Senior Living LIVE! Your Dementia Questions Answered

Video Transcription

Hello, everybody, and welcome into Senior Living Live. My name is Melissa. Thank you so much for taking your time to be with us here today. Well, we have a very special webinar, live here today with Susan Robbins, who will be here to answer all of your dementia related questions.

We don't do many webinars like this. Susan, she has a deep understanding of this complex condition, and she is here today to help you support your loved ones, covering a wide range of topics from early detection signs to advanced caregiving strategies. You're definitely going to want to pay attention here today. And we've already got quite a few questions from our viewers that come in over time, and we've compiled them in a list here today.

We will get started with those questions, to get things going. And while we are answering those questions, we're gonna go ahead and open up the Q and A box. So at that time, feel free at any point during the webinar to type in your dementia related question into the Q and A box at the bottom of your screen, and I will be happy to read those to Susan. And I know she will be happy to answer each and every one of those questions here today. So while we are waiting for everybody to continue to hop into the chat, Susan, tell us a little bit about yourself and your background.

Well, I am really excited to have this forum for people to just be able to open all those questions that you have either trying to figure out if you have a loved one living with dementia or somebody that is already living with dementia and on their journey. I've been with the Arbor Company for fourteen years, and my role is to go around and support all our communities and our families with everything dementia, from training to hands on support as needed in the communities. I've worked with seniors for over thirty five years in different platforms and in different roles. And I just absolutely love what I do. Never thought this is what my role was gonna be in life, but I am here. This is what I love doing. And more than anything, I love being able to help families understand how to create some meaningful moments even with somebody living with dementia.

Yeah. And, you know, we have many videos that we put together over the years about different topics related to senior living. This is always the most popular topic, and you are always our go-to person for this topic because of your deep knowledge and understanding of dementia, just literally from the beginning, first diagnosis, and until the very end, you really have a grasp on, what the person who's living with dementia is dealing with, on a day to day basis, and you've helped so many people. Let's go ahead and get started with some of the questions that we have already compiled, that we have gotten into the Arbor company over a period of time. And, again, if you're watching and you have questions for Susan, the Q and A box is going to be your friend today. Alright. First question. I think my mother's memory is getting worse. Is memory loss with normal age, or could it be dementia? And how can I know the difference? And this is a very popular question.

It is a very popular question. First of all, there is some slowing down that is natural part of aging. I may take me a little longer to recall a word, or I may repeat a story because I have three daughters and I've told the same story, but I don't know which daughter I have told it to. That's not dementia. But when I start telling older stories is a sign. And remember, it's not just memory recall. It's everything. It's okay if you go to the grocery store and you can't find your car. That's not dementia. That means you didn't pay any attention when you got out of the car. And lots of times, we're finishing a phone call or a text message, or we're thinking about what we need in the grocery store, and we're not paying attention. When it becomes a problem is when you get in your car and you don't recall whether you're just getting ready to go into the store or have you just or are you getting ready to leave? And that is kinda that that's the big overview of it. So normal forgetfulness is fine. It's also I'm not aware that I forgot. You know? You've told somebody something, and you know and you know that you told them. And when you remind them, oh, yes, you did tell me, or they have no recall that you told them at all. So reminders work for people without dementia. Reminders don't work as well when somebody has dementia.

Gotcha. That's a really, really good way of putting it. And, you know, I think we've all been there. We've been tired or we just have a lot going on and we just forget things. And that is always the, big concern for people, especially as we age. So thank you for clearing that up. And here's what I'm gonna do, guys. We have, already quite a few questions coming in from you viewing today. So I'm going to kind of take those questions and, put them kind of back and forth between the questions that we have, gotten over the past and then the ones that we have today. So let's go ahead and just hop into the Q and A box for those of you joining us today. And, we've got a, guest, anonymous. What specific training and qualifications do you have in providing care for patients with dementia? This goes a little bit more to your background, Susan.

