Wednesday, 31 October 2018

Care Partner Wednesday--Hallowe'en and Dementia

When my kids were little, I was not a fan of Hallowe'en. That's an understatement. I hated it. The spiritual implications, the cost, and all that candy put me off. I probably scarred them for life, but they got dressed up and we took them out to Chuck E. Cheese, where they came home with lots of prizes and a small bag of candy. Bah, humbug.

I've changed. Now I dress up, give out candy to the hordes of kids who come, and coffee, tea and hot chocolate to their frozen parents. It's a neighbourhood thing and I love the sense of community.

If you're a care partner to someone with dementia, the conversation in your head may sound something like this: "My life is difficult enough. I'm exhausted, my elder is unpredictable, especially after dark. The last thing I need is for the doorbell to be ringing incessantly and excited kids screaming. I'm going to turn off the porch light, take mom down the basement and turn on a movie--loud. Hopefully, it will all be over by the time she wants to go to bed."

Hallowe'en can be the best of times or the worst of times, and you won't necessarily know how it's going to go. Here are a few ideas that might help.

1) Watch the media--Over the month of October, malls can have some pretty scary displays. People with dementia sometimes have difficulty discerning reality from fiction and may get scared by the fake blood and gore. This is also true of the content on TV, especially as the date draws closer to the 31st. Try to keep mall trips to a minimum, and monitor television, stocking up on favourite movies to watch instead.

2) Know your elder--You know better than anyone if Hallowe'en will be fun or stressful. You can't predict everything, but if loud noises such as doorbells and children yelling "Trick or Treat" would bother them, find something else to do. If they tend to sundown and get anxious in the evening, it's probably best to look for a quiet place to retreat.

3) Have fun--One of the first characteristics I learned about people with dementia was that they generally love to have fun. Little children in costumes are a delight, and if you think the cacophony of the door in the evening would be too much, invite grandchildren to come over in their costumes or check out a program at a local library. Children in costumes are everywhere, and they do so love to be admired.

4) Dress up--It may not be everyone's thing, but I've been amazed at how many elders enjoyed putting on a feather boa or a funny hat when everyone else is dressing up. Take pictures, do silly poses and give yourself permission to laugh.

5) Give--One thing elders love, especially those with dementia, is to give. If they are up to it, have your elder give out candy. They may need a bit of help, but seeing the smiles on little faces will give them purpose and joy.

I give you permission if Hallowe'en is too overwhelming, to turn off the lights and go elsewhere. but maybe this is the year you grab your feather boa. And your camera.

Care PartnerWednesday--Hallowe'en and Dementia

Thursday, 25 October 2018

Care Partner Wednesday--Who Is A Care Partner--Maria

In celebration of my 300th blog, in the month of October, I will be featuring a series called "Who is A Care Partner?" Each week, I will interview a professional care partner. Different responsibilities, nationalities, and perspectives, but one thing in common--a heart for elders. This is the fourth in the series.

Tell us a little about yourself and your family. Where were you born, your family of origin, your family now.

I lived in the Philippines my whole life well into adulthood. My mother raised us alone and taught us the value of hard work. One of eight children, we were always poor and had to learn to be creative to put food on the table. My mother taught school, and even in her difficult circumstances, she impressed on us to never complain and always be positive. Those values are part of me today.

I attended the school where mother taught and later became a nurse. I worked in the community, in the Regional Epidemiology Surveillance Unit of the Department of Health. The work served the World Health Organization.

I met and married my wonderful husband, who was always supportive, and we had our two boys. When I married, we lived with my in-laws, my first encounter with elders except for brief visits from my grandparents, who lived in the States. Later, when father-in-law later became sick, his dying wish was that my boys live in Canada.

I was afraid. I didn't know anything but my home, and immigrating was a long and difficult process. I moved here, leaving the boys with the nanny they had known from birth. I took the required courses to upgrade and practice as a nurse in Canada, but my first job experience was horrendous. They treated me like a slave but I was afraid to say anything and jeopardize my family's chances of coming here. A  friend encouraged me to find another position, which I did, and at this one, I lived with my employers who were elders.  I was so much happier. One of my fellow students encouraged me to apply at Christie Gardens,  a continuum for elders in Toronto, which includes independent living apartments and life lease suites and a care floor. For a long time, I didn't, but when I worked in a long-term care home across the street from Christie, I'd look at the building and wonder about it. Then a position was posted and  I applied. I'm so thankful they took a chance on me. I have worked here ever since. I was able to sponsor my husband and our boys, so now our family is together again in Canada.

