Highlighting High Involvement at The Cedars

The Cedars, a retirement community in Portland Maine, has long held and worked toward a vision for person-centered life. They have been engaged in learning, practicing, stumbling and achieving minor and major feats moving away from institution toward home.

Lately they have been working hard at High Involvement – engaging a Steering Team and several Action Teams, as well as holding a variety of circles — some for fun, some to work step-by-step through large and often complex decisions. One of the action teams focuses on getting the word out. Continue reading “Highlighting High Involvement at The Cedars”

The Magic of Music

Music-key to memory-editedEnjoying and appreciating music may still appeal to persons living with dementia, but music may offer a lot more than pleasure: a connection to memory and emotional expression that might not be otherwise accessible. Read these simple but powerful stories to be reminded of the myriad ways we might incorporate music into daily life, to both entertain and ENGAGE!

 

The following story is from The Piper Assisted living and Memory Care in Kansas City, KS. Steve Harman, a Household Coordinator, is working on his CNA, and during a recent clinical at another community, he had this great experience.

Bologna Song Whets one Appetite!

Recently I spent a few hours with Mrs. B., who has pretty severe dementia and is known for not eating her meals. Usually when Mrs. B. sits down to eat, she is “full” before the meal is even served. The more people try to get her to eat, the more she refuses to eat. My experiment was to ask her about anything but her meal. My niece and I used to sing songs at the dinner table, which kept her from getting bored, so I tried this with Mrs. B. “Mrs. B., do you know any songs?” She replied, “Yes, all of them.” That being the case, I chose a musical masterpiece, the Oscar Mayer Bologna song. “Mrs. B., do you know this song? My bologna has first name...” She sang back to me, “it’s O-S-C-A-R!” “My bologna has a second name…,” I sang, and she replied with a full mouth. She had taken a big bite of food! So I patiently went through all the songs I knew the words for (5 commercials, Jessica by the Allman Brothers, and You Are my Sunshine). Somewhere in the middle, Mrs. B. started making up her own songs about the food on her plate. One was the word Gravy sung repeatedly to the tune of Happy Birthday. Another was a song about how good vegetables would be if they were cake. When she finally finished, she had consumed half of her plate, doubling her intake from the last three meals combined. Throughout this experience, she would occasionally ask to be taken to the front of the room where people congregate to watch television and other things. That was when it occurred to me: Mrs. B. was bored. She never asks to go home, or simply to leave the facility. She wanted to go to the front of the room because that’s where she can be entertained.  I took her to the area where a volunteer had started playing guitar. On our way up there, I overheard one of the staff say, “I’ve never seen Mrs. B. so lively or excited like that. She seems to be excited about music.” I’ve only spent a small amount of time with Mrs. B., but several people have informed me that this was very different from her usual behavior. She was deemed difficult or grumpy. This was such an encouraging experience.

Shared by Stephen Harman, Household Coordinator


The next four stories are from WindsorMeade in Williamsburg, VA

The Tide is Changing….

A few weeks ago I worked on an evening shift as a CNA on the HealthCare unit. When I came on to the shift, which wasn’t my regular shift or job duties, I was very task oriented. I was focused on what needed to be done: who needs vitals taken, who gets a shower, what time is the meal, etc. After dinner I went to give a shower to one of our residents. The resident, Mr. W., was not happy about me interrupting his evening; he was quite happy just flipping through his magazine. This resident usually doesn’t speak words, and if he does speak them, it is normally just a few that don’t make a complete sentence. Many times he communicates only with sounds like bee-bops. It had been a few days since his last shower, though, and he needed one. I was too focused on what I had to do next and the tasks of the evening, but then I just stepped back, looked at his blue eyes and smiled. The tide had changed… I started singing “ I got the whole world in my hands….” He started humming and by the third verse he was singing with me, teary eyed. I have never heard him sing before. Then I quickly thought about what other songs he might know. So I started singing Amazing Grace, and he began singing with me — and we sang all the way to the shower. We sang during and after his shower until he was all clean, dry and cozy in his pajamas, under his warm blankets and off to sleep.

Shared by Angela Peay, LPN, AL Nurse Manager

Our Song

Working in the Health Care dining room, I have had the pleasure of witnessing many beautiful moments.  This one brought tears to my eyes.

