[MUSIC]
Greetings.
Will Mobley again for On Our Mind
presentation of the Brain Channel for UC TV.
I'm speaking again with Linda Cho,
who is Executive Director of stellar care and
assisted living environment for people with dementia.
We want to now talk, Linda,
a little bit about the environment of assisted living.
What kinds of folks are there,
how are their families engaged in the process,
and what are your goals for
assisted living for those with dementia?
Well, assisted living industry is not the
same as it was way back when people said,
"Please don't put me in a home."
The home that they are thinking about
is often skilled nursing
or nursing homes back in the days when
there were white walls and three,
four people to a room
and they sat in the wheelchair all day.
To the residents who are currently with us,
they envisioned a home being somewhere where they
went to die and had no stimulation at all.
The model has changed.
I think the assisted living industry,
when person came and we gave them a tour of
our building and told them about
all the activities and
the things that we do and they said,
"Wow, this is like Club Med for seniors."
We laugh, but we want it to be that way.
The families are grieving their losses,
but we see in our residents
still life to be lived and moments of joy to be had.
When they come in, we do an assessment.
We do try to place them with people with similar needs.
Dementia has such a broad spectrum of need from
mild cognitive impairment and
with people who need medication reminders,
who need a little bit of assistance with
dressing and reminders to go to their meals;
to the end-stage dementia when we really
need to give them pureed diets,
we need to feed them,
we need to change them,
and we're providing end-of-life care.
It runs the whole spectrum.
The building has to be large enough to make
sure that all those needs are being met.
Like I said, we have about 100 residents
and we're over 100 people on staff.
It takes a lot of hands to do what we do.
Large part of what we do is work
with families very closely because
residents are not able to
speak to us necessarily for their needs.
We rely on the families to communicate.
We partner up. We're part of a team.
We communicate very closely with
the doctors to talk about medications,
what medications are necessary,
and the side effects of medications that we see.
We're the ones that see them day-to-day.
If they're too sleepy or it's not working at all,
it's having the opposite effect,
we let the physicians know
and the medications can be adjusted accordingly.
We also have to communicate with the families.
They have to know what's going on
in their loved ones lives and
they're as much part of the team as the caregivers.
They are the caregivers.
We just do the day-to-day and they are
caregivers in that they provide all the extras.
They come to enjoy their mom and
dad in the outings that we have.
They come and play with the dogs and they
bring pets and their children.
This needs to be their home.
It's not an institution.
It's their home, and we respect that.
While the families are going through
this tremendous guilt of placement,
they will eventually see that mom and dad with
all of the socialization that's going on,
the activities that are there, they do well.
In spite of themselves,
in spite of their concerns,
initially, they do open up.
They do enjoy the music therapy
and they do enjoy the pet therapy,
the aroma therapy, or simple outings and lunches.
We have the Charger Band coming,
and they enjoy that,
and we have dancing,
and as much as possible,
we don't necessarily say,
"Do you want to do this?"
We often say, "Come on, Jim, let's go.
I'm going to go in the courtyard.
I'm going to have a cup of
coffee. Why don't you join me?"
This is a generation that are very co-operative and
they want to be nice and they often will join you.
We're pretty good at getting our residents to engage.
Sometimes people wait too long.
That's one of the things that we talk to families about.
The goal is to keep mom and dad at home as
long as possible and we talked about earlier,
how to safeguard your home and sign up with
supportive services to keep mom and dad
home or your spouse home as long as possible.
But when it becomes too much and there
is a point when one person or even
two or three cannot care for
somebody with dementia all by
themselves and it's time for placement,
they do come,
we do try to have the resources
available so that they're not going to
be sent out repeatedly.
Toward the end of life, we do work with hospice,
which suggest families and investigate
hospice care so that there's not
a disruption in their life and
they can have end-of-life care in the community as well.
Disruptions are a problem, are they not?
Changing [NOISE] a venue,
changing where a room is,
even changing the way the room is
organized can be upsetting and disorienting.
Absolutely. Familiarity and routine,
even with dementia,
routines can be established and there's
familiarity and comfort in having a routine.
We try to set up each day.
Basic schedule is the same.
They get up in the morning, we assist with grooming,
they come down for meals,
they have their breakfast,
and then right afterwards everyone goes to
the various activities and there's
usually music going on,
chair exercises, dogs running around.
That starts the day.
Because most people are doing it,
it's not too hard to just join the crowd.
Whereas at home, come on,
mom, let's do this puzzle.
No, I don't feel like it.
But when everyone else is
going out there enjoying the music,
it's easy to play follow the leader,
and they're able to participate.
The socialization process would
seem to be really helpful.
Absolutely.
As you suggest, really live out one's life,
not just secure,
not just safe, not just no longer
burdening the family in ways that create lots of guilt,
but with real joy.
Absolutely. I always say,
memory loss is not a straight shot.
It comes and goes at times.
There are treasure moments of cognition,
I think, when things come back for a time being.
One of my experiences is that I walked
in up the stairs and came to work
one day and at our salon,
there are ladies waiting to get their hair
done and one lady was sitting there in the chair.
I greeted everyone and I
passed and I was walking down the hallway.
Pretty soon I heard Miss Anne following me,
"Linda," and I turn around I'm shocked because
Miss Anne was basically non-verbal.
She really didn't talk very much.
I didn't know she knew my name.
She called me and said,
"Is it okay for me to get my hair done today?"
I said, "Absolutely.
You have an appointment
there. You can get your hair done."
She said, "Thank you so much.
I really appreciate.
I really enjoy getting my hair done."
This is a lady who basically did not communicate.
I was shocked that she knew who I was.
She knew that I worked there and she knew my name.
Many of us think that because they don't respond,
our residents and the loved one, they're beyond that.
But there are moments.
If we fill their lives with activity and joy,
it's not there, they enjoy.
That moment is still there
and they're able to retrieve it at will.
Not necessarily at our will,
but when it's ready for them.
Recently, I've had a family member
diagnosed, very recently,
and we took a trip and we
traveled all over and my husband and I
came back and we're sharing photos.
My husband's a photographer and that's his hobby.
He took 600,
700 pictures. It's on the computer now.
You don't just develop a GIF to fix it up.
He's going through the computer and looking all this,
and we had mom sit next to
him and she looked and she was, "Oh, wow."
When I talked to her after this trip,
she really didn't remember the detail.
She knew she had gone somewhere and she enjoyed it.
But talking to her about what we
ate, she didn't remember.
Going over those pictures,
she really enjoyed and a lot of it came back to her.
We printed up 600 pictures.
He wrote everything on the back
and every day she looks at it.
We take her to work with us and she comes home
with us and she looks at those pictures and she says,
"You know what, it never gets too old.
I really enjoy them."
On a personal level, we deal with this
and we focus on the joy.
We focus on the things that are
positive and things that they're
still able to do and we treasure each moment.
You do this not only as a professional,
but as also a family member.
My guess is that one
informs the other in a very important way.
Absolutely.
Linda, thank you for being with us.
Thank you.
Will Mobley for the Brain Channel,
and this is On Our Mind.
Thank you. [MUSIC]