What to Expect Now that your Loved One is in Memory Care by Niki Gewirtz If you have made the decision to move your loved one into a memory care community, you have made a big step in providing appropriate care and stimulation for him/her, and prioritizing your health and sanity!  Taking care of someone with Alzheimer’s/dementia is no easy task, and you are to be commended for all you have done! So, now that your loved one is in a community, what should you expect to happen?  It is important to be realistic in your expectations of your loved one and the community team providing the care/food/activities.  They are all getting to know your loved one – the things he/she was passionate about in life, struggles related to the dementia and other health care needs, ways to redirect and engage when he/she is having a hard day, and the acclimation to a new environment.  Things you may have taken for granted because you know the details of your loved one’s life, the staff is still figuring out.  The best gift you can give to the community is a detailed list of the nuances that would make your loved one’s day better.  Does he/she like to have a tissue or handkerchief on hand?  What about what is in a wallet or purse?  They may not need cash, but many people (men especially) like to have some cash in their wallets.  What about what is on the nightstand?  Do they always have a glass of water or lip balm?  (I do!)  What is the morning routine?  During one exercise where we had a group of family members talk about their own routines, many said the first thing they did in the morning was weigh themselves.  Would a scale in the bathroom be something your loved one would want to have available?

Many times as an executive director, I have heard these kinds of comments from families: • You have all these activities throughout the day – I want my mom at all of them!  She     shouldn’t be in her room when she should be active.  I expected her to participate in     everything when she moved in. • My husband was always shaved every morning.  It is afternoon and he still hasn’t been    shaved – what is going on? • Mom never took a nap at home, and now she is napping in the middle of the day by     the nurse’s station.  What is going on?  Why isn’t she in activities? • The sweater my wife is wearing doesn’t belong to her. There are many other things families are concerned about, but these are things that  thematically we hear over and over.  What these families don’t seem to understand are: • With activities, just because someone now lives in a community, doesn’t mean    that all of a sudden they are going to want to do everything. An introvert is not    going to change just because of a new environment – likely, they are going to be    in need of even more persuasion to come out and meet new people.  Again, the    more detail we have about likes/dislikes, passions, routines, the more we can help    residents to connect with other people with similar interests and support where    they are in the dementia progression. • Men don’t typically enjoy being shaved.  I know my husband would love NOT to    shave if he didn’t have to!  Think for a moment that maybe the morning was not very     easy for that gentleman, and he didn’t want the staff messing with his face.  When     given the choice of getting hit or letting the shaving go for the day, it isn’t a hard    decision… The fact that he is dressed may be the big success of the day for him. That      is ok!  The staff will keep trying and figure out what approach works, and as the disease     progresses, those approaches will continue to be modified.   •  When you see your loved one or other residents napping in common areas    (typically around the central area of activity like the nurse’s station), it doesn’t    mean they are bored.  For some residents, sitting in these areas is a great place to    people-watch, engage with the staff, or be stimulated appropriately to what they    can tolerate.  You see that even in group activities – people sitting around the outside    of the group, or even outside the room, but still passively enjoying the music,    discussion, or visual components of the activity.  We talk about how the whole    community is their home, not just the room where their bed and belongings are.     What a great feeling to know that they are comfortable enough to want to stay out of     their rooms and take a little cat nap where they know people are around to help   them when they wake up!  Also, realize that as the disease progresses and they age,     napping will be a normal part of their daily routines.  Their bodies and minds need time to rest.  It isn’t normal to be actively engaged in activities all day long – and not     poop out at the end of the day! •  Residents in dementia care communities tend to wander throughout the    community and pick up things that look interesting, take off sweaters (and other    clothing) when they are hot, or look for something to put on when they are cold.      Many residents don’t know where their rooms are, so they may look into other rooms     to find what they want – a sweater, a comforting item like a teddy bear, or a pretty     object that they like.  Many communities encourage you to label clothing for this    reason.  It isn’t that the staff doesn’t know how to separate laundry, but rather it is     because residents share their belongings.  I had two residents who lived next to    each other, and their families would find both their things – clothing, electric shavers,     shoes –  in both rooms, as they would visit with each other.  Rather than get upset     about it, they would just sort out the things that didn’t belong to their loved ones and     either put in the other room, or bring it to the nurse station for the staff to put away.

Certainly, if you as a family member have concerns regarding care needs not being met, your loved one looking neglected or unkempt, or any other issues, you should also expect to have your concerns addressed by the staff in a timely manner.  One thing that always upset me is when we would get a new resident to my community who had lived at another memory care, and the family’s concerns were not addressed at all by the former community staff – completely ignored, which was more often the reason they chose to move to my community.  There is no excuse for that.  The administrator should keep the team accountable for good care, good communication, and timely response.  No matter what a staff member’s position is, the whole team should come to work with the united goal of providing exceptional care while exceeding expectations.

Niki Gewirtz has been a leader in senior healthcare for over 20 years, managing independent living, assisted living and memory care communities in California and Colorado.  Niki is now a Senior Living Advisor with A Place For Mom, helping families to find communities and resources for care.