The Journey with Dementia: Assisted Living and Memory Care

As our loved ones get older, we want to be there for them in their golden years. We want to give them great care, a safe environment to live in, and the proper treatment if they become ill. However, most American families with older relatives find it difficult to provide them with the finest care possible. Family members may find it difficult to simultaneously provide all the necessary care to their loved ones while going about their daily lives.

One solution for many families is to use the services of an assisted living facility. Assisted living is a form of accommodation for seniors who require varying degrees of medical and personal assistance. Memory care programs are available in several assisted living facilities for those individuals with dementia. These specialized units provide safety features that make quality of life safer, since there are frequent behaviors like wandering, agitation, and falls which expose these individuals to risk.

In this podcast, Perry Limes interviewed Maresa Henry, the Executive Director at Spring Arbor Senior Living Severna Park. They discuss the benefits of receiving services of an assisted living facility for seniors, when the time is right to get the services, what programs are offered especially for those with dementia, and the positive experiences and moments in these kinds of communities.

Key Takeaways
What is assisted living and its purpose for individuals with dementia
Key indicators to look for the services of Assisted Living
The Memory Care Program and what is it all about
The benefits of Assisted Living Facilities partnering with Palliative and Hospice Care
Experiences during the COVID outbreak and how they've managed

Quotes
No one is really excited to sign up for an assisted living. However, once they move and they've acclimated to the community, they love it and they thrive. - Maresa

They find themselves in a space where they're not being judged and they can be themselves. - Maresa

Partnership with hospice and supportive care programs makes their loved ones really enjoy and make the most of their stays. - Maresa


Featured in this Episode
Maresa Henry
Executive Director, Spring Arbor Senior Living Severna Park
Facebook: https://www.facebook.com/SpringArborSevernaPark/
Website: https://www.springarborliving.com/md/severna-park/spring-arbor-of-severna-park/

Perry Limes
Director, Strategic Partnerships
Hospice of the Chesapeake
Profile: https://www.hospicechesapeake.org/perry-limes/
LinkedIn: https://www.linkedin.com/in/perrylimes

Thanks and Appreciation
We'd like to thank the John and Cathy Belcher Institute for their generous support of our community outreach and education programs.

Chapters
00:00 Intro
01:32 Maresa Background
03:21 What is assisted living?
05:28 Getting the services of assisted living
07:46 The provided services
10:07 Factors in decision making
10:49 The Memory Care Program
13:50 Qualification for Memory Care Program
15:28 Mingled with cognitively impaired persons
16:35 Palliative care and hospice care
18:08 Pearls of wisdom
19:43 During the COVID outbreak
21:40 Thanks and appreciation

Episode Transcript

(00:08):
Good afternoon, and welcome back toLife, Death and what Matters in Between.
I'm your host, Perry Limes,and I am joined today by Marisa
Henry, executive director Spring Arbor,Saverna Park, and today's program will be
the Journey with Dementia, the assistantLiving Facilities and memory care. Before we

(00:34):
get started, and we want totalk about your role in this journey,
I'd like to remind our audience.You know, in every episode we talk
about our composite patient. His nameis Joe, sixty six year old African

(00:55):
American who's been dealing with dementia fora couple of years in his life for
forty years for Veronica, who ishis primary care giver. In this stage
of Joe's journey with dementia, itis becoming harder for Veronica to take care
of him. She's exhausted and concernedabout leaving Joe alone and his safety,
but she's not sure what her optionsare. So let's get into it.

(01:22):
First of all, tell us alittle bit about yourself and how you came
to be in this great role ofexecutive director. Okay, thanks, Perry.
Well, first, I really appreciateyou asking me to join this this
is subject near and dear to myheart, obviously, so I always tell

(01:42):
my families I have a story too. My father's mother had Alzheimer's and when
I was twelve years old, mymother quit her full time job and she
moved in with us, and mymom became her full time caregiver. And
as a twelve year old old,that was a really difficult thing to process
and understand. And ten years later, when my grandmother passed away, it

(02:08):
was it was difficult to see theimpact that that had on my own mother,
being her only primary caregiver. SoI feel like I was put on
this path to help families know thatthere are other options and other resources so
that they can not only take bettercare of themselves, but really give the

(02:30):
best care to their loved ones.So I've worked through long term care and
now assisted living, and every familymember I meet, it has been a
joy to help them find the answersto their to their journey. Oh that's
that's an amazing Thank you so muchfor sharing that. With that, I

