What’s your best practice for memory care?

Conferences are a chance to learn from industry experts. Last week's Memory Care Forum in Austin, Texas, sponsored by the Institute for the Advancement of Senior Care, was no exception. The days were filled with fascinating presentations, but often the richest insights are shared during coffee breaks or while networking at lunch.

Long-Term Living took advantage of those water cooler moments to learn best practices actually in practice. We asked attendees one simple question: What do you think is a dementia care best practice that your facility employs?

Here are some of the responses. We invite those of you who might not have been able to attend to keep the discussion going at the virtual water cooler by sharing your own best practices in the comments section below or on our Twitter or Facebook pages.


"We just started a music care therapy. We select a few patients who have increased behaviors: wandering, agitation or anxiety. We get with their family members to learn their music preferences, and we put on these headphones a couple times a day. They just listen to music. Some dance. Some of them will keep it on for an hour, some of them for only five minutes. All of the wandering, the agitation goes away. They are calmer, more alert and their general affect is just happier."
—Sarah Stephens, RN,Glen Rose Nursing and Rehabilitation Center in Glen Rose, Texas


"I call it personal activity preference scrapbooks, which is not life-story books. Having pictures of the family and things that he's been in the past means nothing. Instead, it's objects of special value. I did this with my dad who has dementia, and this is what I teach. I put a picture of his World War II ship with the story on the back. It's laminated so staff can just take it out, read that and show that to him. He was a musician, so I had scores of easy music so he could see the notes on the page. I had poems of some of his favorite poets. These are interests that staff can use to engage him. That becomes the exercise. It works really well."
—Natalie Davis, activities and education consultant and owner of ActivTimes Consulting and Education in Dallas


"We do consistent staffing. We have two crews: Monday through Thursday and Friday through Sunday, same staff. We don't rotate them around unless we're short. It gives them consistency. We also encourage our staff to hang out with the resident when they're doing activities to help them engage in activities. We train new hires right off the bat because this is the expectation. We don't do like the other facilities. We don't correct a resident. If a resident says, 'Oh my husband is here,' we don't say, 'Oh no, he's not here, he's dead.' We just ask them to tell me about your husband. What does he look like? Why he's coming to visit? The resident can talk, and we'll listen. And have the familiar face of the staff stay with them."
—Bunleng Hill, director of nursing at Wellsville Retirement Community in Wellsville, Kan.


"You know how rehabbing old furniture is a big deal? I have an employee who loves to do that. So she went to the antiques store, and she found all these old TV cabinets that everybody's getting rid of. Our maintenance guys put them on rollers so I can roll it wherever I need it. Let's say you have an agitated resident but they love babies but they like that so we might hand them the baby and say 'The baby needs to be changed. Will you help me?' 'Yes.' Then we'll take them into their room with the cuddle station. You open it up. It has a bassinette. All the blankets are textured with the little knobby stuff, soft, satin. On the doors, she actually screwed in old nursery rhyme pictures and songs that we can sing them 'Twinkle, Twinkle Little Star' and things like that. We're doing another one for men related to radios. We put screwdrivers and stuff like that in there so that they can fiddle with it. And when they're not being used, they're closed off."
—Terri Howell, nursing home administrator for John Knox Manor II in Montgomery, Ala.


"The most effective top best practice I've seen, maybe it's because I'm an animal person, is the Eden Alternative program and incorporating that into the dementia program. I have seen a lot of positive effects on the residents' quality of life. If they're acting out, animals relax the resident. The animal has the sense of knowing when a resident is in pain or dying, so it's a calming effect for the family, staff and the residents. I've never seen them get aggressive towards an animal or a cat that goes into their lap or goes into bed with them."
—Barbara Bierstedt, RN, senior nursing consultant for Solutions in Houston


"We have a resident profile and that information that allows us to provide person-centered care. The profile helps us get to know what makes that person an individual and what their triggers are. We do a Montessori program, so it's basically a self-paced program, and we can personalize it towards them. If we do a game of bingo, not everyone will want to play bingo. Some people absolutely hate the number calling part and the repetitiveness. Why are you going to put someone in that position if it's something that they don't tolerate?"
—Jenny Castillo, executive director of Orchard Park in Kyle, Texas


"We receive training on specific Alzheimer's symptoms. Not all of our clients, but some of them are late-stage Alzheimer's, so I think it's really important for the staff to understand. For example, some of our clients won't go past a dark mat on the floor. They won't go past that doorway. They think it's a hole. We learned to pull up mats in their bedroom because that could be a fall hazard. Residents in the nursing home are responding better to the CNAs, nurses and housekeeping because the staff knows how better to approach the residents. In turn, I believe that makes the residents less scared."
—Amy Olson, RN at Yalobusha General Hospital, which operates adult day services and nursing home in Water Valley, Miss.


[Editor's Note: In January 2016, Van Dyk Park Place created Lighthouse Connections, an informal program for residents who need assistance but whose dementia doesn't yet require them to be in a secure, supervised dementia unit. Lighthouse is offered to residents identified by staff as needing more attention and offers sensory-based activities.]
"I think the best practice is really bringing it to a smaller group, a group that's manageable. It's up to nine now, but it still gives it more of a chance to be individualized. They really were being lost in the big population and so, for example, they might not even go to an activity. They might just sit in their room while an activity is going on, and we would see them and say, 'Can we engage them somehow?'"
—Nancy Soto, vice president of strategic planning at Van Dyk Healthcare in Ridgewood, N.J.


"We try to have a care plan meeting within a week or two of their admissions so we can find out through their family what did they do and how did they do it. You find out all kinds of good stuff like mom got up at 3 o’clock in the morning and cleaned the house. That was just what she did. So when mom’s getting up at 3 o’clock here, the staff knows not to try to get her to stay in bed. Just get her up, bring her out and have her fold towels or something."
—Kristine Martinez, director of nursing at Brookside Retirement Community in Overbrook, Kan.


"I think the best type of practice would be using an evidence-based model. I think it’s appropriate to make sure even direct care staff have some type of training. We do actually get trained to be certified dementia care practitioners. Not everyone is certified because it has to be done in phases. At least two times a year, direct-care staff has the opportunity to become certified dementia care practitioners because the owner is an educator."
—Enjoli Harrington, MSW, social work director at Advantage Management Group in Harper Woods, Mich.

Topics: Activities , Alzheimer's/Dementia , Articles , Clinical , Facility management , Leadership