April 2019

A Fond Farewell and A New Beginning


Activity Director Dana Jensen Is leaving Olive Branch Estates to start a new adventure in Tennessee. Dana’s last day will be April 6th, 2019.

Dana’s infectious smile and unbounding energy has touched the lives of everyone who graces our doors! She has been a tremendous friend and source of joy for the people who live here. She will be greatly missed!

Thank you, Dana, for making such an impact on Olive Branch Estates. We are sad to see you go, but we wish you success with your new Adventure!

thank you

Meet April’s Every Day Hero!

The definition of an everyday hero is a person of integrity with a will of compassion to serve others. At Olive Branch, all our staff are every day hero’s who go above and beyond to provide exceptional care for people every day! Each month we will highlight one of our staff so you can learn all about our everyday heroes!

Betty
Betty Valenzuela

Interesting Facts: Betty speaks Spanish fluently, and loves to paint in her free time. She enjoys hiking and spending time on a kayak in the summer.

Career Choice: Betty chose a health care career because she is passionate about helping others. The feeling of helping and caring for others is what Betty finds rewarding. She gives expecting nothing in return.

Every Day Hero: Betty has been a CNA with Olive Branch for 2 years. Her co-workers describe Betty as very kind and helpful. Betty strongly believes in teamwork and is always willing to jump right in and help anyone! She is known for going the extra mile. She is a valuable member of the team!

Thank you, Betty, for all that you do to enrich the lives of the Olive Branch Family!!!

April is Poetry Month!

Charming Spring

Reminiscent melodies
serenade the morning breeze.

Feathered creatures’ nest with care
in cherry blossoms pink and fair.

Perfumed scent of roses flow.
Tiny blades of green grass grow.

Misty showers soak the earth,
glorious colors come to birth.

Gathering clouds come and go,
rain, sun, and vibrant bow.

Dainty petals, fancy flair,
dancing in the warm, sweet air.

Violets, yellows, purest white,
graceful, gentle, welcomed sight.

Thank you, oh sweet lovely Spring,
patiently waiting the charms, you bring!

Author Patricia L. Cisco

April_sidebar_Header

Happy Birthday

Sharon 4/12

Global Astronomy Month

Poetry Month

Golden Rule Week April 1–7

No Housework Day April 7

Barbershop Quartet Day April 11

Scrabble Day April 13

Easter April 21

Hug an Australian Day April 26

Notable Quotable

“As we express our gratitude, we must never forget that the highest appreciation is not to utter words, but to live by them.”

~ John F. Kennedy

“The day the Lord created hope was probably the same day He created Spring.”

~ Bernard Williams, philosopher

Upcoming Events:

Bi-Monthly Family Meeting

Monday April 22nd 2019
6pm-7pm

Mother’s Day Tea

Saturday May 11th, 2019
10am to 11am

Senior Prom

Tuesday May 23rd, 2019
4:30pm-7pm

Reminders:

Please be sure to check your loved one’s folder for mail. Folders are located at the front desk.

March 2019

Peaceful Pathways

Introducing Peaceful Pathways, the name of our new Dementia Care Program at Olive Branch Estates! In the November newsletter I gave an overview of the preparations being made to define how Olive Branch provides dementia care. I am excited to announce we are ready to roll out our new program! The official kick off date for our new program is Monday April 1st, 2019. Our Peaceful Pathways program will include:

1. Bi-Monthly Family Meetings. The meetings will be a place for families to learn more about the dementia disease process, ask questions and give input to better improve our facility. The Director of Nursing will be present for all meetings. Outside health care professionals will be brought in from time to time for learning/educational opportunities.

2. New Activities Programming: New structure to the daily activities that will be tailored to the different levels of functioning of our residents. The new design will include more physical activity, daily music program, daily cognitive exercises and sensory stations between scheduled activities. More community outings and activities will be offered during the warm months. We will be offering more special events with family invitations.

The new activity design will create stimulation for the physical, mental and spiritual needs of the residents every day. Each resident will have an activity page that lists the activities that are appropriate for their cognitive and functional level.

3. Individual Behavior Plans and Interventions: All residents will have an individualized plan to redirect anxiety, agitation, wandering or just create moments of joy. A form will be sent out this month to families to gather more detailed information about likes and dislikes, specific activities and music that is meaningful to each person. The staff will have direct access to this information to give them the tools for a successful re-direct when needed.

4. Minimal use of Psychotropic Medications: The individualized behavior plans will be used before any PRN (as needed) medications are used to control anxiety or behaviors. The goal is to reduce or eliminate the amount and frequency of psychotropic medications given. Right on the description of the medication it will list interventions specific to the individual that needs to be tried before giving the medication.

