Welcome to “It’s My Turn To Care.” We know the challenges you face caring for someone with dementia. That's why each week we bring you tips, strategies, and most of all, support as you navigate your role as caregiver. Let's get started. [00:15.6]
Dave: Hello, and welcome to It’s My Turn To Care: Secrets for the Dementia Caregiver. My name is Dave Parks. I'm a certified senior advisor and the owner of Home Care Assistance, and we're located in the northern part of Tarrant County in the great state of Texas. It's our goal for each show to bring you tips, strategies, secrets, and support you need as you care for someone suffering from dementia.
I sincerely consider it an honor and a privilege to host this podcast, and bring you some of the most knowledgeable and insightful people in the industry. Case in point today, we have Amber Johnson. [01:00.0]
Amber is a licensed master social worker with a passion to serve the geriatric population, specifically those with memory impairments. She's currently the director of resident and family services as Silverado Memory Care Community in South Lake, and I met Amber several years ago. Silverado was one of the first communities that I called on when Jane and I bought this business and have had a great relationship with them ever since. It's great to have Amber on.
Amber, thanks so much for being on.
Amber: Yes, thank you for having me. I'm really excited to be here for the opportunity to just share with caregivers some of the benefits of having a memory care facility as part of your care team, as you go through this journey with your loved one. [01:55.8]
My role at Silverado is really to work with the families and the loved one with dementia, as they transition into a facility. Even whenever a family first starts touring, it's my responsibility to help with educating the family on what to expect, what may happen as their loved one progresses and how we may handle that as they move into a facility like ours.
Some of that may be through tools. I have a library of books that may be helpful. I have spreadsheets, research. Just depending on what the family needs, I want to make sure that they are as prepared as possible to understand what's going on with their loved one, because the more that the caregiver knows, the better care that they're able to give.
I also lead a support group at our community that I encourage families to get involved in as soon as possible, just to add on an extra level of support and start creating a group, a group of friends that going through the same thing. By working with families, I really want to just educate and change the perspective about what life can look like after a diagnosis of dementia. [03:09.2]
Dave: Great. I know, Amber, you do a lot of different things at Silverado, but tell our listeners a little bit about Silverado itself. What makes it so unique?
Amber: Silverado is a standalone memory care community, so everybody who works at Silverado is dementia care certified and has gone through many hours of training on what to expect in the different types of dementia.
We have separate departments that do each thing that needs to be done, so we have a separate laundry team, caregiving team, engagement activity team. Everybody is separate, but we all work very well together and communication is really key, but having each department allows us to really specialize in what it is that we do in our particular departments. [03:56.4]
We have a specialized engagement program that is based on research. It's stuff that we have all probably heard that we all need to do just for our own health, as far as balanced diet, making sure that we are getting enough physical activity, that we're taking care of ourselves emotionally, and everything that Silverado does is very purposeful and built on these.
Dave: Great. I know y'all do a lot of great things there, but kind of stepping back a little bit, when should I start asking for help if I sense that my loved one …maybe they've just been diagnosed or I sense that they're going to be suffering from dementia? Can you give me a little guidance there?
Amber: Sure. As soon as you start noticing that there are deficits, that is the best time to start asking for help. Asking for help can look like a variety of different things, but we've all heard about making sure you put on your own oxygen mask before you put on someone else's. In order for you to be the best caregiver you can be, you really need to make sure that you are taking care of yourself. [05:05.2]
That could be starting to ask questions if your noticing maybe your loved one is getting a little bit more forgetful or maybe their personality is starting to change. You can ask other people who have been through the dementia journey, talk to your doctor and start researching. If you're researching online, just make sure that it's reputable because it can be overwhelming, the amount of information. If you think that somebody is going through and it could be dementia, the Alzheimer's Association is a great place to start.
Also, maybe just talking to your friends and letting them know what's going on. At first, friends may notice first and offer to help you. They may come up to you and say, I noticed that this is going on. How can I help? And you may be in denial and tell them no, but remember those people, so when you do need help, you can reach out to them. [05:57.2]
Help may initially just be having somebody that you can call and talk to or vent to. At some point, it may be that you need them to come over and do your laundry or bring a meal, or just come talk to your loved one, so that you can get a good nap or pay the bills or go to a doctor's appointment.
And what help looks like will change for you, but I just encourage you to ask for it to be humble. This is a very, very difficult journey and you cannot do it alone. A lot of people may feel that they can or they may feel guilt around it, but I think it's really important that you realize that you have to make sure that you're caring for yourself to really care for your loved one.