Mr. D has both memory and hearing loss.  His wife, Mrs. D, is an independent living resident, and comes to visit him regularly.  I have heard her say many times that she knows he recognizes her as his friend, but she isn’t sure if he remembers the life they made together.

Recently, WindsorMeade installed a new piano and placed it in the resident lounge next to health care dining.  On the weekends, we have volunteers come and play the piano during lunch and dinner services so the residents get to enjoy music while they dine.

A few weeks ago, Mr. D was already seated in the dining room and Mrs. D was walking up the hallway to join him.  The pianist was playing a song that I don’t know the name of, but Mr. D certainly did.  As he listened to the music, he stood up and called Mrs. D out by her nickname.  I had never before heard him call her by any name at all.  As she answered him from across the room, she stopped, looked at the pianist and said, “They played this song at our wedding 65 years ago.”  As they hugged each other, it was obvious that in that moment of clarity brought on by a familiar song, he knew exactly who she was.

Shared by Brian Eck, Health Services Dining Supervisor

Happily Lost in Music

I worked upstairs today in the HCU and ALU areas for the first time again in about two weeks. During lunch, a woman named Mrs. Kathy came in to play the piano. She started in the HC dining room and ended in the AL dining room. In HC, a few of the residents nodded their heads as she played. Mr. W. was one who stood out to me the most. He was nodding his head with his eyes closed, tapping his feet, and lightly tapping a fork on the table, enjoying the music. To be quite honest, I haven’t seen him this happy in such a very long time. His mood nearly brought tears to my eyes — tears of joy that is. Mrs. Kathy’s music generated so many smiles today that I asked her to return to us soon and to come more often.

Shared by Marquera Delk, Lead Server

Music Makes the Body Move

One of our residents loves music! Whenever he hears music, he is clapping his hands, moving his feet, and sings a long. We have purchased an Ipod shuffle for him and have downloaded music (Elvis is one of his favorites) onto the device. Family members have also brought in CDs for us to download music. Throughout the day, we give the resident his Ipod and he absolutely loves it! When he hears the music come on, he gives you the biggest smile and hug. When you walk onto Healthcare you will see him with his Ipod just dancing away. We are in the process of becoming “Music and Memory” Certified, where we will receive Ipods for the residents to listen to their preferred music. When that happens, I will sing, dance and clap, too!

Shared by Caroline Kaliris, Recreation Therapist


Dancing:  It’s not just for feet!

<p>Lakewood Hand Dancer from <a href=”https://vimeo.com/user37978821″>Marsha Poulsen</a> on <a href=”https://vimeo.com”>Vimeo</a&gt;.</p>


 

The following story is from Uniting Wontama Orange in NSW, Australia

Love for Dancing Remembered and Shared

Last Friday evening we held our Annual Cocktail party with the theme of ‘Mad Hatters’. All of our residents across the site were invited along with their families and participated in making a hat to wear. We had a wonderful turnout and brought many smiles to many faces. We also had our Old Time Dancers come along and dance for and with our residents. It was heart-warming to see our residents enjoy themselves so much, and to watch those people who either have limited mobility or changed cognition ‘come to life.’ Once the music and dancing started, a gentleman who faces some of the more challenging aspects of living with dementia, was on his feet and danced the night away. The conversations that were possible with him during this time were both insightful and emotional, especially his ability to talk about his love for dancing in his younger days. An important objective we have been working towards focuses on making every moment count, even in the smallest of ways. This felt like a big success.

Shared by Helen Mobbs, Service Director


This sound of life – music –  is SO IMPORTANT for us all. The common thread in these stories is that someone took the time to notice. The observations shared and then more people notice and are encouraged to provide music, share in the joy of music, or use it to help someone feel better and/or engage in a way they might not otherwise. So go out and look, listen and find ways to share music with those folks you serve. You will make life better in big and small ways, as Helen says above!


If you are fascinated by brain research and what scientists have learned about music, you must read the article “New Ways Into the Brain’s ‘Music Room’,” just published in the New York Times!   Read it now.