5. Program Training for Staff: All Staff will be trained on the Peaceful Pathways Program in March to ensure understanding of the program and continuity in approach.

am excited to bring our care to the next level. I welcome any comments or suggestions along the way!

Heidi Lohre RN

IF TRUTH WERE TOLD

Everybody has a story
They are glad to tell you all
How they grow to great heights
And how they had a fall
It is just I am interested
I sit there to hear the tale
It may take hours
It never turns stale

R. Stahl

Family Tree

Happy Birthday

David S. 3/13

Irish-American Heritage Month 

Optimism Month 

Mardi Gras March 5 

International Women’s Day March 8 

Pi Day March 14 

St. Patrick’s Day March 17 

Notable Quotable

“But Shakespeare’s magic could not copied be; Within that circle none durst walk but he.

~ John Dryden, English poet

women_fist

“If men can quilt and take over the kitchen, then women can pick up a wrench and fix a leaky pipe.”

~ Hanna Rosin, writer

Activities: Dana Jensen

Painting Fun!

Baking!

February 2019

Dementia and the Effects on Speech and Communication

Dementia affects the chemical and physical structure of the brain as the disease progresses. Memory loss is often the most associated symptom of dementia; however, every level of functioning is affected by dementia.

The area of the brain responsible for language and communication is affected by the cell and nerve damage that occurs in the brain from the formation of plaques and tangles, nerve and cellular damage and brain inflammation. These changes affect the individual’s ability of speech, including difficulty finding the correct words to use, vagueness of speech, very limited language ability, and garbled speech. In the final stage of dementia, an individual will often lose all ability to communicate verbally

Dementia can affect communication in two major ways. It affects the way the person with dementia interprets information and it affects the way the person expresses him / herself. Difficulties with speech are often one of the first noticeable symptoms in people with dementia, particularly those with Frontotemporal Dementia.

In the early stages of dementia, persons may carry on normal conversations, but simply forget a word, use the wrong word, substitute a word that sounds familiar, or have difficulty resuming a conversation after an interruption. However, in people with dementia, language problems eventually become more noticeable. Communication problems that were initially just minor inconveniences become much more severe and difficult in the later stages of dementia, as language and conversation become more greatly compromised. It becomes harder for individuals with dementia to remember or to learn new phrases, slang, or expressions It is also more difficult for people with dementia to hold several ideas in their heads at once. Therefore, they may jump from topic to topic without completing a coherent sentence. 

It also becomes increasingly difficult for persons with dementia to understand what others are saying. In addition to not understanding certain words, rapid speech, high-pitched speech, and complex speech all become difficult to follow.

Communication Skills Loss Through the Stages of Dementia

Early dementia / Alzheimer’s:

Some difficulty concentrating and following conversation; difficulty finding the right words when speaking or writing; losing train of thought when speaking; repeating oneself. Usually the person with dementia is aware of these problems and may try to hide or overcompensate for them.

Moderate or mid-stage dementia / Alzheimer’s:

Difficulty following along with group and one-on-one conversations; losing train of thought when speaking; increased difficulty finding the right words when speaking or writing; loss of vocabulary, like proper nouns and slang terms; substituting words that sound the same or inventing new words; difficulty following storylines in books, TV shows, or movies; difficulty following directions; poor recall when telling others’ about recent events; increased used of gestures to communicate.

Severe or late-stage dementia / Alzheimer’s:

Inability to follow along with anything other than simple conversations and instructions; increased loss of vocabulary, including personal information and loved ones’ names; inability to follow storylines in books, TV shows, or movies; tendency to talk about nothing, rambling, or babbling.

End-stage dementia / Alzheimer’s

Inability to speak or otherwise respond verbally; difficulty or inability to understand when spoken to; all communication may be done non-verbally.

What to Expect as Communication Problems Increase:

As dementia progresses, people with dementia may use a set of common phrases or words more frequently, In later stages of dementia, this small set of repetitive language may turn into a babble of language to the point that the individual with dementia can no longer express what they want or need with words.

Many people who have trouble communicating and have memory problems can remember songs from their youth or years past, since music and melodies are stored in a different part of the brain’s memory center than words. Therefore, singing songs with loved ones with dementia might serve as another way to connect.

In the later stages of dementia, barriers to communication become greater and the ability to communicate may decrease until there is minimal to no communication. Individuals with dementia might use curse words (a strange quirk of diseases that sap language skills) or grunting may replace words. As the ability to form and understand language fades, recognition of the person’s own name may linger longer than understanding of other words. That said, a caregiver’s physical presence may be appreciated long after words no longer make sense or even after the person with dementia no longer recognizes people around him / her. In addition, the person might still be able to understand one’s tone of voice at this point.

Effectively Communicating with Someone with Dementia

As dementia progresses and the ability to communicate decreases, effective communication becomes increasingly more important for both the caregiver and the individual with dementia. Touch is an important means of communication. If the person can tolerate it (and some people cannot), caregivers can give a kiss, hold hands, give a very gentle massage, or lightly brush hair.

If a loved one is not carrying on conversations as he / she once did, it does not mean that he / she isn’t listening or doesn’t want to engage. Often, the individual with dementia cannot recall the word he / she wants to use. Fortunately, there are several strategies that can effectively help with communication:

  • Speak slowly, with proper pronunciation and grammar.
  • Avoid lengthy streams of conversation and going off on tangents. Instead, try focusing on one idea or short story at a time.
  • follow the other aspects of a loved one’s conversation to figure out what the individual is trying to say. Don’t be afraid to ask him / her if he / she really meant another word but avoid over-correcting.
  • Be patient. The person may just need more time to respond. Do not fill the silence by asking the question again or asking another question, it adds more confusion and restarts the processing time again.
  • Identify yourself before starting the conversation and refer to the person by name. This will get the person’s attention and help to bring awareness of who you are.
  • Keep it simple. Use basic language and keep stories brief. Try to talk about only one topic at a time. Avoid slang, nicknames, and idioms. Give simple explanations. Reminiscing can be healthy, but avoid asking, “Do you remember when…?”
  • Minimize distractions. Turn the radio or television off and remove things from sight that are visually distracting. If possible, sit down face-to-face in a quiet, calm place. Be mindful of the tone, pitch, and speed of your voice. Keep your voice friendly, low, and slow.

The Importance of Non-Verbal Communication:

Communication is more than just language and speech. Non-verbal communication is increasingly important as an individual’s dementia progresses. This may include hand gestures, body language, facial expressions, eye contact, touch, and even actions. For people with dementia who get frustrated or angry when having a conversation or can no longer find the words to express themselves, non-verbal communication can still be an efficient way to connect with others.

Use non-verbal communication to reinforce a message. For instance, ask a person if they want something to eat and then point to the refrigerator to help clarify the question. Convey agreement or disagreement. Nodding “yes” or shaking your head “no” will help the person with dementia understand how you feel. A warm smile or hug conveys a message just as strongly as words can.

Heidi Lohre RN

Reference: www.dementiacarecentral.com

February_sidebar_header

Happy Birthday

Martha Buss 2/8 

Mend a Broken Heart Month 

Library Lovers Month 

Bubble Gum Day February 1 

Groundhog Day February 2 

Celebration of Love Week February 10–16 

Valentine’s Day February 14 

A Big Thank You!

Thank you to the students from Chanhassen High School. Students Now, Leaders Forever came out and led morning stretches. We did a valentine craft followed by lunch.

Do Not Ask Me to Remember

Do not ask me to remember, Don’t try to make me understand,

Let me rest and know you’re with me, Kiss my cheek and hold my hand.

I’m confused beyond your concept,

I am sad and sick and lost. All I know is that I need you To be with me at all cost.

Do not lose your patience with me, Do not scold or curse or cry. I can’t help the way I’m acting, Can’t be different though I try. Just remember that I need you,

That the best of me is gone,

Please don’t fail to stand beside me,

Love me ’til my life is done.

– Owen Darnell

Come Join Us!

March Events:
Carolyn Jaynes: Music Entertainment Saturday, March 9th @ 1:00
Gloria Jesperson:
piano, accordion Friday, March 15
th @ 1:00

January 2019

Hospice

Most people envision Hospice as a service that is brought in to care for a person who is moments, days, or a few weeks from dying. Hospice is widely accepted under these terms as appropriate and the best way to keep someone comfortable right at the end of life. Waiting until Imminent death is a widely held misconception about Hospice and the benefits associated with it. Some patients and family members fear that choosing hospice means that nothing more can be done. But this is not the case. In fact, hospice patients often receive a lot of services to help improve the quality of life.

What is Hospice?

Hospice is a philosophy of care that focuses on comfort and quality of life for people suffering from a serious or terminal illness with a life expectancy of 6 months or less. The focus shifts from seeking a cure or invasive treatments to managing symptoms and pain. Hospice focuses on the whole person; body, mind and spirit. Hospice provides guidance and support to patients and families while preparing for end of life.

