Cognitive Connections

The approach taught and used in all of Jarlette’s 18 homes across Ontario was developed through the work of Gail Elliot, founder and CEO of DementiAbility Enterprises Inc. (see dementiability.com). Gail has worked closely with Jarlette in the implementation of dementiability methods.

Originally conceived as a method of education for young children by Maria Montessori in Italy in 1897, the Montessori approach to dementia care is relatively new. It was first pioneered by Dr. Cameron Camp in the 1990s at the Myers Research Institute and made its way into long term care facilities by the mid-2000s. 

According to alzheimers.net, Dr. Camp’s approach to dementia care revolved around the question, “How can we connect with the person who is still here? ... Our job is to allow this person to be present—to help them, wherever they are in the journey of dementia, to be connected with a community and contribute to the best of their ability.”

Before the music came on, Jill’s resident was not connected to the world. She was struggling, clutching the side railing in the hallway, unable to speak her fears and frustrations. But once the music began to play, a smile spread across her face. She couldn’t stop beaming as she twirled along, almost light on her feet in dance.

This is the kind of transformation that can take place in people suffering from dementia when practicing the Montessori dementiability method. Local 302 members at Royal Rose follow its methods every day to help the residents they care for connect to the world around them. 

Imagine waking up in bed one day and no longer remembering who you are, what you used to do, what makes you who you are. You don’t recognize where you are, but you’re sure you need to go somewhere, anywhere—somewhere that’s not here.This is what it is like to live with dementia.

For many dementia sufferers, this cognitive loss is not the whole of their experience. They also experience all the other “joys” of old age—failing vision, aching joints, loss of balance, shortness of breath, speech difficulties, incontinence, and many other physical limitations too numerous to list.

Royal Rose is a fully integrated facility, one where residents of mixed levels of ability live about,” adds Jolan Taylor, who is a life-enrichment aide at Royal Rose. “It’s about creating belonging and meaningful purpose in their daily lives. It isn’t entertainment or filling time. It doesn’t require communication. You put a peeler into a resident’s hands and vegetables in front of them and they know what to do—they contribute.”

Jolan believes the program connects with the residents and makes them excited—an emotion that is not common for individuals forced to deal with the obstacles of dementia. “Letting the residents help with day-to-day activities gives them a sense of belonging and purpose,” he says.

The Local 302 members at Royal Rose are a dedicated group of caregivers. Like Karrie Jenkins, who quit her desk job in finance and enrolled in the one-year Personal Support Worker Certification program at the District of Niagara School Board. A friend had wanted to change her career, and Karrie decided that she would take courses alongside her friend. She was looking for a change and wanted to come to work every day knowing that she was making a direct difference in someone’s life. “Just before the course started, my friend called and let me know that she wasn’t going to go through with the plan,” says Karrie. “I was nervous going by myself. I went to the first days of the course fully believing that I would not continue. But to my surprise, I loved every minute of it.”

For Breanne, who was recently diagnosed with multiple sclerosis, working in long term care has taken on significant meaning. She chose PSW work as her first career. Her sister had gone through the PSW course work, and Breanne could see that working as a PSW would allow her to spend her work life helping people.
“I want to help people,” she says. “Being a PSW is the most rewarding work I can do. I love it! I love what I can do for the residents. I love being there for them and being with them.”

This desire to serve, to support, and to have work that allows for the ability to care daily for others is a recurring theme spoken by CLAC members employed in long term care homes across the country. It too is the reason why Jolan chose his profession. “I wanted to work with people, especially people who needed extra help,” he says.

Watching the staff at Royal Rose, a facility with 96 beds and 150 employees, it is easy to see that despite the pressures and limitations that come with working in the long term care sector, these members have a strong desire to care and connect with each resident—no matter their level of physical or cognitive ability. The frustrations and difficulty of long term care work are well known to them.

When asked about her biggest frustration, Karrie quickly and firmly utters a familiar refrain: “Time. I wish that I had more time. Time to sit and to have conversations with residents. Time to do a whole puzzle with them. Time to sit and admire their ‘baby.’ ” Instead, the work often becomes one of charting, processing, redirecting, and dealing with behaviours. Even so, staff are always looking for ways to cater to each resident’s needs. And that’s where the dementiability program comes into play.

“With the addition of the dementiability program, we have seen the residents get more involved,” says Karrie. “I have the residents help me as I work throughout the day. They help me make beds. They help fold towels and bibs. They love to help not only because it gives them something to do, but because it reflects and reminds them of what they did at home—they made their beds, did the laundry, and took care of their families.”

While Jill and her resident dance along to the radio on one side of Royal Rose, on the other side, a resident is seated in the open concept dining area near a table of laundry waiting to be folded. A cue card on the table reads, “Will you help fold this laundry?” Breanne sits briefly with the resident. She gestures to the pile but he declines this time. Later, while she continues her work, she carefully observes the resident wandering close to the pile of laundry. He only stands there for a few moments at a time but returns frequently—standing, holding an item, placing it down, and then coming back. The pile of laundry seems to provide an anchor for him during his wanderings.

Perhaps that is why the dementiability method of care works. It is not a magic solution that fixes all the problems in the long term care system. It doesn’t cure the underlying physiological condition that manifests as dementia. But it does provide an anchor, not only for residents, but also for staff. It reminds staff of the motivation that drew them to their profession in the first place. The atmosphere at Royal Rose is one of openness and partnership. Members work with each other, their residents, and management to effectively reach across residents’ physical, emotional, and mental barriers. In doing so, they provide the vital human connection that those suffering from dementia so desperately need.