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Who can you Trust?

My friend Suzanne came to me one day in tears to talk over the situation with her mother. She knew that I had dealt with my own mother’s dementia care and eventual movement to an assisted living dementia care facility. In fact, back then she had been the one to dry my tears, talk me down from my emotional meltdowns and make me a cup of tea (I am English and we believe that a cup of tea is the answer to everything) After lovingly acting as the main caregiver to her mom for many years who was diagnosed with Lewy Bodies dementia, it had come to that difficult place where her mother’s dementia was quickly progressing. It was clear that she could no longer be cared for at home and needed an assisted living memory care facility.

But how can I know what assisted living dementia care home I should trust with her care? They all look good on their websites, they all say the right things but I often hear horror stories. I don’t know where to start she said.

I also have heard of many difficult situations families have faced with their choice of homes, here are just a few…

  • Arriving for an assessment only to have no one expect you.
  • Trying to communicate with a staff that clearly does not want to hear your concerns.
  • Situations where you feel the home is not telling you the whole truth.
  • Having the home commit to something and then not follow through.
  • Caregivers not listening and showing no follow through.
  • No sense of urgency to finding the “Why” of a change of behaviors.

Albert Einstein recognized the importance of trust when he said, “Every kind of peaceful cooperation among men is primarily based on mutual trust.” Yet often these days our trust may be broken, abused, misplaced, or violated.

Trust is intuitive confidence and a sense of comfort that comes from the belief that we can rely on the assisted living memory care home to perform competently, responsibly, and in a manner considerate of our interests. It is dynamic, it is fragile, and it is vulnerable. Yet it is very difficult to define and quantify.

Trust is easier to understand than to measure. Yet, trust is essential when dealing with people with dementia in an assisted living situation. Their families are looking for help at a time that is most vulnerable for themselves and their loved one with Alzheimers Lewy Bodies Parkinsons or Frontotemporal dementia. Lack of trust creates cynicism, doubt, and anxiety

Assisted living Dementia Care Homes need to be able to provide much needed emotional support to families as well as the person with dementia. Families need to know that their loved one’s care is tailored to their individual needs and challenges; they need to know that their thoughts and information will be respected.


These are points to look out for when choosing an Assisted Living Dementia Care facility

  • Is the staff proactive, do they show they care for you; do they listen to you, the caregiver and probe for unspoken fears and concerns?
  • Do they provide sensible solutions that work?
  • Are they honest and truthful?
  • Do they demonstrate respect –Do they ask you what you consider the best ways of dealing with your loved one?
  • Do they answer your questions with straight talk?
  • Do they clarify expectations?
  • Do they listen first?
  • Do they keep commitments?

There are “best practices” – approaches and techniques that are most likely to get the desired response from the person with dementia. Frequently these best practices maintain a familiar routine and recreate a familiar environment. Many family caregivers have learned a lot about the patient’s disease but their special expertise lies in their long history with their loved one. Many feel that only they understand this person and know how to meet his or her needs. They see themselves as the patient’s advocate and protector, and they may be afraid that the assisted living memory facility won’t be able to provide good care.

So when choosing a home that you want to know you can trust run them first through the ABCD checklist.

abcdA = Able, do they demonstrate competence. Are they qualified and experienced in the dementia and  memory care field

B = Believable, are they acting with integrity, are they honest with their dealings with you?

C = Connected, are they demonstrating care and concern for your loved one and other residents and staff and are they communicating effectively.

D = Dependable, are they reliably following through on what they say they are going to do, this means being accountable for their actions and being organized and predictable.


In an Assisted Living Dementia Care home trust must be treated as precious, highly valued, and treasured by the home. It must be viewed as if it were an egg that when treated roughly could shatter. Remember actions can speak more loudly than words, don’t be fooled by fancy sales presentations and pretty pictures.

The main question to ask when choosing and Assisted Living Dementia Facility is

“Do you TRUST them?”

