Tuesday, June 20, 2017

Dementia Resident Care Transition Strategies

My late wife, Clare, had Alzheimer’s disease and spent two and a half years in the lockdown dementia wing of an assisted-living facility (ALF) and two months in a nursing home (NH). New facilities meant new faces and establishing a new protocol for communication between myself, Clare’s caregiver, and staff routinely responsible for Clare’s care. These experiences showed me that a few small changes in facilities could make these transitions much easier for new residents and their caregivers.
1.  Issue a staff list to caregivers
When I first met with ALF and NH admissions staff, I was given a folder with lots of helpful information. However, after Clare was admitted, I never received a list of the specific personnel responsible for Clare’s care. While I was introduced to the social workers in both facilities, the dementia unit director in her ALF, and the supervising nurse in the NH dementia unit during the intake assessment, I was never given direct-line phone numbers and email addresses in the event that I may need to contact them. Having a list of Clare’s aides in each facility and names of the other nurses in her NH unit would have also been helpful. 
With this additional information, I could have more easily familiarized myself with the names and faces of those responsible for Clare’s care and known who to speak to about concerns. I eventually obtained most of this information without any assistance from management at either facility but only after investing much personal time and effort. I never did receive information on how to contact Clare’s NH doctor directly, forcing me to repeatedly leave messages for the doctor at the front desk. Providing caregivers with names and contact information will help reduce caregiver stress and also improve patient care.
2.  Provide highly visible name badges for personnel
Many ALFs and NHs provide personnel with badges where the name of the facility is very prominent, but the name of the individual is typed in comparatively small font size; the employee’s title is often even smaller. Now I have 20/20 vision but, in order to read names and titles clearly for most personnel, I had to get very close to each person, almost violating their personal space. I know that ALFs and NHs are proud of their names and want to market their names, but what is important to caregivers is the name and title of the people working with their loved ones, not the name of the facility. 
3.  Provide removable name badges for residents
ALFs should consider supplying name badges for residents in their dementia units. Prior to her entrance into her ALF, Clare attended social day care programs at various sites. Upon arrival at each site, she and all the other participants were given name badges that were then collected at the conclusion of their program. This was very helpful for Clare because even though at this stage of her cognitive decline she could no longer remember names, she could still read the names (first names only!) on those badges and interact with fellow participants by name. Name badges would have allowed Clare to know who she was interacting with and allowed me to readily identify and interact with her friends during my daily visits.
4.  Establish a monthly meeting schedule with caregivers
When I worked as an elementary school principal, busy parents always knew that they had the opportunity to ask me questions at the monthly PTA meetings. I can understand the reluctance of ALF/NH administrators to add more meetings to their busy schedules. However, dementia unit administrators should provide a monthly opportunity for caregivers to meet with them to discuss general concerns or offer suggestions for improvement with respect to routines, activities, medication protocols, etc. More communication between caregivers and ALF/NH administrators can only be more helpful.
Dr Vann is a frequent writer in caregiver magazines, medical journals, and in major newspapers. After his wife, Clare, was diagnosed with early onset Alzheimer’s disease, Dr Vann made it a point to increase public awareness of Alzheimer’s and to help fellow caregivers. You can read his other pieces at www.allansvann.blogspot.com. If you would like Dr Vann to respond to questions or comments about this article, please email him directly at acvann@optonline.net

Published in Annals of Long-term Care, June 20, 2017.  Access online only at: