Some families wait too long before moving loved ones into Memory Care campuses like the neighborhoods at Episcopal Church Home. That’s unfortunate because people with mild memory impairment can greatly benefit from living with, and befriending, others who are living with dementia.
Families’ hesitation to place loved ones in Memory Care is happening for more than one reason, says Jomiya Coleman, administrator of the 22-acre Episcopal Church Home campus in the in the suburban Graymoor-Devondale area of Metro Louisville, Ky.
Delaying moving in
Oftentimes, families don’t realize their loved one has dementia, because they’re with them every day, and their family member is able to follow a daily routine.
But, Coleman cautions, “She’s doing that because that’s a routine, not because she doesn’t have dementia. Some of our residents with dementia do have those routines, but they’re not able to remember short-term information.”
Other families delay for different reasons. During the height of the COVID-19 pandemic, many families felt they had no choice but to care for their loved ones at home. And they figure, “Well, I can just take care of my loved one at home, since I’ve been doing it.”
“And they feel as if that’s enough, but it’s not,” Coleman said. “Because at home, you may have caregivers there, but they’re not able to connect with other residents who are like them.”
Still other families delay because they don’t think their loved ones have significant memory issues. For those families, Coleman recommends free assessments involving both the families and their loved ones, which also can be arranged to coincide with tours of the Episcopal Church Home campus.
When families finally realize, ‘OK, Mom does have dementia,’ and bring her in to a care community, often times, “they’re no longer Memory Care-appropriate. It's too late to receive the benefits of living in the community.”
“I think it’s important to see someone who’s like you, and who understands you,” Coleman said about the ability to live with other residents with memory impairments. “When we have a neighborhood full of people that are able to do their activities of daily living (such as grooming, bathing, dressing and feeding themselves), and also have memory impairment, they don’t feel singled out – because their neighbor also has similar challenges. This creates a sense of community. We create opportunities for residents to get together all the time.”
Exercises for bodies and minds
Residents exercise both their minds and bodies. They gather for physical exercises daily at 10:30 a.m.
They also participate in ‘Bingo-cise.’ Bingo-cise is similar to the usual game, but there are breaks for exercises, so residents are not only filling out their Bingo cards. They’re also getting muscle stimulation.
“It is an amazing idea,” Coleman said. “We used to do it in our old building, so I was excited to bring it back through a grant we received.”
Thanks to a partnership with The Thrive Center in Louisville, that organization, which promotes healthy aging, is providing music therapy for residents.
There's so much to enjoy and engage in with neighbors just beyond their studio apartment.
That program stimulates memories, because the instructor plays music from younger days in the lives of residents.
“For example, if the instructor is playing Elvis or something like that, our residents can connect that with, ‘Oh, my goodness, I can remember when I was younger, and I used to love Elvis,’ Coleman said. “So it kind of starts up the conversation, which helps with their memory. It’s not that they totally can’t remember. Sometimes, they need a cue to remember. A certain smell, or maybe a certain food.”
Episcopal Church Home offers “five or six activities throughout the day, and we make sure our activities have memory stimulations, and muscle stimulations, for residents in our dementia neighborhoods,” Coleman said.
Sometimes, families believe their loved ones can appropriately live in Lyndon House, a neighborhood on the campus that provides Personal Care services (known as ‘assisted living’ in most states). When they learn Memory Care may be more appropriate, some families don’t move their loved one into an apartment.
“If you bring your loved one in and they are needing Memory Care/Personal Care, but you decide to take them back home, or not allow them to come into our neighborhood, they’re kind of missing out on socialization opportunities that build a sense of community,” Coleman said. They’re also missing activities that strengthen their minds and bodies.
When those families finally realize, ‘OK, Mom does have dementia,’ and bring her into a care community, oftentimes, “they’re no longer Memory Care-appropriate,” Coleman said.
Memory Care levels
In ECH’s Memory Care/Personal Care neighborhood, residents can do most of their activities of daily living (ADLs) on their own, she said.
“But what they’re needing is additional cues,” she said. “A cue would look like, ‘Hey Miss Coleman, it’s time to come to supper.’ And then, five minutes later, Miss Coleman has totally forgotten that. So I need to go and give her another cue to say, ‘Hey, Miss Coleman, come on, follow me. Let’s go down to the dining room so that you can eat.’”