As a nurse, you could work anywhere. Why did you choose to work among the elderly?
I don't believe I made a choice. I think it is my destiny. Although I didn't grow up knowing my grandparents well, each step of my journey thus far involved elders and each of them taught me so much. I believe I'm where I'm supposed to be.

There is no denying it, some elders are more difficult to serve than others. How do you handle a situation when someone is challenging?
I think you have to look beyond what is happening. Often there is a reason, an unmet need, which is the root cause of the problem. Many are dealing with so much--losses in their life, sickness, pain. We have to listen with our hearts and look for why they are acting this way. Compassion, patience and active listening are important. Sometimes what they aren't saying is also significant.

Tell a story about how you served an elder and met their needs in a non-medical way.
When I was living with the elders in my second job in Canada, there was a sight-impaired family member. Because of this, her hair was cut crooked, as were her nails. She tried to vacuum, and it hurt me to watch. On my break, I did things like style her hair, cut her nails and help her keep her place clean. I told her she felt like family and it pleased me to do it.

 At work, there are so many non-medical things I can do. Simple things like helping someone with their socks and shoes, assisting them in the toilet and taking their tray back to the dining room. Nurses work as a team with all other care partners, and everyone can help.

What is the most rewarding aspect of your work?
I love when I'm able to make residents smile. If they are comfortable and happy with the care, they relax and appreciate the time you give them. They have so much to give. When they share their wisdom and knowledge with me, I learn from them. I respect them and their contribution to my life.

If a student is planning to work as a nurse in eldercare, what advice would you give them? 
I would encourage compassion and to provide caring as well as nursing care. Sometimes it can be unbelievably busy. You have medications to give out during a certain time and then maybe someone has a fever and someone else falls. Sometimes I feel like I am running in all directions. The important thing to remember is that they are people, and to really listen and give compassion with     the medications.

Another thing that's important to remember is to look after your other team members. No one can do the job alone. We need each other, and we have to care for each other to make that happen.

So much of what you do goes beyond dispensing medications and treating wounds. How do you develop relationships with the elders you serve? 
Trust is important and must come first. As residents get to know me as a familiar face, they relax and feel more comfortable. I always smile and try to spend some time chatting with them as I give their medications. I listen to what they have to say and I'm interested in their lives. Knowing who they are and sharing who I am, means we become friends.

What do you believe elders need most from their nursing care partners?
Compassion, active listening, genuine smiles and love. And a sense of humour helps, too.

This is what I have learned: Elders may not remember your name. They may not be able to say what you have done for them. But they will always remember how you made them feel.

Care Partne Wednesday--Who Is A Care Partner-Maria

Thursday, 18 October 2018

Care Partner Wednesday--Who Is A Care Partner?--Lillian

In celebration of my 300th blog, in the month of October I will be featuring a series called "Who is A Care Partner?" Each week, I will interview a professional care partner. Different responsibilities, nationalities, and perspectives, but one thing in common--a heart for elders. This is the third in the series.

When Lillian talks about making appetizing meals for elders, her eyes sparkle, her animated face lights up and her fingers flit as she pours forth her passion. Lillian is a nutrition partner. She's a member of the dietary department, but so much more. An integral part of the team, what drives her is to make food tasty, pleasing and fun.

Tell us about yourself. Where were you born, what did your family of origin look like, when did you move here? Tell us about your family now.

I was born in the Filipines, the third of eight children. In my thirties, I moved to Canada and in my first job here, I worked in a restaurant. A few years later, I became a Canadian citizen, and could sponsor my parents and my younger sister to come to live here. My dad developed prostate cancer,
and received treatment, but he couldn't handle the Canadian winters. He went back home and passed away there about a year later. My mom, however, is in her nineties and lives with me. She doesn't like the winters either, but she loves to be with me. She's still able to do some things, but her arthritis is quite painful. I'm able to look after her and, of course, make her favourite foods. Caring for her has taught me how better to serve the elders at work, and I see her in them when I am here. I also have a son and two wonderful grandchildren.