(02:50):
think sometimes our viewers don't really understandall of the segments of healthcare and assistant
living, especially with the rise ofthe baby boomers. Is becoming more and
more prevalent in our society. Couldyou just briefly explain to us what an
existent living is and in essence,you know, miss Veronica, our patient's

(03:13):
wife, you know what, howyou would kind of describe this to her
moving forward? Okay, So definitely, especially even in just the last five
to ten years, assistant living hasreally evolved. I think thirty years ago
it was designed to be more ofa hospitality service versus healthcare, and it

(03:36):
has definitely transitioned into a healthcare settingand industry. Assistant living is what it
sounds like. We're there to assistour residence with their activities of daily living,
medication management, helping them with theirbathing, dressing as needed. But
we also want to foster as muchindependence as we can for those residents.

(03:59):
We don't want to take anything awayfrom them that they can still do on
their own. And I think thatthat's the part people don't see or understand
on the outside, is that we'renot there to take your car keys and
tell you no more fun. Youknow, we still have residence that do
drive, you know, So it'sreally just a safe place for residents to

(04:23):
know that help is less than fiveminutes away, but also to have their
privacy and independence and also be healthyand safe. That's that's excellent. You
know, it's interesting in my healthcareexperience, I learned early on in post
acute that you do not call theresidents patience. And I think that's done

(04:48):
with purpose because this is where theylive, this is their home, and
they don't see themselves as patients despitethem getting you know, interventional care into
minutely correct. Very true, verytrue. And again I think that label
of resident again helps foster that independence. This is your home. You still

(05:11):
get to make decisions, you stillget to be in charge of your life.
We're just here to support you whereyou need us. So how does
someone know when it's time for assistantliving. I think that you know,
for each individual, you really haveto consider who they are as a person,
because not everybody is ready to jumpinto a community living lifestyle. But

(05:36):
with that said, it is reallyimportant to pay attention to medical needs or
cognitive decline. Obviously, if there'srisks of that person falling or mismanaging medications
at home, that can be veryrisky. Those are those are some key

(05:56):
indicators that it might be time tolook at assistant living. Also, something
that we see even within our owncommunity, from assistant living to memory care,
is if we start to see peoplewithdrawal or isolate themselves socially. You
know, that's typically an indicator thatsomehow they feel they can't participate any longer

(06:17):
with the group that they're around.So you know, if mom or Dad
were normally really social outgoing every Friday, they played bridge with their friends,
and now they're not interested in doingthat anymore, that's kind of a sign
that everybody needs to pay attention to. You know, in seven years of
assistant living, there's only been onetime that I had a resident who was

(06:41):
really excited about moving in. Thisis a big step and it's a difficult
step. So what I'm saying isis that in this journey, no one's
ever excited to sign up for assistantliving. But what they find is once
they've made that move and they've acclimatedto the community, they love it and
they thrive. They're in a manageablespace, they know that they're safe,

(07:05):
they know that they're cared for,they can come and go, they can
have visitors, so it becomes theirnew home. So now I've had the
pleasure to be to your community andit's an amazing property, and you're right,
it does have a very homely feelto it, but it seems like
a sister livings go from as youknow, big as these like they look

(07:28):
almost like hotels do small homes.What are some of the services that are
provided in an assistant living for families? So what we offer at Spring Arbor
is twenty four hour nursing care.I think that's one of our most important
features that families need to know about. And when I say nursing care,
we have LPNs twenty four hours inthe building, so if a resident does

(07:54):
fall or showing signs of a UTIor has something going on, that nurse
can call all the physician and getorders and execute those orders on the other
end. So we're not sending peopleto the ear every other day. And
we all know the last place anyof us like to spend time is in
the er about so those nurses areable to administer medications and of course manage

(08:18):
symptoms for the residents. And thenwe also offer our resident care assistants who
are able to help with things likebathing, dressing, hygiene, personal care
type things. And again as muchor as little as that person needs.
We really want to cater that serviceto what they want and what they need.

