For Rita Altman, Sunrise Senior Living's senior vice president of memory care and program services, the word "institution" just cannot be applied to the memory care neighborhoods she oversees, secure or not.
It's a non sequitur that defies reason.
It flies in the face of everything Sunrise has been about from its inception, she
"We're not institutional," she
"The very premise of Sunrise from the time of its founding was to provide holistic care in a very homelike setting.
"A Reminiscence Neighborhood is a real homelike setting," she
adds, "and the additional level of security is there to provide safety to residents with moderate to severe memory loss who may no longer be able to recall their address, who are disoriented as to person or time.
Few people could be more qualified to lead that effort than Altman
Along with her
more than 30 years' experience in health care facility management, Altman
is one of only eight Validation Masters in the world, and she
was taught the technique by its creator, Naomi Feil, a geriatric social worker whose method is practiced internationally.
The Validation Method starts with the staff member taking a deep, cleansing breath.
The purpose of this is to "turn down the caregiver's own internal dialog," says Altman
It gives the caregiver a moment to center herself, open, and focus completely on that resident in that moment.
"Establish good, genuine eye contact at the level of the resident's eyes," says Altman
"The most important part is we're hearing it's helping the team members to have those 'aha' moments, and they are better able to figure out and meet the resident's need," says Altman
"Really, what we do is train all of our team members to understand that every resident has basic human needs," says Altman
Alzheimer's disease and other dementia can make it hard for residents to express what they need, or even know that they need it.
That's why training staff to identify it for them is so important.
"The challenge is to meet residents in their own world, to step inside their shoes," says Altman
"It requires us always being very open and observant and trying to figure out what that need is."
And then it requires knowing the resident well enough to find a way of meeting that need, rather than relying on redirecting their attention onto something else.
uses grief as an example.
Redirecting a grieving resident by offering a bowl of ice cream may help briefly, she
says, but the underlying human need of intimacy, belonging, friendship, can only be resolved with a real human connection.
Rather than just offering the resident a distraction such as a bowl of ice cream, the caregiver encourages the resident to express his
Ultimately, the care manager gets them both a bowl, and as they share the ice cream they can spend time just talking, helping the resident reminisce about a loved one he
is missing, and talking about all the feelings the loss has engendered.
?Charting Individual Memories
Because dementia is a degenerative condition and a day may come when residents can't remember what they used to like, what made them feel good, safe, or loved, Sunrise
staff keep a record of each resident's individual favorite things, "so we have all that knowledge available and can pull on that on any given day," Altman
"It's making care so person-centered that we know what gives that resident a sense of meaning and purpose even when they can't say those words.
When we validate them in those ways, you can see it on their faces."
remembers a particular Sunrise resident whom she
saw at different points of her
The recent training specifically focused on behavioral expression is having good results, Altman
says, and although the program is still too new for anything other than anecdotal evidence, she
does expect to see data to prove it eventually.
"I think it's really helping people understand how important Sunrise's approach is, how important it is to help that resident feel secure, feel heard, feel they have purpose-to meet their basic human needs," Altman