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Living with dementia: functioning from the heart

Deerfield resident Delver Matter (center) listens to music on an iPod on Jan. 30, 2014, while Jackie Waalen (left) and Keenan Luke help him use the device. (RiverTown Multimedia photo by Jordan Willi)

Editor’s note: This story is part of an ongoing series by Jalen Knuteson looking at Wisconsin’s long-term health care crisis. To see other articles in this series, click here.

As roles reverse, one of the most difficult questions a child can ask as they begin taking care of a parent is what is normal forgetfulness and what is dementia.

There is a major difference between a senior moment and having dementia.

Though, as people are fortunate to live longer than ever before, it's crucial to understand how to detect forms of dementia such as Alzheimer's early.

Early detection is one way to alleviate the need for care in long-term healthcare facilities which already have shortages of caregivers to take care of the residents.

With dementia comes a wide range of challenges that are not natural in the aging process. Instead of forgetting which day of the week it is and being able to figure out the answer on a calendar, people with Alzheimer's or another form of dementia may forget what season we are in.

St. Croix Aging and Disability Resource Center dementia specialist Nancy Abrahamson explained the progression of cognitive function of people with dementia.

"When we mature we think the best way to be is rational and logical," she said. "When you have dementia you lose that rational and logical ability. Instead you function from your heart."

St. Croix County dementia specialist Nancy Abrahamson

An immediate reaction in early stages of dementia is to avoid socialization for fear of not recognizing people and being humiliated. The Wisconsin state government and the Alzheimer's Association offer resources to combat isolation because it contributes to the progression of the disease.

St. Croix County hosts "memory cafes" in which people can meet in a "safe, comfortable and engaging environment" while seeking support as they live with the disease.

The goal is to provide support for those living with dementia, whether it be vascular, Lewy Body, Parkinson's, Creutzfeld-Jakob, or another type of dementia.

In Pierce County, skilled nursing and assisted living facilities have taken different measures to care for residents with dementia.

Socialization

Ellen Thompson, the administrator at Heritage of Elmwood Nursing Home, said the facility has recently decided it would be best to stop separating residents with dementia into memory care units.

"We recently integrated our memory unit residents in with the general residents," Thompson said. "Our general residents were more outgoing and had a more community feel, which is what we were hoping to achieve with all of our residents."

In the early- and mid-stages of dementia, it is common for people to become anti-social because socialization can become overwhelming.

At Heritage of Elmwood, the caregivers realize residents who have dementia require different levels of attention and care and they maintain extra focus on them.

"We combined our units and since we did, we've seen positive results with our residents that do have dementia," Thompson said.

Trained staff

Many facilities market and promote memory care units, but that marketing needs to be backed up with staff trained to care for residents with dementia.

Hiring and training dementia caregivers requires a special type of person, said Abrahamson, who used to be a director for a memory care unit.

"We didn't hire for skill," said Abrahamson. "We hired for respect for the elderly, compassion and a general interest in the elderly."

Being interested and respectful of the elderly is important to Abrahamson because in order to create a positive environment for people with dementia, patience and attention to detail are key.

"If you weren't interested in people, you were not going to be able to draw them out," Abrahamson said.

Given the demand for nurses being much higher than the number available, it is difficult for facilities to meet ideal standards.

"(Memory care) units need employees that are trained in communication and other techniques specifically for the population with (memory care needs)," Plum City Care Center Director of Nursing Dawn Davis said. "These units also need caregivers that are willing to work specifically with this subset of residents consistently for continuity."

River Falls Comforts of Homes administrator Kim Szymanski reiterated the need for familiarity between caregiver and resident.

"The biggest thing is that the residents with dementia need more structure and familiarity," Szymanski said. "They need daily routines in the same place with the same caregivers."

Which returns facilities to a familiar challenge: a shortage of caregivers.

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