(08:39):
So it might be that we're justhelping someone step into a shower,
or it might be that we're washingtheir hair all the way to their toes.
We do individualize the care for thosepeople. Also, what we offer
is programming, so we have activitiesthroughout the day of all different interests.
So we have every thing from paintingand pottery to happy hour. We have

(09:05):
volunteers from churches that come in,so music, magicians, all different types
of entertainers. So we really offera wide variety of programs for our residents
to engage in. And now wealso are resuming our outings, so we're
going to concerts in the park andout to eat and trying to enjoy things

(09:26):
outside of the community, just asif we would in our own home.
So we do offer those transportation servicesas well. Those are probably the main
things that families are looking at awesomenow, I think with as with all
things here in this country, costis always a factor. And I know
at that age, you know they'repaying for medical interventions and prescriptions and so

(09:52):
many other things. How does costfactor into that decision? Making. I
know for us often cost makes thisfeel prohibitive for a lot of families and
future residents, but we are ableto work with them and offer resources that
will help fund their stay with us. I know different companies partner with different

(10:18):
companies, but we do have severalresources that we offer to our families that
can help fund their stay with us. So, since we're on the journey
of dementia, I know a churefacility. You have a memory care program.
Can you describe what that program isand what some of the features are.

(10:41):
Sure, so I take a lotof pride in our memory care.
I shared at the start of thisthat I had a grandmother with Alzheimer's,
but I also had two other grandparentswith dementia, so this is definitely a
subject near and dear to me.So we have an open floor plan for
our memory care. It is secure, but it's almost like a continuous circle,

(11:07):
so there's no dead ends, youcan't get lost. A lot of
people with cognitive impairment like to keepmoving, they like to walk, so
we've offered them the space that theycan move freely and not feel confined.
There's also a beautiful outdoor space wherewe have raised flower beds, and we
do gardening with our residents and spendtime outside. In addition to that,

(11:30):
we offer both private and semi privateapartments depending on the situation. I've actually
found some residents do better with aroommate. It can be beneficial to have
that person there. It makes themfeel comfortable and safe. We do a
lot of sensory based programming, sowe have things art from the Heart where

(11:56):
people can express themselves through painting ordrawing, coloring, avengers, We've done
some work with clay. We dohearts and harmony. Music is timeless and
even there's as you know, Perry, many many, many studies that show
that someone even with very advanced dementiacan identify and still sing along with some

(12:20):
of their favorite songs. So wedo have a lot of music programs,
and then we do other things againgoing back to that personalized care, we
have a program called Royal Treatment wherewe like to spend some extra time really
giving that person, you know,hand massages, styling their hair, giving

(12:41):
the men a nice shave, youknow, really making them feel special in
that moment. So those are afew of our signature programs that we offer.
Well, that's amazing and great forthe visual of the circular and I
can see individual getting confused and wherethey're at. But if you kind of
wind up in the same spot whenyou're walking, it's that that's great.

(13:05):
Yeah. And also just to addto that, we we did add murals,
so as they're going, it's likea walk in the park, all
these beautiful trees and flowers. Um, it really is a beautiful space.
It's amazing. So a couple ofthings, Um, do you have to
have a specific diagnosis in order tobe you know, to I guess reside

(13:28):
in the memory program? It isit a special is it a separate part
of the alf as opposed to Okay, because you did say, well cous
a locked unit correct, Okay.Yeah. So in our particular community,
we have three floors, and um, the middle and top floor are our
assistant living apartments and in our memorycare is on the ground floor. Um,

(13:54):
you don't necessarily have to have aspecific diagnosis, but you do have
to have a diagnosis cognitive impairment toreally be qualified. I have had situations
where you know, a husband andwife like Veronica and Joe, and the
wife wants to stay and we won'tallow that, you know, because that's
not healthy for the person that doesn'thave cognitive impairment. So we do have

(14:18):
situations again where we have husbands andwives. One is on the assistant living
side, one is in the memorycare I tell people, you still live
in the same house, you justhave different bedrooms. So they can visit,
they can eat meals together, butat the end of the day,
the loved one that has the memoryimpairment would stay in the memory care area.