How long have you worked with elders?
Twenty-two years ago, I started working at Christie Gardens, a continuum for elders in Toronto, which includes independent living apartments and life lease suites and a care floor. I started with part time work, and worked at various times of the day. I've served all three meals, and worked in different areas of the building. In the neighbourhood I'm a part of now, I serve lunch and dinner, and work with the team of care partners to prepare, serve and clean up from those meals for thirty people every day.

What part of working with elders makes you feel like you’ve made a difference in their lives? Tell us a story about when you went beyond the perimeters of your job in order to make an elder happy.
I try to do that every day. Often when people get older, their appetite wanes, and nothing sounds good to them. It's important to get to know them well, and find what kinds of foods they like, how they like it prepared and what makes it appealing to them. For example, someone may not like anything that's being served that day. Even though we have two choices of soup and four entrees, it may be that nothing sounds good to them. I might offer to make a fresh grilled cheese sandwich, or an omelet. I try to find something that appeals to them.

Also, when we have birthdays, I decorate a piece of cake with whipped cream, and garnish it with small pieces of orange and strawberry. Everyone in the dining room--residents and staff--sings for them, and it makes them feel special.

Sometimes elders are on special diets (minced or pureed foods) that are less appetizing. What do you do to help in these situations?
These are more challenging. One of our ladies has to eat pureed food, and giving her variety and tasty meals is important. Before she came to us, she was in a hospital where the pureed food was prepared ahead, and she hated it and lost significant weight. I show her the menu, and she chooses what she would like. I then puree it and she eats it immediately. It's much nicer for her and she appreciates that it's fresh and her choice. Another man is on a gluten-free diet. He enjoys salads, and I make them especially appealing with different colours and textures. We also supply gluten-free bread for him. We have a man who likes everything bland, 
which limits his choices. I try to find different options for him so he isn't 
having the same food all the time. Another person isn't able to handle utensils well, but enjoys finger foods. Sometimes I roll a piece of ham and put fruit with it and some bread to make a kind of salad, and he eats it all. You need to be creative and look for ways to meet their needs.

If you were giving advice to a care partner who was finding it difficult to make meals enjoyable for their elder, what would you suggest?
I try to make sample plates, so when the care partners are serving, they have an idea of the best way to serve it. I like to have lots of options ready, so there is something for everyone. 

What kinds of things do you do to make meals special and fun? Why is that important?

Presentation is important. You can't throw a spoonful of food flat on a plate and expect it to be interesting to a person. I look at the position of the main course, the salad or vegetable, and how the garnish looks. Sometimes I put part of the meal in a small nappie so everything isn't at the same height. I garnish with colourful things like yellow or red peppers, peaches, strawberries or orange slices, and a sprig of mint. Elders are thankful for the extra effort and are more likely to eat well when it not only tastes good but looks nice. Many of our residents love a scoop of ice cream, but unless they specifically want it plain, I put chocolate sauce and a dollop of whipped cream on it. 

Every meal can be a celebration.

Care Partner Wednesday--Who Is A Care Partner--Lillian

Wednesday, 10 October 2018

Care Partner Wednesday--Who Is A Care Partner--Niala

In celebration of my 300th blog, in the month of October I will be featuring a series called "Who is A Care Partner?" Each week, I will interview a professional care partner. Different responsibilities, nationalities, and perspectives, but one thing in common--a heart for elders. This is the second in the series.

Niala Dookie was born in Trinidad, but her ancestors came from India. Her great-grandparents came to Trinidad as children to work on the sugar plantations for the British. Her large family includes eleven siblings. As her father died when she was ten, her mother raised the children, fulfilling the roles of both parents. Now her mother has Alzheimer's, and Niala looks after her.       
How and when did you come to Canada?                                                                                     
I came at 18 with my mom and four of my 
brothers. We came to live in Winnipeg as two
of my sisters already lived there. 
The rest of my family moved to 
Toronto, but I stayed in Winnipeg 
until 2011. My mom had a fall and broke 
her hip after her 80th birthday, 
and my family realized she couldn't live alone.

