A memory care facility can seem like a savior. Care giving for someone experiencing cognitive decline means that simple daily activities can be a grind. Eating, bathing, cooking, cleaning, even just conversation can become stressful as the elderly one struggles to remember where he or she is, what day or time it is, how to complete activities of daily living, or even who the caregiver is. Add to that the emotional strain on family caregivers as they witness a loved one being lost to a disease, and those who care for an elderly one are drinking a potent cocktail of stress and emotions that may make a memory care facility sound like the perfect solution. Experts in memory care will be there every moment, the brochures promise; the elderly loved one will receive top-of-the-line care, the brochures claim; the implicit and explicit promise is that the elderly one will be safe and happy.
Yet that is not always the case, especially in regard to such facilities dealing with the aggression that is unfortunately common in seniors with memory loss. In fact, how a memory care facility deals with aggression is a signal of its worth.
Finding a memory care facility that works well for a beloved elder has to begin with considerations for safety and quality of care. For example, a memory care facility that deals with aggressive behavior with frequent, heavy sedation or with disdain from the staff members will likely not be the ideal place, even if the person in question has not shown signs of serious aggression before. Here are some ways to evaluate a memory care facility’s reaction to aggressive behavior and determine if that is appropriate and healthy.
Visiting any long term care facility, adult day care, or respite care facility is vital before sending a loved one there for care. Visit smart. Drop in more than once, advises writer Tara Bannow in Oregon’s The Bulletin, and visit during transition times, when behavioral challenges in residents often become clear. Those are good times to witness how the staff responds to aggressive behavior and how frequently residents become aggressive. If only minor incidents occur and they are dealt with calmly by staff members, or even if a major incident (or two) occurs that is safely resolved in ways that find a solution and keep everyone safe, odds are that the policies, staff, and training have all aligned to create a facility that works well for elderly loved ones, even where aggression is concerned.
Night time is when most aggression incidents occur for many seniors with memory loss, so meeting and checking on staff members who work during the night (and will help a loved one through the nightly routines, such as taking medicine, eating light meals, bathing, and getting dressed for bed) is key to determining how comfortable and cared for the loved one will feel. Visit the night staff in order to determine their attitudes and overall behavior. If the staff is friendly, calm, well-trained, and responsive, they will ask questions of residents, have good conversations with them, and respond quickly to aggressive behaviors with the same expertise as the morning or afternoon staff.
A well-trained, well-supported staff can make memory care a much healthier, happier experience for an elderly person suffering from dementia, especially in regard to aggression
Ask About Training
A well-trained, well-supported staff can make memory care a much healthier, happier experience for an elderly person suffering from dementia, especially in regard to aggression. Do staff members attend comprehensive training sessions? Are there visits from experts? Are they required to be re-trained constantly on the newest methods, medications, and research on memory care? Specifically, how are the staff trained to respond to incidents of aggressive behavior? What policy exists which outlines the course of treatments, and is there flexibility for patient need? Even better, how do staff members feel about this policy? There is nothing wrong with asking staff members how the policies in place seem to work for patients. Does the way the facility deal with aggressive behaviors only punish bad behavior, or does it promote good behavior? Is the attitude disdainful or is it patient-oriented? The answers to these questions will give a good idea of how a loved one will be treated should he or she have an aggressive incident.
Check the Records
Depending on the state, different requirements exist for different licenses assigned to facilities. Memory care facilities may be held to a much higher standard in some states; in others they may not be. Some may have mandatory staff to patient ratios, while others may not; and some may have to create detailed patient care plans while others do not. Regardless, checking the requirements of a facility can prevent family members from being impressed by a label and inform those seeking care for a loved one to ask more intelligent questions of staff members during the visiting process.
Specifically dealing with aggression, inquire about incident reports and policies. How frequently do staff members file them for patients? What is the policy for resolving aggressive behaviors? How often are police reports filed, if at all? What would be the line of demarcation between manageable aggression and aggression which could bring about medical or physical intervention by staff members? What does the facility consider aggressive—is it only physical aggression, or does it include verbal aggression as well? All of these questions (and more) can help determine the attitude and overall plan in facilities for seniors whose disease causes aggressive behaviors.
Identifying and removing triggers from the life of a senior with memory loss can be tricky, as it is not an exact science, nor is it always possible. (A “trigger” is something that sets off an emotional episode—in this case, an aggressive one. It can be anything from a topic of conversation to a scene in a movie to a particular activity.) If family members know that certain activities, people, places, smells, or other stimuli cause a loved one to become aggressive, it is important to discuss this with a facility under consideration. Can they remove such stimuli, if possible? Is there a plan for dealing with new triggers as they crop up? If they can develop a comprehensive plan for avoiding triggers, they are, at the very least, going for preventive over reactionary mode, which is far more proactive. For memory care patients who need round-the-clock care, preventing aggressive episodes is one key to keeping them emotionally healthy.
Family members should not neglect the importance of how a facility deals with aggression–including whether it is proactive or reactive–in making the important choice for the care of their loved one who is suffering from dementia.
Alzheimer’s Association. Aggression and Anger. Caregiver Center. Available at http://www.alz.org/care/alzheimers-dementia-aggression-anger.asp. Retrieved June 13, 2016.
Bannow, Tara. (August 13, 2015). Experts urge caution when choosing memory care facility. The Bulletin (Serving Central Oregon since 1903). Available at http://www.bendbulletin.com/health/3377593-151/experts-urge-caution-when-choosing-memory-care-facility#. Retrieved June 13, 2016.
Gerace, Alyssa. Memory Care Takes Proactive Approach to Manage Aggressive Behavior. Argentum. Available at http://www.alfa.org/News/3419/Memory-Care-Takes-Proactive-Approach-to-Manage-Aggressive-Behavior. Retrieved June 13, 2016.
Span, Paula. (July 12, 2013). When Aggression Follows Dementia. The New Old Age. Caring and Coping. The New York Times. Available at http://newoldage.blogs.nytimes.com/2013/07/12/when-aggression-follows-dementia/?_r=0. Retrieved June 13, 2016.