A Hospice team consists of trained doctors, nurses, social workers, chaplain, home care aids and other health care providers. The team may include physical and occupational therapists, massage therapists and music therapists. Some Hospice Providers offer pet therapy, registered dieticians and volunteer services. Hospice Providers are governed by Medicare and have a set of rules and regulations that define the Medicare coverage and guidelines needed to qualify for the Hospice Benefit under Medicare part A.

What are the Qualifications for Hospice?

The transition from chronic conditions to end-of-life can be subtle. Some disease processes are terminal but can take years from onset to conclusion. Alzheimer’s, COPD and Congestive Heart Failure are some examples of terminal illnesses that can be managed for years before death occurs. The following are some of the indicators that help determine if it’s time for Hospice:

▪ Multiple Hospitalizations or ER visits, Recent or progressive weight loss

▪ Difficulty swallowing,  Decreased communication

▪ Decreased caloric/fluid intake, Increased number of infections

▪ Changes is comprehension, Increased incontinence

▪ Changes in physical ability, Decreased communication

▪ Increased shortness of breath, Wounds not healing properly

▪ Increased edema, Decreased stamina and endurance

What are the Benefits of Hospice?

Hospice offers a familiar environment. Hospice providers come directly to the patent’s home. While some people choose to relocate to a specialized Hospice Home, it is not required.

Hospice provides a comprehensive plan. The key to providing comfortable final days is a comprehensive plan that involves a team of medical and health care professionals, who address all aspects of a patient’s illness with importance on controlling and reducing pain and discomfort. The hospice team works closely with the facility team and family to develop the plan of care. The use of massage therapy, pet therapy and music therapy can reduce anxiety and bring enjoyment to the patient.

Hospice provides equipment as it is needed. Hospice provides hospital beds, wheel chairs and lift equipment as physical changes progress. The cost is covered under the Hospice benefit and can be delivered on site within a few hours.

Hospice provides extra support for loved ones and families. While the facility staff continue to provide the day to day care, the hospice team provides additional support and attention for the patient. Families are also offered guidance and support during the dying process and after through counseling and bereavement services. Hospice nurses are on-call and can make a visit 24 hours a day to address any new changes or concerns.

It Respects a patient’s wishes. This is an essential element of hospice care. By placing a loved in hospice, families can focus on spending time with the patient and not dealing with the red tape and extensive procedures of a hospital environment. With physical, emotional and spiritual pain addressed, patients and loved ones can spend the precious time remaining focusing on the things that are important to them.

Conclusion

End of life changes can be frightening for loved ones and families. The extra guidance and support from a hospice team can help patients and families cope and prepare for death. To receive the full impact and benefits of Hospice, it should be implemented sooner rather than later.

To find out more about Hospice, qualifications orHospice providers in our area, please contact the Director of Nursing for more resources.

Heidi Lohre RN

heart_hands

Blessings

Blessings, little and large Make each day beautiful Being such we do our duty To conceive, to grow without being snooty

Of course there is grace for what we eat For all, but we are discrete For shoes to wear on our feet For a crossword puzzle when complete

Of course for a horse to ride With a companion at my side Discussing the troubles that we know Away, away, we go, go, go

A place for a picnic lunch A restaurant for brunch A park bench to set upon this day To pass the time away

-R. Stahl

Braille Literacy Month 

Soup Month 

Cuddle Up Day January 6 

Make Your Dream Come True Day January 13 

Popcorn Day January 19 

Martin Luther King Jr. Day January 21 

Puzzle Day January 29 

Notable Quotable

“Exploration is really the essence of the human spirit.”

~ Frank Borman, NASA astronaut

 

January Birthdays

In astrology, those born between January 1–19 are Capricorn’s Goats. Goats are focused on lofty goals; these hardworking souls prevail with grit and resilience. Those born between January 20–31 are Water Bearers of Aquarius. Water Bearers are deep-thinking intellectuals, unafraid of exploring new ideas.

Betsy Ross (folk hero) – January 1, 1752

Joan of Arc (French heroine) – January 6, 1412

Zora Neale Hurston (writer) – January 7, 1891

David Bowie (musician) – January 8, 1947

Alexander Hamilton (politician) – January 11, 1755

Faye Dunaway (actress) – January 14, 1941

A.A. Milne (writer) – January 18, 1882

Edgar Allan Poe (writer) – January 19, 1809

Benny Hill (comedian) – January 21, 1924

Virginia Woolf (writer) – January 25, 1882

Bessie Coleman (aviator) – January 26, 1892

Tom Selleck (actor) – January 29, 1945

Activities:
Dana Jensen

Happy New Year all! I hope you all had a great holiday season. We are ready for the New Year hear at Olive Branch. We have so much planned.

Highlight Event

February 9th 1:00 p.m.