What made you choose to be a professional care partner?
I trained as a medical assistant, but couldn't find work in that field. I'd also worked as an office assistant. I cared for my mom already, so it seemed natural to decide to take the PSW (Personal Support Worker) course. When I graduated, I came to work at Christie Gardens, a continuum for elders in Toronto, which includes independent living apartments and life lease suites and a care floor. . I'm still here.

You are looking to change careers and serve elders in a different way. What made you decide to take this route?
Working as a care partner, I heard about the Eden Alternative, the philosophy of care that looks at the whole elder, and takes a person-centred approach. My desire was to do more than just help our elders get dressed or get their meals, I wanted to give them a voice. My passion is that each is treated with dignity, given independence in a personal and private manner, with safety foremost. This is how I treat my mother and all elders.

I decided to take the Activation and Recreation Coordinator Course in Gerontology at George Brown College. In my second year, I'm learning so much about people living with dementia.

You have some special challenges, as you aren't only a care partner at work but at home. Tell us about that.

It is challenging, but if you love what you do, it doesn't seems as much so. People laugh when I say I go to work to have a break from caring for my mom at home. A special woman who worked hard all her life raising her children without my dad, she is the only parent I know, and it's my duty to ensure she gets the best care possible. When I go to work, I use the same philosophy. Every elder is someone's mother, father, sister or aunt, and they want the best for them. I see my own mother in others, and it makes the job lighter.

The Eden Alternative talks about the three plagues of loneliness, helplessness and boredom in elders. Tell a story about how you adressed this at work.

Loneliness--Connecting with others is the key to fighting loneliness. I chuckle when I hear someone tell the same story over and over to her tablemates. They always act as if it's the first time they've heard it.

Helplessness--I like to offer lots of choice. What would they like to wear today, or eat of drink or do. It's also important to enlist their help when possible. It gives them a sense of purpose and helps them feel needed and valuable.

Boredom--I like to find out not only who they are, but what they enjoy. Knowing what they love to do makes it easy to engage them in meaningful activity. I also love to talk to them about their lives. There is so much wisdom to be gained.

Tell us about a day you went home feeling you made a difference.

Hopefully that's every day. When I help someone with their meal or make someone smile or engage in girl talk, I know I've made a difference to that elder. One day I went to help another care partner because an elder was refusing to have a shower. I had a relationship with this elder, and she allowed me to shower her. I felt I made a difference that day.

What is the most difficult aspect of your job?

When we lose an elder it's by far the most difficult aspect. Because we develop relationships, we form close bonds, and it hurts to say good-bye when they pass away.

What advice would you give to all care partners--professional ones like you or those who are caring for family or friends?

Do your job to the best of your ability. See each person as an individual, and care for them as you would want your loved one cared for. Doing your best for someone is the best gift you can give them.

Tomorrow is not guaranteed.

                                                  *picture of elder used with permission

Care Partner Wednesday--Who is a Care Partner--Niala

Wednesday, 3 October 2018

Care Partner Wednesday--Who Is A Care Partner--Honeygirl

In celebration of my 300th blog, in the month of October I will be featuring a series called "Who is A Care Partner?" Each week, I will interview a different professional care partner. Different responsibilities, nationalities, and perspectives, but one thing in common--a heart for elders. This is the first in the series.

Honeygirl’s journey to her present job was a long and winding road which involved another job, a wedding and getting laid off!

 She’d always wanted to work at Christie Gardens, a continuum for elders in Toronto, which includes independent living apartments and life lease suites and a care floor.
Ten years ago she took a private duty position with a resident who lived independently but needed some extra care. This gentleman wanted to get exercise, so they walked together all over the building. One of her co-workers told her “a Filipino guy in the kitchen would like your phone number.” Her na├»ve thought was, “That would be good, because if I know someone, I’m more likely to get a job here.” That wasn't why he wanted her number. 

They were married. A few years later, she got a job at Christie Gardens, but later was laid off due to lack of seniority. She had her children, and two years ago applied again. I was a part of her interview, and we knew immediately that she was the kind of person we were looking for. She has been working part-time since, and just recently applied for and received a full-time position, which will be starting this month.

