maximize the Quality of Life, in a measurable way, for each individual. Learning and practicing the special sensitivities and skills appropriate for dementia care will benefit everyone needing care. Part of our purpose is to have our special model of care implemented in many other homes for the benefit of many others beyond our home.
A major part of appropriate care is to provide and evaluate it from the perspective of the recipient, rather than the intentions of the provider. Another is to realize that care is dependent on relationships that support the spirit of each person. Quality of life for persons with dementia will come from the sum of the moments, of Joy, of Comfort, of feelings of Love, of Attachment and Inclusion, and Meaningful Engagement that each person experiences on a daily basis. The basics of safety, healthful nutrition, cleanliness, comfort, medication management and appropriate assistance for daily living activities are also essential.
Providing this type of care depends on our understanding of each resident as an individual and extending the effort to see things from their point of view. It means focusing our energies on generating those special moments in EVERYTHING we do. Through continuing education and learning we take steps to raise our level of understanding of the point of view of the person for whom we provide care, and to develop our communication skills. Relationships develop from effective, compassionate, communications that support each individual’s sense of self and worth. The work of the late professor Tom Kitwood is the largest single influence upon the spirit and the structure of our model of care. ‘The Best Friends Approach to Alzheimer’s Care’, ‘Creating Moments of Joy” by Joline Brackey, Moyra Jones’ “Gentlecare”, John Killick’s interviews, Kate Allan’s ‘Finding Our Way’, “Communication and the care of people with dementia”, by Killick and Allan are also significant resources for us in our care model development at Patti Lewis Care Home.
Implementing our philosophy of support for each person may mean that our communications and interaction with our residents will differ from your previous experience. The way we mix and manage medicine may be different. (I always tasted Patti’s meds. It doesn’t go into her mouth until it tastes ok. That is why the pills are ground VERY fine and carefully mixed into cinnamon applesauce, or yogurt, or ice cream in layers, not just poured on and mixed.) The way we do peri-care may be different. We will do it per our definition of doing the absolute best for each resident. That means that when we change an incontinent resident, our purpose is way above clean and dry and minimizing the risk of infection. It means that we see the need for changing as an opportunity to raise the level of comfort and create a moment of connection. Our method of feeding and hydration may be different. At our home we will do these and other things, in a particular way so that the experience fulfills a social need for the resident.
Our approach to the details of caring, our focus on trying to understand each resident’s point of view, our communications to support a sense of self worth and ensure meaningful engagement, has only one point: Maximizing the Quality of Life of each our residents.
Appropriate care will result from a partnership between our staff and our residents’ families. Professional caregivers cannot take the place of family. Family members of prospective residents need to consider their role in the partnership. Each resident will have a care plan developed with his or her family. The care plan will include a thorough history, including beliefs, values, preferences, activities and areas of fulfillment in life. Expect to participate in a family care plan review meeting twice a year after the original meeting at admission.
It is important that whoever enters our front door bring joy to all of us. Part of our mission here is that our coming together enriches the lives of our residents, their families and our staff. We have some wonderful people on our staff that care very much, and are working to expand their understanding of our residents’ point of view. Our staff and our residents, need to feel the love and support of our residents’ families.
Our financial objectives are simply to maintain and sustain the home as a permanent entity, and over time, to improve the rewards to our caregivers of whom we expect so much. Our goal is that our residents will experience more moments of joy, will feel attached, connected, included and valued, and will be “meaningfully engaged”, throughout their days.
Establishing a new standard for dementia care and elder care is very important, because we face an increasing need for such care, and a health care system that is not able provide it. As we make it possible for our residents to experience a measurably higher quality of life, then the very special lady who inspired this program, Patti Lewis, has a fitting legacy. This is a matter of love. By understanding our purpose, remaining focused and with the help of dedicated caregivers, we will succeed.
We share these thoughts in the interest of understanding.
Jack & Dee Lewis