Dave: Yeah, there's no question you need to ask for help. I did hear a little tip that I think makes sense when it comes to asking for help. [06:48.0]
My parents both suffered from dementia, and I live here in Texas and they lived in Atlanta, Georgia, and so obviously I couldn't provide hands on care, but what I could do—so this gets back to the tip—is that when you ask for help, it's helpful to be specific on what it is you want help for.
For example, a lot of people say, let me know if I can help you, and if they say that, then say, On Fridays at 7:00, I'd like to go out to dinner with my husband. If you could just come over and keep my mom or dad, or whatever the case may be, company, that would be a big help, and maybe just once a month or whatever the case may be, but be very specific on your request. Then people respond better to that than something that's more general.
Anyway, you talked about feelings of guilt. So how do y'all help people deal with that? [07:54.4]
Amber: Really, it's important to first recognize, recognize that guilt is what you're feeling. That's the main reason that you're not asking for help. Another reason that people often feel guilty is that they don't feel like they're doing enough or they're caring enough, and it is a very, very difficult job. There's no rule book on what needs to be done and the exact phases that we'll go through, but just allowing other people to help you shows that you are doing the best that you can with what you know and how you know what to do.
Dave: Okay, because I think that's probably a feeling that almost every caregiver goes through, and so there's a lot of [guilt]. You mentioned support groups. I agree. That's a great place to get some feedback, and another place to get tips and ideas on how to handle your situation, what's worked for others, but also just to share those feelings of guilt. I know this always sounds funny coming from a, but sharing those feelings is really important when it comes to giving care to someone. [09:02.3]
Talk a little bit about memory care, memory care communities. Give us a little bit of education and that as an option for living options for people with dementia.
Amber: Sure. As you get to where you're feeling that you can't do it all on your own, and you've had friends come over to help and things like that, it's a good idea to at least start looking at facilities. There are many different programs. There are memory cares that offer day-stay program.
What that looks like is that you would select the hours each day. You would drop your loved one off in the morning and pick them up in the afternoon, and all day they are going to have a structured day planned. And then, you are able to go home and maybe rest.
That's what a lot of my families do when they bring their loved one. They go home and they sleep, or they go home and they just watch TV. Even though they may not be watching something that is really intriguing, it’s just a moment to sit and relax, and you don't have to feel guilty about that. That's part of taking care of yourself. [10:08.1]
There are also long-term care communities like Silverado, the one I work in. These kinds of communities offer respite care, so that could be short term, a couple of days, a weekend, a month, whatever it is that you need to just get a break and refresh.
They also have structured activities throughout the day, meal plans and things like that. One of the biggest benefits about using one of those types of facilities is just your peace of mind, knowing that they're not going to wander out the door in the middle of the night, that they're not going to maybe try to get in the car when you leave and go to a doctor's appointment. It's giving you peace of mind that they are safe.
These facilities are also geared to people with memory impairments, so they don't have things like dangerous knives out on the counter. They have all of their cleaning equipment put up where it's not accessible. [11:07.1]
The doors are secured in some way. It varies depending on the memory care community, but they may be completely locked where you have to have a code to open and close the door. They may be an egress door that you have to do something special, hold it down a certain amount of time to get to open it. But all of these help make sure that the resident is able to stay in the facility while you're not there.
Through all the training that we talked about earlier, they are all completely educated in redirection and engagement to help keep your loved one entertained, so they're not at the door trying to leave while you're gone.
Dave: What I've seen in some of the larger memory care communities, kind of like Silverado, is appropriate activities and structure, depending on where they are in their cognitive journey. Can you talk a little bit about that and how that maybe operates at Silverado? [12:05.1]
Amber: Sure. At Silverado, we follow the three-stage model for dementia, so that would be early, moderate and severe dementia, and we have structured our engagements or our activities to follow those structures.
We have an area that is for people who are very early stages, so we may see mild cognitive impairment. A lot of people who you can talk to and you wouldn't know that they have dementia, unless you spent an extended amount of time with them, and their type of engagements might look like going on an outing to the aquarium, doing puzzles on their own.
We're currently working on a book club where the residents picked the book. They read the chapter on their own and then at the end of the week, we meet together as a group to talk about it. But maybe they can't handle their finances anymore. Maybe they just can't live alone because at night they get really scared and try to leave. But the engagements are geared to not be overwhelming to them, but to keep their mind stimulated. [13:03.7]
And then in the moderate, the more moderate engagements, we have things that are much more hands on and a little less overwhelming, so instead of giving them a book that they need to read on their own time, we may read that book together as a group, or we may work on a puzzle together as a group. We do a lot of painting and art classes of different sorts just to stimulate different parts of their brain.