Kevin Doely, Musical Ventriloquist: See a true storyteller, comedian and amazing puppetry with ventriloquist Kevin Doely, a minister from Coon Rapids. He uses life like vent figures and puppets, blending comedy, storytelling, music, and audience participation that will make you laugh and laugh and laugh. Oh, did I forget to tell you, you are guaranteed to laugh!

Come Join Us!

December 2018

Music and Memory

Most of us have experienced moments when an old song comes on the radio that triggers vivid memories and emotions from our past. The memories may include people we used to know, places we have been, and the emotions tied to that time and place the song takes us back to. What is the neuroscience behind the ability of music to evoke such strong memories of the people and places from our past?

The answer to that question is complex with documentation from a number of studies revealing how the brain is stimulated and memories triggered by music. Studies have found that listen to music engages broad neural networks in the brain, including regions responsible for motor actions, emotions and creativity. 

The part of the brain that is activated with music is located in the medial prefrontal cortex region right behind the forehead and is one of the last areas of the brain to atrophy over the course of Alzheimer’s disease. According to doctors at the Mayo Clinic, “musical memories are often preserved in Alzheimer’s patients because the area of the brain associated with musical memory are relatively undamaged by the disease.” (Institute for Music and Neurologic Function, 2018)

What seems to happen is that a piece of familiar music serves as a soundtrack for a mental movie that starts playing in our head. It calls back memories of a particular person or place, and you might all of a sudden see that person’s face in your mind’s eye or recall a specific memory of a time and place. 

In 2012, an initiative was created to reduce the use of psychotropic medications for dementia patients in nursing home settings. The trend of using sedation through medication to control behaviors was no longer acceptable. The expectation became to eliminate or reduce psychotropic medications to the lowest effective dose with periodic review to determine if the medication was still needed.

The focus shifted industry wide to include Assisted Living settings. Non-pharmaceutical measures were to be put into place to handle behaviors with medications shifting to secondary options only if non-pharmaceutical measures failed. Individualized plans and engagement through activities became a focus. With research and the information revealed, music has taken on a bigger role in caring for residents with memory issues. 

Music therapists who work with Alzheimer’s patients describe seeing people “wake up” when the sounds of loved and familiar music fill their heads. Residents after months or even years of not speaking at all, begin to talk again, become more social and seem more engaged by their surroundings. Some Alzheimer’s patients begin to remember names long forgotten, even remember who they are.

Connie Tomaino is one of music therapy’s pioneers. She founded the Institute for Music and Neurologic Function to encourage study of the effects of music on the brain. More than 37 years ago, she walked into a dementia unit carrying her guitar and looked at the patients. “Many were overmedicated. Half of them were catatonic and had feeding tubes. The ones that were agitated had mitts on their hands and were tied to wheelchairs,” she says. “I just started singing ‘Let Me Call You Sweetheart.’ Many of the people who were considered to be catatonic lifted up their heads and looked at me. And the people who were agitated stopped being upset. Most of them started singing the words to the song.” (The Healing Power of Music, 2015)

Tomaino found that even some late-stage Alzheimer’s sufferers could respond to songs meaningful to them. “One woman who was nonverbal — after one month, she started speaking again. She said things like, ‘The kids are coming, I have to get home to make dinner.’ They were memories and words elicited by the songs.” Her advice: If someone you know is in the early stages of Alzheimer’s, start associating key songs with family members or important ideas. Later, those songs may trigger that association. (The Healing Power of Music, 2015)

Researchers are finding new ways to use music as part of the treatment of dementia. Music is so much more than an activity to pass the time. Evidence supports that music can be key In positively impacting mood, behaviors, and stimulate memory. 

As we begin to define our way of caring for dementia at Olive Branch Estates, music will become a bigger part or our activities and day to day tools to help redirect behavior, improve moods and stimulate memory for those we care for. I highly encourage you to utilize music as a gift for your loved ones this holiday season!

Heidi Lohre RN

Chef's Corner:
Ryan Schmitt

I hope everyone had a wonderful Thanksgiving with their families. We had another great turn out here at OBE. It was great to see the residents and family members having a good time.

We will have a Christmas lunch held at noon again this year. Please let us know if you would like to attend.

I wish you all a Happy Holidays!

Poetry by Bob

Listening is a delicate art
A mouth that is shut is the best place to start

With an open mind receptiveness improves
Ideas flow in and fill the grooves

The speakers, we will find, will even flow and glisten
If we will only concentrate and listen

Absolutely no limit to learning
If our ears are open we will fill the yearning

Should we dedicate ourselves to seek the word?
Comments, asides, and even whispers are heard

From children we hear the sound of thrill
They touch the ear with beauty so shrill

The aged voice so low and in muted tone
Tells us of the past and we seem so alone

From the scholar we hear of great detail
His in depth knowledge causes our mind to sail

These and many more are only a start
Yes, yes, listening is a very delicate art

Christmas Pics

Activities:
Dana Jensen

We are ready for Christmas here at Olive Branch. And the New year is upon us.

