Mrs. Elizabeth Gentry* is going to move in to our Memory Care community in a few days. I am sitting with her daughter, Maryanne, to do the preliminary paperwork and get a more detailed history about her mother’s life.
One of the things I enjoyed most when I was an Administrator in a Memory Care community was this initiation of the relationship with family and learning more about the resident. As I ask questions, I learn that her mother is a nurse. I smile and tell Maryanne that nurses often start “working” again for a period of time as dementia progresses.
She looks at me quizzically when I say that nurses often believe they are working again if they move in to an assisted living community or nursing home. Maryanne shook her head and said, “Oh, my mother has been retired for over twenty years. She hasn’t thought or talked about nursing in a very long time. She got in to gardening and being with her retired friends so I don’t think that will happen with her.” I smiled again, replied, “okay” and we returned to reviewing her mother’s medications.
Prior to Elizabeth’s move to Austin, she lived in her own home in Orlando for many years. Maryanne wanted her mother to live closer to her after noticing the increasing confusion during her visits to Orlando over the last six months. Elizabeth did not want to leave Orlando, however she finally acquiesced to her daughter’s request. It did not take long for Maryanne to realize her mother was in later stages of dementia and required residential care.
Elizabeth moved in to her new home in the Memory Care community without any resistance. Her daughter had lunch with her that day and then returned to work. Elizabeth slept well her first night. She appeared in the doorway to my office at 10 am the next morning, pointed a finger at me and said emphatically, “You have GOT to do something about the staffing around here! I have worked too many double shifts and I need a day off!”
I looked at her as seriously as she was looking at me and replied, “Yes ma’am, I will review the scheduling with the nurse in charge.” She immediately looked less stressed, thanked me, and went on her way down the hall.
It may seem odd to some of you that I responded in that fashion. It is part of a validating technique. To tell Elizabeth, at this point in the later stages of dementia, that she was not working double shifts and that she had retired many years ago would most likely have angered or agitated her.
You will notice that I did not say anything about her double shifts and needing a day off. I acknowledged her concern about staffing and told her I would look in to it; a valid and validating response to her statements.
The community nurse went to visit with Elizabeth later that day and promised to return the following day so Elizabeth could “make rounds” with her. Walking through the halls became a regular event for Elizabeth and our nurse over the next six months. Two to five days a week, they did this procedure. Sometimes it was two or three times a day because she would forget they had done it earlier.
After a few months and many conversations with Maryanne about her mother’s adjustment to living in the Memory Care community, she walked in to my office one evening and sat down. She smiled as tears glimmered in her eyes. She said, “My mother often used to say the years when she was nursing were some of the best years of her life.” She paused before continuing, “When this awful dementia started, she was so angry and she was angry for months. I wish she didn’t have Alzheimer’s and was still gardening in Orlando and lunching with her friends. On the other hand, she smiles more and cusses less. Since the doctors can’t make this disease get better . . .” She paused again and with a brighter smile she said, “Thank you for helping her live in those happier times.”
*Names and locations have been changed to maintain confidentiality.