SEE ALL OF OUR LATEST STORIES

High Involvement Has UnitingCare Australia on Fire

Action Pact founder LaVrene Norton tells the story of how her grandfather used to head out in early spring to “warm the soil” for his garden. While he accepted frost as a natural part of the cycle of life, he saw no reason to let it go on any longer than necessary. He would light a large bonfire on the garden plot, let it burn until the soil had been softened, then turn the coals over into the earth. As a result, their family had peas and lettuce sprouting in their garden before anyone else. Continue reading “High Involvement Has UnitingCare Australia on Fire”

“Coming Home” Is Made Possible In The Household Model

coming home

I travel for work, a lot, and so I am very familiar with the feeling of “coming home,” of looking forward to being with my family again and settling into the comfort and security my home offers. As part of Action Pact’s transformation work with clients, we explore the elements of home, one of which is “journeying.” Whether for an hour, a day or a few weeks, journeying includes the excitement of planning for the trip, the experience of being away from home and the inevitable return. I’ve been wondering if I, as a serial traveler, experience journeying the same way people living in nursing homes, assisted living and personal care do. Continue reading ““Coming Home” Is Made Possible In The Household Model”

Caring for a Pet Helps Meet Essential Human Needs

As I sit at home writing this, I am warmed by a cuddly kitty in my lap and a dog at my side on the couch. My pets (I have four in all) are a core element of what home means to me.  When I think about the attachment to my pets and the comfort they provide me, I realize they fulfill what Tom Kitwood describes in his book Dementia Reconsidered as the “human needs.” Continue reading “Caring for a Pet Helps Meet Essential Human Needs”

Facilitating Organizational Change from Within

At Action Pact our philosophy of change focuses on developing leaders who inspire a vision, listen to others and step out of traditional roles and patterns. We specialize in creating learning organizations. In order to do this we help create—and help our clients learn to create—a climate for learning. An important element of that is utilizing different learning strengths. Some of us are visual learners, others are auditory learners and others are kinesthetic learners. Continue reading “Facilitating Organizational Change from Within”

When Communicating with Someone Who Lives with Dementia: Wait.

I love growing PersonFirst® teams. For many reasons, it is highly satisfying to collaborate with caring, willing people to really think through and then take action to empower those who live with dementia. And what I love most is how much I learn every time I engage with a new team. This year, one of the things I learned was from a CNA who is a Neighborhood Coordinator in a dementia specific neighborhood. It is the very simple and very powerful thing she says she teaches all of her staff: wait. Wait at least 90 seconds for someone who lives with dementia to answer or respond. Do not ask again, do not suggest, just patiently, wait.

This was such an easy thing to remember that is stuck with me. And I try to use it.

Photo by Alexander Raths

One morning recently, I was visiting a newly opened household. My mission was to find out how life and work was unfolding and to be able to offer any support or suggestions. To do this I talked with as many people living and working there as I could. The household I was in was nicely appointed, wide open spaces, the kitchen and dining area opening into the living area where here were comfy chairs, a table with chairs and a couch. At the table, Marge was sitting in her wheelchair. I introduced myself and asked her name. Then I explained my mission and asked, “What do you like about living here?” I then waited…30, 60, 90 seconds passed. I am not a patient person, usually. I am much better about it when serving those who live with dementia, but it is not my nature to be patient – but I waited.

After about two and a half minutes, Marge said, “It’s quiet here.”

“Oh,” I said, “What else do you like about living here?” And… I waited.

This time she answered in about 60 seconds, “The space.” Then she nodded her head and shut her eyes. I took that as a signal that she was, in fact, finished speaking with me.

I went on to talk with others who live and work in that house, moving around the space, until lunch time when I found myself back at the table in the living room with Marge who was still sitting there though now awake. I greeted her by name and sat down. Presently, the household leader came to remind Marge that is was lunchtime. She said, “May I take you over to the dining room?”

Marge replied, “No.” She then looked at me and asked, “Will you take me to the dining room?”

I was surprised, but mostly honored. What I think happened is that I waited…. and listened, and heard. Even people who feel in their hearts that they care deeply, at times do not recognize that interactions that may be slow, soft and quiet often grow a relationship. I did take Marge over to the dining room. We ate at the same table. She said little. I said little. Yet, we were together for that time.

Megan Hannan, MS, is an Executive Leader at Action Pact and has provided leadership in long-term care for over 25 years. Megan developed Action Pact’s signature train the trainer program, PersonFirst®. She serves on the Board of Directors of The Pioneer Network.