Thursday, December 13th Chef Ryan will be doing a Food game at 2:00. We are going to close our eyes, try food and see if we can guess what it is. Please join us for the fun! We will also be making a trip to the Minnesota Arboretum to look at the Christmas lights and maybe a little window shopping to end the visit.

If you have not already, please check out and like our Facebook page. You will find helpful articles and many photos of what we are doing her at OBE.

November 2018

Defining our Dementia Care

Over the next several months, Olive Branch will begin to define how we care for our residents with dementia. Processes and systems will be put into place using evidenced based procedures and best practices to accomplish the following goals:

  • Personalized plan of care for each resident
  • Personalized non-pharmaceutical interventions for behavior management
  • Increased stimulation and engagement
  • Holistic approach acknowledging the needs of body, mind and spirit
  • Modifying activities based on level of cognition

The above goals will be achieved by:

  • In depth training of all staff in all aspects of dementia. This is in addition to the required 8 hours of new hire training and additional 2 hours each year required by the Minnesota Department of Human Services.
  • Cognitive testing on each resident to identify stage of decline. The Director of Nursing is responsible for performing the assessment using a test referred to as the SLUMS assessment. (Saint Louis University Mental Status Examination)
  • Collaboration with Physicians, Pharmacy and Families in a team approach to care
  • Collaboration with Activity Director to Add/Change/Modify activities according to cognitive scores. Goal is engagement, socialization and satisfaction
  • Evidence based utilization of music therapy. (next Month’s newsletter topic)

Nursing has already began laying the foundation by changing all residents plan of care to have services scheduled at specific times that meet the needs of each individual preferences. Cognitive testing is under way and interventions are being added to help manage behaviors without medication.

Great care happens daily at Olive Branch. We have an amazing team of dedicated direct care staff. We are excited to raise our standard of excellence even higher to a whole new level!

Heidi Lohre RN

Christmas is Coming!

Christmas is just around the corner. Here are a few gift ideas that could help bring smiles to your loved one!

Memory Box – Small tote filled with items that will trigger pleasant memories and reminiscing. This can be a useful tool to start conversations from long term memory and help redirect behaviors. Some examples:

A memory box for dementia can also be effective at combating bad moods, or for when an individual is feeling agitated, restless, or upset.

When creating Memory Boxes for Dementia use, keep the following tips in mind:

Try to include items that use a variety of senses, items to read, touch, and smell Variety is key; include objects from different areas of the person’s life and different periods

Here are some examples of items that can be included:

A favorite book – Photos of family, friends, and important life events that trigger memories

An enjoyable smell, such as perfume,

souvenirs, tickets (an old football season ticket, for example), memorabilia, etc. Items that reminds them of their most enjoyable job/vacation. Objects that have enjoyable/funny stories associated with them

An important part of a memory box can also be a short summary sheet, this should list all the items included in the memory box, and the reasons why they were added.

A Summary Sheet can be especially useful in care homes, where there may not always be a family member available who knows the complete history behind all of the items.

Music

Researchers are finding new ways to use music as part of the treatment of dementia. We will explore this in detail next month. Evidence suggests that an MP3 player loaded with favorite music and a set of comfortable headphones (the size of ear muffs) can make a big impact to memory, stimulation, emotional well-being and engagement. Here are some suggestions:

MP3 player or iPod nano (does not need to be expensive)

Music from the 40’s, 50’s or 60’s depending on what era they enjoyed most!

Sing along type songs (Let me call you sweetheart, You are my sunshine, etc.)

Traditional church hymns

Big band/ Polka music.

Heidi Lohre RN

Chef's Corner:
Ryan Schmitt

Fall is officially here and that means holiday season is just right around the corner.

This year we will be hosting a Thanksgiving lunch here at OBE which will begin at 12:00 Noon.

Please RSVP with our activities director, Dana at 952-448-4800 or email: dana@olivebranchestates.com before the November 16th deadline if you plan on attending. I hope to see you there!

Food Demo with Ryan Tuesday, November 20th

10:30a.m.

Come join us!

Happy Birthday

Wayne Troyer – 11-1

Celebrating November

Novel Writing Month

Gratitude Month

Inspirational Role Models Month

Love Your Red Hair Day November 5

World Kindness Day November 13

Thanksgiving Day: U.S. November 22

Cider Monday November 26

Entertainment by:
Kent Appeldoorn

November 29th
12:00 Noon

Getting Ready for Halloween!

