By Jennifer Beach, LSW, MA, C-SWCM
I stopped at a facility to check in on my client John (81). He has been residing in a long-term memory care facility for about seven months. Things have been going well, overall. On most days, he seems comfortable. There are days John is not as comfortable, and he doesn’t want to follow the routine or participate for a variety of reasons. Just like for you and me, some days are better than others and some days are simply difficult. We may not have slept well, are experiencing pain, are worried about something, someone was rude, the day didn’t go as planned… all things that may contribute to the quality of our day.
Often, when individuals are living in a care facility, we seem to forget all the factors that contribute to their overall day.
When I stopped to see John around 2 p.m. one afternoon, the nurse told me that he was still in bed, as he was having a “bad” day. He reportedly “refused to get out of bed and was resistive to care.” John didn’t want any breakfast but was still in bed.
I went to John’s room and knocked on the open door. The blinds were drawn; the room was dark. “Hello, John,” I said, as he opened his eyes and saw me standing in the doorframe. I introduced myself and asked if I could come in. He said “yes.” I sat next to his bed, so I was eye level, and spoke softly, asking John if he was in pain. He said no, but he was trying to express something. I could see his mouth was dry and asked if he was thirsty. He shook his head, and his eyes opened wide, sending a clear yes, he was thirsty. I asked if he would like water or maybe juice and he said “yes.”
I found an aide to get water and juice, preferably in a cup with a lid and straw, as drinking when in bed can be tricky.
I came back to the room and asked John if I could elevate the head of his bed so he would be more comfortable drinking; he said “yes.” He quickly drank the liquids. Next, I asked if I could raise the blind so we could see what the weather was like. Again, a “yes,” and then in his own way, commented on how pretty it looked.
While we were visiting, a person walked in, opened his drawers and put his laundry away. I could see John looking at this stranger entering his room, going into his space and not knowing why. I said hello to her, introduced myself and asked if she was putting away John’s clean laundry. She said yes and we thanked her.
All small details, but they matter. Here are a few simple details that can make a difference in the quality of one’s day:
- Introduce yourself, look the person in the eyes. Re-introduce yourself every time. Living in a facility with 24-hour care, there are many different faces coming and going each day. It can take time to get to know someone, recognize their voice, their face and finally, their name. Most staff are in and out individuals’ rooms or apartments within a matter of minutes. Saying hello and introducing yourself is so important. It shows respect and builds trust.
- ALWAYS Let the individual know what you are doing. Caregivers should always tell someone what they are going to do before they do it. Never put hands on someone without letting them know. If someone touches us and we are not aware, we all would likely “be resistive.”
- It’s not what you say but how you say it. Tone of voice and the way something is phrased makes an enormous impact. Learning to ask versus telling someone what they are going to do is a game changer. For example: “Helen, today is Tuesday and you are scheduled for a shower, how does that sound to you?”
- Slow down. We live in a fast-paced world where we often multi-task. When one has increasing complex comorbidities, including hearing and vision loss paired with mobility issues, responses are going to come at a slower pace. Rattling off several commands in a row can be overwhelming and unrealistic.
- Again, Slow Down! Trying to rush someone to get to the shower, to an appointment, or to dinner can be difficult and counterproductive. Anticipating the time needed to do tasks should be excepted and built in their routine. We need to respect the pace at which each person functions best, and adjust care and support accordingly.
What seems like simple little details are actually important details that matter significantly and make a huge impact on a person’s day. Whether the issue is staff shortages, a need for increased training, understanding someone’s abilities and pace, our tone of voice, asking versus telling… all these details are important. If we want to help older adults have quality days, even with their challenges, we need to focus on the importance of the small daily details.
Original Article: https://www.northeastohioboomer.com/blogs/small-details-matter/