When families don’t move in their loved ones early enough, “by the time they come to the community, they don’t need Memory Care anymore. They need more advanced nursing care, and that means they have to go to our nursing neighborhood, not our Memory Care/Personal Care neighborhood,” she said.
“There’s a big loss there,” Coleman added. “Sometimes we struggle with our loved ones, because we don’t want them to come to a nursing home, but by bringing them back home, they don’t have someone who has dementia like them.”
ECH’s Marmion neighborhood provides 24-hour skilled nursing care for residents with advanced cognitive decline and increasing physical needs. Residents have the freedom to stroll around their neighborhood, but aren’t able to wander away.
Less stress for families
When a spouse or adult child has been caring for someone with Alzheimer’s disease or other forms of dementia, that can cause immense stress and burnout for the care partner.
When a loved one is being cared for at a quality facility, “You get to be a child. You don’t have to be a caregiver, which is amazing,” Coleman said. “And you get that opportunity because we offer 24-hour nursing services here.”
ECH team members can also help coordinate medical care for residents, and provide transportation to doctors – even providing someone to accompany them on the appointment when family is unable. Some residents switch medical services to ECH’s medical director who works on site. That can further alleviate stress for families.
“We’re here to be the caregivers,” Coleman said. “That’s what we’re here for. We just need you to be family.”
Recent changes at Episcopal Church Home
Beverly Edwards, ERS’ vice president of residential health care, encourages families to explore communities that provide memory support – not just Episcopal Church Home – “before the need arises.”
“Oftentimes, people reach out to us when they’re in a state of emergency, but I would encourage them to explore care communities earlier, and I would also encourage them to, in addition to taking the tour, consider coming and participating in activities that we offer within the communities so they can get a feel for what life is like within our memory-support communities.”
Our neighborhoods at ECH are “designed for socialization. Our common areas are inviting, and we encourage our residents to engage in life-enrichment activities to get to know their neighbors. All of the resident rooms are private and have their own baths, it’s designed much like our homes that we live in day-to-day.”
As with a traditional home, once you leave your bedroom, “you’re able to have a conversation or engage in activities in common areas,” she said. “You’re also able to dine in the neighborhood or in the dining area (Grille 75’s restaurant-style dining), if you prefer to do so.”
ECH also has “versatile workers” who care for residents. That’s helpful for people who need memory support because the same team members who help with their personal-care needs, and also help them with life-enrichment activities, dining and housekeeping.
“So you have one individual who becomes extremely familiar with the residents in the memory-support area, and is able to help them in all facets of their life,” she said. The familiarity of working with fewer team members is comforting for the residents.
Edwards believes those who visit will see, “We provide great care for our residents here at Episcopal Church Home. But we want to make sure that our home, and our care model, is right for the individuals, because that’s what it’s about.”
“Our community, or other communities, become that resident’s home, and we want them to be comfortable within their surroundings, but also with the individuals who are caring for them,” she said. “Here at Episcopal Church Home, we focus on developing relationships, which is why we have the versatile-worker model.”
Tours and assessments, often on the same day
Coleman recommends families not only take a tour, “but also be open to an assessment.”
“Something really good here is that before we would place your loved one in any level of care, we would assess them,” to make sure they are in the most appropriate place, Coleman said.
“Some people think that they are more appropriate for personal care, but when they come in and they do the assessment, they realize, ‘Oh, my loved one actually does need to go to memory care, they do have underlying dementia.’ And they probably wouldn’t have found that out if they didn’t come and do an assessment. So not only is the tour piece important, the assessment piece is also important.”
Assessments are free, and typically take 60-90 minutes, which gives the director of nursing a chance to talk with family members, while a social worker does an assessment with the resident.
Then they switch, and family members talk with the social worker, while the resident talks with the director of nursing. They have an assessment form that they go over, and families typically receive the results that day. To set up a tour and assessment, contact Gry Seymour at 502-396-8987 or gseymour@ERSlife.org. She also is the person to contact when interested in tours of ECH Personal Care (Assisted Living), Skilled Nursing, or Memory Support.