Making Memories

Activities:
Dana Jensen

As the warm weather turns to cold, the activities will change. This winter I am looking at more baking, a field trip to the Minnesota Arboretum, crafts and games to keep us warm and busy.

October 2018

Reality Orientation vs Validation Therapy

Last month we explored the reasons behind memory loss and the changes that occur in the brain. This month we are going to focus on how to approach memory loss in our loved ones. First it is important to understand what the definitions of Reality Orientation and Validation Therapy are. 

Reality Orientation is presenting information about time, place or person to help a person understand their surroundings and situation. For example, a person with dementia would be continually reminded that she is 89 years old and that her mother passed away 20 years ago. The goal with reality orientation is to maintain and sustain as much cognitive functioning for as long as possible at a higher functional level. Reality orientation strives to assure the person that they are safe and that the world makes sense. 

Validation Therapy emphasizes empathy and listening and is not concerned with orientating a person back into our reality. The thought process behind this approach is that instead of focusing on correcting a misconception, it places the emphasis on the possible feelings and thoughts behind a person’s behaviors and the underlying emotional needs. 

 One basic idea behind validation therapy is that people who are in the late stages of life may have unresolved issues that drive their behaviors and emotions. The way caregivers and family members respond to these behaviors and emotions can either make them worse or help resolve them. 

Reality vs Validation: In truth, both approaches have their purpose and place in responding to a person with dementia. The trick is to be able to discern what approach should be used within any situation. Within the early stages of dementia, using reality orientation to remind a person of the time of day, location or upcoming events is completely appropriate. Reality at this stage can help a resident regain their bearings and regain control. In later stages, it is still appropriate to orient to the time of day. 

“No it is not bedtime, it is morning, do you see the sun shine outside? Now we are going to eat breakfast.”  However, as the dementia progresses, and the memory loss becomes more significant, Validation Therapy begins to lead the way in our responses. 

What’s the best way to respond to someone with dementia if she’s anxious and yelling out for her mother who passed away many years ago? 

Reality Therapy is logical and instinctual. The thinking is that things would be all right if only the person with dementia could get the facts straight However, for Reality Therapy to work, people with dementia need to have fully functioning memories — which is exactly what they have lost. (Moore, 2010, Alzheimer’s Association, 2011, n.d., Snow, n.d.) 

Tell a dementia patient that her mother has died, and one of two paths will unfold, both with the same outcome. Either she will deny that her Mother is dead (“I just saw her this morning before school, and she was fine!”), or she will believe it to be true, grieving and in shock as she takes in the news for the “first time”. In either case, there will be high emotional turmoil. Soon, she will entirely forget the incident, though she will still carry with her a feeling of great upset. Later, she will again be 8 years old, waiting for Mother to pick her up after school. Repeated applications of Reality Therapy end no differently. So, what should care givers and family do instead? Validation Therapy gives the highest value to the emotional well-being of the person with dementia. (Alzheimer’s Association, n.d., p. 66) It also leads us to ask: is it really a problem that sometimes this woman with dementia believes that she is 8 years old and that her mother is just about to arrive? (Alzheimer’s Association, 2011) What if we didn’t try to correct these errors? Wouldn’t that allow care partners to help preserve her emotional well-being, dignity and calm?

Not attempting to drag the dementia patient out of their reality can be the most difficult aspect of using Validation Therapy for caregivers. It requires them to knowingly accept what is not “true,” and sometimes even to actively tell lies. To do so goes against all training to always tell the truth — especially to one’s elders.

Do care givers really need to let untruths stand unchallenged? Yes. Sometimes this is truly the wisest path. Lies are not told to mock the person with dementia, hurt their feelings, or exploit their weaknesses. Instead of looking at our responses as “lies” we can look at our responses as higher truths. The person with dementia is living in a former time in their memory, and as caregivers, we are going back to live in their truth from the past. The goal is to give any person with dementia a high-quality life where they are safe, comfortable, and can live with intact dignity and positive experiences. (Alzheimer’s Association, 2011)

Important information about unmet needs is buried in dementia patients’ mistaken information. (Moore, 2010, Alzheimer’s Association, 2011) Take the example of the 89-year-old woman who believes she is 8 and waiting for her mother after school: She is making an important communication about how she feels and what she needs. This is information that, when uncovered and used strategically, can help prevent difficult behaviors, and allow her to function at her best.

To uncover this information, care givers need to know something about her life. In this example, it turns out that going home after school at age 8 to milk the cows made her feel she was fulfilling an important, grown-up function in her family. Connecting with and living in that time in her life may be the only way she can still communicate today how she feels and what she needs.

