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2023 APR Family Caregivers Blog

Family Caregivers' Blog is available to share helpful information to support families caring for those with dementia.

Vibrant Discussion about Facility Selection!

Today, Ms. E's mother, who lives alone, initiated a conversation about selecting a facility. She experiences loneliness, sadness, mild dementia, anxiety, and visual impairment. In the case of admission to a public facility, one typically starts by receiving home care services such as assistance with bathing from Health Authorities or Private Agencies while still living at home. Gradually increasing participation in day programs and utilizing other community resources may lead to transitioning to a facility when home care becomes challenging. Ms. E's mother is currently in this process and has submitted three preferred facilities to the home care provider for consideration. They are contemplating whether the current neighborhood or Ms. E's proximity would be preferable.

Other participants have undergone similar processes, with their families already residing in care facilities. When a vacancy in Mr. A's facility was announced, he received a call urging him to decide and move in within 48 hours! Admission to public facilities requires a decision within this timeframe, although there are exceptions. Ms. A had been waiting for a vacancy, but when the call came, and the strict 48-hour deadline was mentioned, she felt mentally unprepared. Everyone empathized with her sentiment. Ms. A had been caring for her husband at home, mentally pushing herself until the last moment, but she found it challenging to prepare emotionally. She described feeling mentally and physically disjointed, a sentiment echoed by Ms. B regarding her mother's situation.

Participants also shared advice, suggesting that preparing for a sudden move might involve packing, like going on a 2-3 day trip to be ready even if the call comes unexpectedly. They acknowledged that mental preparedness is elusive, with shared understanding among participants.

Once admitted, it's challenging to determine whether visiting the facility immediately is appropriate. Some facilities advise against visiting for the first 2-3 weeks until the resident adjusts, emphasizing that family members shouldn't see until then. While individual experiences vary, listening to advice from facility staff can be beneficial. Nevertheless, everyone gradually adjusted to facility life, including family caregivers adapting to their new routines.

Various Aspects of Communication

According to the staff, Ms. A's mother resides in a facility, "it seems like her mother no longer understands English well." Since it's an English-based facility, the staff's attempts to communicate in English haven't been very effective either. However, even when Ms. A speaks to her mother in Japanese, recently, there hasn't been much response. It's said that as dementia progresses, individuals who were once fluent in English may revert to Japanese. While some individuals experience this transition, others, regardless of language, struggle with comprehension. It appears that Ms. A's mother is finding language comprehension challenging.

In such cases, communication relies more on visible cues like tone of voice and facial expressions.

We discussed the importance of visual cues. For instance, when you want someone to stand up, you might say, "Let's stand up," while rising from your seated position. You can say, "Let's go outside," walk towards the door, open it, gesture towards the outside, and exit together. Instead of instructing them to take food out of the fridge, place the meal in front of them and say, "Let's eat."

Relying solely on verbal communication can lead to challenges and stress for both parties. Let's incorporate visual cues! While it may be assumed that understanding English declines in a facility setting, comprehension difficulties extend beyond language. Therefore, it's crucial to communicate this to the facility staff.

Visual Cue

When you want someone seated to stand up, say, "Let's stand up," while you also move from seated to standing. If you're going outside, say, "Let's go outside," while you walk towards the door, open it, and show them the outside before stepping out together. For meals, instead of saying, "Take it out of the fridge and eat," place the meal in front of them and say, "Let's eat."

Relying solely on verbal communication can often lead to misunderstandings and frustration for both parties. Incorporating visual cues can make interactions smoother and reduce stress. In care facilities, it’s crucial to remember that it's not just a matter of language comprehension; sometimes, the ability to understand language deteriorates. Informing the facility staff about the importance of using visual cues can be very helpful in such cases.

Visual cues can improve communication and make daily activities more manageable for individuals with dementia. For a more supportive and practical approach, try integrating these cues into your caregiving routine.

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