By |June 12th, 2015|Senior Care|Comments Off on Who can you Trust?

In praise of small…The benefits of relationship based care

Who is on with her today?

This was always the first question my sister and I had when discussing our mothers care at her first residential memory care facility.  The degree of peace of mind I felt for each day was determined by who that staff member was, a factor I had no control over.  I still recall that familiar, anxious, dark dread I felt in the pit of my stomach.  It felt as though I were leaving my vulnerable and innocent child in a dangerous situation.

Don’t get me wrong it was a good facility, but, based on the size and number of patients, there were constant changes of staff.  Some cared and others showed only surface- level compliance and to be honest others simply did not care.  We were always cautious about complaining too much for concern that it may be taken out on mom in passive aggressive ways when we were not around.

I have heard this story repeated by so many friends who are dealing with the same issue.

After a number of repeated problems we took the plunge and moved mom to a much smaller home and now I am truly “Sold On Small”.

Home Sweet Home

To provide a dementia sufferer with a home is far different than providing a home like environment in a larger facility.  I relate it to staying in a nice hotel, it’s attractive, and it’s comfortable, it may even be luxurious but it is not home.

What my sister Denise and I found was that the small home environment provided the opportunity for my mom’s caregivers to become like family and allowed for relationship between the caregiver and patient to become one.

Care happens when one human being connects with another.  In order for healing to be maximized, residents and their loved ones must feel safe and cared for. This is only possible when caregivers are encouraged to forge authentic human relationships with those in their care, an environment where there is a regularity of staff allows for these relationships to form.

We also found my mom’s caregivers in this home environment, to be much happier.  They seemed to work with a feeling of purpose and meaning.

Connecting, empathizing and understanding is a process of learning and caring, for a caregiver to be able to do that for a manageable number in a family setting becomes much more achievable than when rotating between large numbers of patients.

See Me as a Person …

Happy SeniorOften when caregiver, family and resident relationships fall short, it’s because of a failure to make an authentic human connection with patients and families.  In a small family setting caregivers have the opportunity to interact with people with dementia right where they are! An atmosphere can be created where the person with dementia has interaction based on who they were in their finest hour…

Relationship Based Care means knowing and understanding who the person with dementia was in his or her finest hour. It includes life-long interests and favorite subjects.

For instance from talking with Moms caregivers we learnt that mom was continually pulling at threads and tearing off buttons from her clothes. As a young mother our mom was constantly sewing, making and repairing clothes for us four kids.  We put our heads together and came up with the idea of a smock which Denise (The seamstress) in our family stitched with dozens of buttons and ribbons and threads.  The caregiver would put this on Mom each day and she would spend many happy hours playing with and attacking each item.

MemoriesWhen you’re caring for residents and their families, knowing how to create therapeutic relationships can mean the difference between a resident and family feeling held in care, or feeling dropped in a time of high vulnerability and fear.

Small home environments enable caregivers to focus on caring for the whole person, body, mind and spirit, allowing everyone in the home to appreciate and honor the uniqueness of each person. This creates an environment where caregivers are able to support patients and families in making decisions about their care and thus allowing the dementia sufferer to “Be seen as a person”

With the help of mom’s caregivers at the home we learnt to connect with mom exactly where she was. We came to understand that this was vital for her because her reality was different from ours.  Her caretakers showed real curiosity and genuine interest in her, they grew to love her and she them (I must point out that mom was not the easiest patient to be around, often demonstrating difficult behaviors. To be honest she had been like this even before her dementia set in) but in some magical way they calmed her down and actually seemed to enjoy the fact that she was so feisty.

To the day she died, peacefully in this, her home, with her family by her side.  I felt that mom was in a safe place where she felt loved, accepted and held in dignity and respect.

Sometimes Small is Simply Superior

By |May 12th, 2015|Senior Care, View All|Comments Off on In praise of small…The benefits of relationship based care
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