Care givers should consider this “meaningless” information to be an important metaphor for her life today. She might be saying, “I want to feel useful again,” “I am afraid I don’t have a purpose anymore,” or “I miss the feeling of working with others toward a common goal.” It could be that focusing her on simple, repetitive tasks around the house and praising her for her helpfulness would work toward satisfying these emotions. This is vital, because if care givers do not find safe and possible ways for unmet needs to be satisfied, the needs do not simply go away. Instead, they continually re-emerge and may eventually assert themselves with force in the form of anxiety, depression, withdrawal, rage, or other painful and difficult behaviors. (Snow, n.d.)

 Therefore, an appropriate response in this example might be to tell the woman something like: “I got a phone call from your mother a little while ago, and she said she was going to be late. Why don’t we go and have a cup of tea and wait for her together? And you can tell me all about your life on the farm. Was it hard to learn how to milk?” As a result, the woman gets to revisit and feel proud of her usefulness on the family farm. She is received by a caring listener and can enjoy sharing a time that is still clear in her memory. In the process, her troubled feelings may pass as her immediate emotional needs are met. It is likely that soon she will forget that she is 8 and waiting for her mother to arrive. 

When researching Reality Orientation and Validation Therapy, I found a lot of support and research for each approach. The importance should always be placed on using genuine warmth and empathy to sustain emotional well-being and dignity in our interactions. Using this as the compass when navigating misconceptions and memory loss will help guide us to the appropriate response. By Heidi Lohre RN 

 

References: Nugent, Pam M.S., “REALITY ORIENTATION,”

in PsychologyDictionary.org, April 28, 2013,
https://psychologydictionary.org/reality-orientation/ (accessed September 26, 2018).
Alzheimer’s Association, Massachusetts/New Hampshire Chapter. (n.d.) Caring for People with Alzheimer’s Disease: A Habilitation Training Curriculum. Watertown, MA: Alzheimer’s Association.at is REALITY ORIENTATION? definition of REALITY Alzheimer’s Association. (2011b). 2011 Alzheimer’s Disease Facts and Figures. Alzheimer’s & Dementia, Volume 7, Issue 2. 

Moore, B. L. (November 20, 2010) StilMee™ Certification for Professionals: Working respectfully and effectively with people with Memory Loss [Training Course] Burlington, MA.
Snow, T. (n.d.) The Art of Caregiving. [Video] Florida: Pines Education Institute of Southwest Florida.
RIENTATION (Psychology Dictionary)

Happy Birthday

Marvel Holland-10-11
Ethel Mahoney-10-14

Celebrating October

  • Country Music Month
  • Positive Attitude Month
  • Popcorn Poppin’ Month
  • Guardian Angels Day October 2
  • Presentation on Incontinence Products
    Thursday October 18th 3:00pm

Let's Go Fishing

Music with Brad Ray

Activities Director:
Dana Jensen

Olive Branch went on it’s first outing late this spring! Several of our gentleman expressed an interest in going fishing so fishing we went. What a great time was had by all not to mention the great memories! Next up is a special trip to the Minnesota Arboretum for our ladies.

We are looking forward to having Children of Tomorrow out on October 29th at 9:30am for some Halloween fun. They will be assisting us in making Halloween masks for a parade while enjoying cookies and milk. I almost forgot to mention we enjoyed live music this past month with Brad. Busy times and great fun! Stay tuned for updates on our latest adventures!

As always, if you have suggestions or ideas or see a photo you would like, please send me an email to dana@olivebranchestates.com.

October Birthdays

In astrology, Libras are those born between October 1–22. Libras, symbolized by the scales, strive for balance, avoid conflict, and desire fairness for everyone. To achieve this, they are sociable, strategic, charming, and diplomatic. Those born between October 23–31 are Scorpios. Scorpios are passionate and deep, qualities that help them counsel others in meaningful ways. Resourceful and determined, Scorpios make good managers.

Groucho Marx (comedian) – October 2, 1890

Desmond Tutu (archbishop) – October 7, 1931

Eleanor Roosevelt (first lady) – October 11, 1884

Paul Simon (musician) – October 13, 1941

Lee Iacocca (executive) – October 15, 1924

Evel Knievel (daredevil) – October 17, 1938

Mickey Mantle (ballplayer) – October 20, 1931

Dizzy Gillespie (musician) – October 21, 1917

Minnie Pearl (comedian) – October 25, 1912

Dylan Thomas (poet) – October 27, 1914

Jonas Salk (doctor) – October 28, 1914

Dan Rather (journalist) – October 31, 1931