(14:41):
Of course, they can still dooutings. They can go out with
family, but we have a signand sign out process just to keep everyone
safe. That's awesome. So inour previous episodes we discuss memory care,
but it's always been on a oneon one situation. This is the first

(15:01):
episode where we're talking about individuals kindof intermingling, if you would, with
other residents that have cognitive impairment.Do you see any benefits of that where
they kind of support each other.What does that look like? Definitely,

(15:22):
a couple of things come to mind. I transitioned to one of our assistant
living residents to our memory care abouttwo weeks ago, and she and another
memory care resident are both artists,and they've connected, and there was a
picture of them sharing an art bookand enjoying the art together and talking about
it, you know, having reallylucid conversations about art. So I think

(15:46):
that what happens is they find themselvesin a space where they're not being judged
and they can they can be themselves. And again we're there to support and
facilitate some of those conversations and thosemoments of joy for the residents and their
families. That's amazing, That isamazing. Um, some of our listeners

(16:07):
might not be aware that supportive care, which we call palliative care and hospices
can be provided in an assistant livingwhich been your experience with palliative care and
hospice which your residence I am.I am a big fan of and advocate

(16:29):
for hospice and the supportive care services. I think that often, you know,
we're in the business, we dothis every day, so we know
what's happening. But families, thisis their first step into this journey,
so they don't know what to expect. And I think that you know,
helping the family bridge the gap fromyou know, the start of their journey

(16:53):
to end of life. It's reallycritical to have that partnership with Hospice uh
AND and the supportive programs because ithelps families make sure that their loved one
is enjoying and making the most ofthose days. We hear the expression it's
about quality, not quantity. Wewant people to have fun and laugh and

(17:18):
dance and do all of those things, and in partnership with these programs,
we're able to do that more andmore. That's awesome. So, with
all said and done, are thereany questions that families should ask when they're
looking for an assistant living to placetheir loved one in. Is there anything

(17:44):
any kind of pearls of wisdom thatyou could share with our audience for them
to inquire when when they're in thatsearch. Sure, I think it's important,
especially with memory care, to talkto them about what training is provided
to their staff. At Spring Arbor, we do a virtual dementia training with

(18:07):
all of our new hires and ongoingso that we can really put our employees
in the shoes of our residence andhave that experience of what it feels like
to have impairment. So I think, you know, making sure that the
staff is trained appropriately to care forsomeone with memory care or just a senior
that has you know, vision lossor hearing loss. All of those things

(18:32):
impact how they need to be caredfor. Also, in the climate we're
in Perry, you know, healthcare, we're all having that same struggle with
staffing. You know, you wantto understand are the staff employees of the
company or are they temp agency people? What's the longevity of the administration that's

(18:52):
been with that community. You know, it's just I think really important and
really telling when you look into thosepieces about what to expect when you walk
in through the front doors as aresident, and you know it's on everybody's
mind dealing with COVID in a placewhere people congregate, and obviously in an

(19:15):
assistant living you have multiple people congregatingwith each other. How have you handled
the COVID crisis over the past coupleof years and what is it looking like
for you now? It has beenthe most challenging three years of my life.
I won't lie to you about that. In the beginning, it was

(19:37):
a very scary time. I closedour doors pretty early because I was determined
that we were not going to haveto fight that fight, and we managed
to keep COVID out of our communityfor almost nine months without any positive cases.
We did, like everyone else,have an outbreak, but it was

(20:00):
managed pretty well and we were ableto end it pretty quickly. All of
our residents are now vaccinated. Itis mandated and required for all of our
staff to be fully vaccinated. SoI think that's going back to your last
question, also important to ask,you know, what are other communities doing.

(20:23):
The most heartbreaking part of COVID wasseparating our residents from their families,
watching people try to visit one anotherthrough a window or over a tablet.
That's just not what any of ussigned up for. So I felt like
I went from executive director to jailwarden for a period of time. So

(20:44):
we're happy that we opened our doorsto visitors. We just require masking,
but they're able to visit in commonspaces. Again, residents have the freedom
to come and go. So Ido think that with nations and the progress
that's been made, that we're pastthe times of isolation and quarantines and we're

(21:07):
learning to live with COVID now notfear it, And so going forward,
I expect that, you know,we're going to be able to maintain these
positive interactions and hopefully go back tohaving big holiday parties and making this really
feel like home again for our residents. That's awesome, and thank you again

(21:29):
for sharing that and obviously doing yourdue diligence to ensure that your residence and
your staff are safe during this pandemic. You know, assistant livings and memory
care programs can be a valuable resourcefor the families and loved ones living with
dementia. I'm certain that the familiesand the residents that reside at Spring Arbor

(21:56):
are benefiting from all that you do, and we think thank you so much
for being a valued partner in thecommunity. We like to thank the John
and Cathy Belcher Institute for the generoussupport of our community outreach and education programs.