Tell us about your family of origin. How did your growing up influence your love of elders today?
 I grew up in Filipines. My Dad passed away when I was three, and in order to look after us financially, my mom had to work overseas. She worked in Hong Kong, Australia and England, and I only saw her once a year during the month of December when her employer would fly her home. Consequently, my grandmother took on a most important role in my life. She raised me, and I was closest to her. When my mom came home, I still slept with my grandmother because that's what was familiar to me. 

This influenced me the most because I wish I could be beside my grandmother. She lives in Vancouver, I call her when I have free time, and we do Facetime. She’s 88. She’s still active.

 Tell us about the family you have now. What do you hope your children learn from you regarding eldercare?
 I have a girl and two boys. I always tell them the story of my life back home. I want them to know what I’ve been through. I wasn’t beside my mom all the time like they are able to be, and I want them to understand. I explain to them what I do, and when they ask what I mean by “elder” I say, “Like Grandma.”

Eldercare to me is very important because I grew up with my grandmother, and I wish I could be caring for her. Each of the elders I care for are like my grandmas and grandpas. I don’t know what my kids will do when they are older or if they will have the same passion for elders as I have, but they know what I do, and I hope that will mark on their hearts. I will be old some day, and I’m not expecting them to take care of me, but at least to give the love and respect with elders.

What have you learned from the elders you serve?
It takes time to earn their trust. They have to get to know me and I have to get to know them. And patience. It can take months to have the kind of relationship with the resident where they trust me and care is easy. Many of the lessons I’ve learned with the elders I take home and can apply with my family. 

Then when they pass away, they leave a mark on me. 

The Eden Alternative talks about fighting the three plagues of loneliness, helplessness and boredom in elders. How do you help to do that?
 When I give care, and I talk with them and share myself with them, I become their friend, and that helps with loneliness. My residents are close to my heart. That’s who I am. There’s something in me that connects to them.

It’s such a good feeling if you did your job well at the end of the day. 

How were you able to serve an elder at their death?
Honeygirl was recently with a resident who lived with us for many years, and passed away suddenly. She wasn’t feeling well at lunch, so the care partners put her back to bed. Honeygirl was with her not long afterwards when she breathed her last. When we were able to get in touch with the family, they were sad that they weren’t there, but so happy when they heard Honeygirl was with her. They said it gave them comfort because it was like having a member of the family with their mom.

What is the most rewarding aspect of your job?
 There’s lots of physically and emotionally challenging aspects of the job, especially working with people with dementia, but I have learned so much from them. I’ve learned how to help them, how to work with them, and how to make them smile and laugh. I’ve learned how important it is to help other people, not just elders. If we care for our elders, it makes their family happy as well.  

It’s also important to look after your co-workers, too. It has to be a team, like a family. 

What is your biggest challenge?
It’s hard when they refuse care, and it makes me feel sad, like I’m not doing my job. 
So, sometimes, I sit with them and talk a bit. Sometimes about this and that, sometimes about my kids. One time I was with a resident, and he seemed so sad. I said to him, “What makes you happy?” We talked a bit about his family, and then I asked him if he wanted to see pictures of my kids. He did, and he was smiling and we were talking. Then I said, “Do you want to get ready now?” and he said, “Yes.” Just a little talking, communication and connecting, and his whole attitude changed. 

If someone is refusing, I’ll give them time. I’ll walk away and come back after five minutes, and sometimes, something has changed. If not, then another try.

What advice would you give to all care partners?
I tell the students who work with us, “If you hear a negative thing from your co-worker or something, you can’t get sad or upset. It serves as a challenge for you. You have to stand up and do better. You learn from this one, from this one, from this one. There are four care partners in this area. We have different techniques. You apply, and it’s up to you to make it your own.

I just love to learn. I learn from the elders, from co-workers, from the families. That makes me so happy that I’m here. It’s like a home that you don’t even want to leave.

I’ve heard you say you love your job. Why?
 I always love to work with elders, and when I come to work, I know I have a purpose. I love what I do. Sometimes it’s kind of challenging, but when I’m here, I know I’m doing what I should be doing.

That kind of says it all, doesn't it?