And then, in our more severe dementia area, we do things that are much more geared to their senses, so things that they can smell, touch and hear, things like that. One of my favorite examples is our laundry club, so we have irons and allow irons that aren't plugged in and allow them to iron clothes. Some of the ladies will continue to match socks together or just fold laundry. [14:00.0]
We have pictures from different areas of ladies doing laundry of what their washer might've looked like, how they used to dry clothes, just pictures that they can touch, pass around and talk about.
We also have the lid from a Downy container that they can smell, so that smell may take them back to a time and you may see it just a little spark, or a little glimpse of what they used to do and what they enjoyed.
In all three of the areas, we really work on gearing our engagements and our plans on what our current residents like and enjoy. If we have more male residents that worked in very difficult jobs, then we try to gear our engagements towards what they're working on. At one point, we had several people that worked on the railroad, so we geared our engagements towards what sounds they might have heard what they were doing at that point.
Dave: So, are there some things that you do? Which I'm sure maybe if you do it than other memory care communities do it, but it's such a big step to go from assisted living to memory care possibly or even straight from home. What are some things that you do to kind of help with the transition? [15:14.8]
Amber: I try to build as much of a relationship with the family ahead of time. If time doesn't allow that's okay, but usually I will meet with the family personally for four or five hours before the resident even comes, just getting to know their story, the resident story, their background. And I find that very often caregivers say, I don't have time for that. You were in an emergency situation, but once we start talking, the family really needs that time, and it just sort of happens.
Whenever we have those conversations, the resident may be at our community having lunch while I meet with the family member, but knowing more about the resident and the family helps our team know them instantly when they come in. We're able to greet them, know what kind of thing they like and know what activity might help keep them engaged, and it just really helps us start conversations with them. [16:10.2]
Dave: Let's say I'm getting close to making that decision as a family, to have someone move into a memory care community, or maybe even it's just a day state program. What can you tell me as to how that’s going to benefit myself, my loved one? What are some of those benefits?
Amber: Sure. The peace of mind is a giant benefit, but also you will have a role shift. A lot of caregivers end up losing that relationship that you have with your loved one, so if it is your husband or wife, you have lost that intimacy that you probably had before. The same thing if you're taking care of your parents. They no longer feel like your parent. You feel like the one that has to do everything and sometimes there's a little bit of resentment that comes along with that. It's not fair that you should be the one caregiving, even though that's happened. [17:01.4]
Having your loved one doing the day-stay program or living in a long-term care facility allows you to go back to whatever your role was as the spouse, as the son, as the daughter. The facility is taking care of the stresses of making sure that there's a balanced diet, that they're structured, that they're getting their medications, they're getting their showers.
So, you can go back to worrying about making sure that you have a nice dinner once a week like you used to have, or making sure that you go shopping or you go to the salon or whatever it is that you have always done with them. You can go back to that.
And moving somebody to a facility doesn't mean that they can never leave. We have a lot of families that will take their loved ones out to do whatever. We have some that will still go on trips now and then. As long as it is good for the resident, whatever works for you as what we encourage. [17:55.6]
Dave: What we try to tell our clients is you can focus on being the son or the daughter or the spouse and not on being the actual caregiver. So, anything else that you would want to tell our listeners about being a dementia…? Any tips that you might have for our listeners or anything else about Silverado?
Amber: I also just wanted to touch on using a day-stay program if you're using that as a first step. Just having the stimulation all day is going to really help you as a caregiver, if that's the day-stay program, if that's using home care assistance to come into your home. By stimulating them all day long, they're going to sleep better at night and it can actually slow the progression of the disease, but it can keep them stimulated, so that's really good.
But, really, my biggest takeaway is just to make sure that you are asking for help in whatever way that looks like as early as possible, so you can be more prepared and there's no surprises. [18:57.8]
We always say things can get exciting when you least expect it. There's a lot of emergency moments that we've had where families say, We're just not ready, and then, all of a sudden, it's an emergency and they don't have time to tour. They don't have time to ask questions. So, make time for that earlier, so that you know what your options are.
Dave: It doesn't hurt to do a little homework on the front end, absolutely. Amber, I appreciate you taking some time out of your day at Silverado and coming into Home Care Assistance to let us know a little bit more about the memory care community. And I will say, I know that y'all do a great job there, and I've always been impressed with the people and, particularly, yourself, and your management team and your caregivers. You even have a lot of pets, right, at Silverado?
Amber: We do.
Dave: Two big old… What kind of dogs are those? Two big old…what are those called?
Amber: I don't know.
Dave: They're the biggest white dogs I've ever seen. But, anyway, thanks again for coming in. [20:00.0]
This is Dave Parks with Home Care Assistance and host of It's My Turn To Care: Secrets For The Dementia Caregiver, and we look forward to bringing you another topic next week. Thanks so much.
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