It does. Yeah. When we are caregivers for Arbor, we go through extensive training for all our employees, not just our caregivers. Because just like dementia is a family disease, it's also our communities are families, and everybody is gonna touch their loved ones in, you know, from our housekeepers to our kitchen team. So we go through understanding dementia, what happens in the brain, and how it differs, what are the most common types of dementia. One of the things people don't really realize, there's a hundred and ten different types of dementia. And, you know, Alzheimer's, vascular, or some of the more Lewy bodies, frontal temporal lobe tend to be the most common, but there are all different types of dementia, and each journey is a little different. So we help our care team understand those differences as well and then what that journey looks like. We use a gem level program that is actually connected to a scale, but we call them gems so that it gives the dignity back to that person. And that's really what this is all about. Right? It's really fine because it, from maybe a decade ago, two decades ago, we didn't know as much as we do now, and it's really we're trying to find more to find a a resolution or try to solve it if we can and prevent it. But then at the same time, for those who are, who have it, try to find dignity, you know, within that day to day living. And, so that's why this is so important.

Another question from somebody today. What strategies do you have for creating a dementia friendly environment for patients and care facilities?

So it comes down to us getting to know the person living with dementia because everybody's journey is different. So if you have somebody living with dementia that's living in a community, let us know what their past habits were because we have a basic routine throughout the day, but we also have to individualize that. Simple things. I may when I retire, please don't get me up at six o'clock for breakfast. I'm not gonna be pleasant. And if I have dementia on top of it, I'm not. So understanding but also understanding those routines change with age. So what your recall of your loved one's schedule may be a little different from what their needs are, but it goes back to knowing what's important and finding moments for people living with dementia to feel needed. One of the activities lots of times we have that people kinda like, what does that mean? It's folding stuff. And you think, oh, it's so simple or how demeaning. Not really because you'll watch the pride that somebody has with the skill set they still have to be able to fold something. Or maybe we'll play a game, but we'll have to tell each person how to play the game through each step. And that's that difference in different neighborhoods and also making sure that loved ones living with dementia are with their cognitive peers. Because I may do the same thing, but I may do it at a different level.

Trying to kind of look through each one as you're talking and try to match with the answers that you just gave. And somebody asked, does the gem level reflect the level of care as we continue to discuss the gems?

Well, it depends on your definition of care. K. And, yes, it does because I need a different approach. But the gem levels are talking about my cognitive needs, not necessarily my physical needs. So I may I may be again, go go back to something that lots of seniors have is arthritis. So it's not that I don't know to do my buttons, but, unfortunately, my hands won't let me do it anymore. So that won't change my level because it's a physical need. It's about my ability to follow and do things. So the gem levels address my cognitive needs so that we can set people up for success. You know, we can make a schedule and follow it. The early stages of dementia, you can follow a schedule, but you might need a reminder or two. But by the time I'm in the middle, which is where our emeralds are, I need lots of reminders, and I'm also not gonna recall that you reminded me. This is where families would you know, I need I've gotta go to the doctor. I need a doctor's appointment, but I can't recall when it is. And maybe you've put it on my refrigerator, and maybe you've written it down on my calendar, and your loved one will still call you and say, when is my doctor's appointment? Because I can't connect the two things together. I can't sequence. I no longer know how to go back and retrieve information. And that also goes back to that question about normal aging and dementia. You know, if I have a doctor's appointment, I know how to go back and find that information if I can't recall when it was.

Sure. Sure. Makes sense. And and two questions that I can kind of put together here. How do you address challenging behaviors exhibited by individuals with dementia, and how do you train employees? And how do you help someone with dementia stay in bed at night? And that goes back to some of those challenging behaviors.

Yeah. Well, I'm gonna start from the going to bed at night. The answer is you don't. Sleep patterns change with dementia, and the people living with dementia lots of times sleep with shorter intervals of time. That's why lots of times you'll find somebody in a neighborhood that may have fallen asleep, and you think it's because they weren't stimulated, they just needed the sleep. But I'm gonna get up at night, and it's okay to let me get up at night. You know? The team members know maybe I'm hungry. Maybe I need to go to the bathroom. Maybe I think it's time for breakfast because my concept of time has gone away. So it's about living in their world instead of trying to bring them back to ours. And doesn't mean you're not gonna give me something to eat and then redirect me back to bed, But I want you to think about this from your own perspective. At the point when you yourself can't sleep and you have actually gotten physically up and out of bed and maybe left your bedroom, is somebody telling you to go back to bed gonna help you go back to sleep? No. Because there's an unmet need, and we need to find what that is and why I got up. You know, maybe I get up and I go sit down in a chair because, you know, maybe I was married for fifty, sixty. Sometimes we've even had couples that had been married seventy years before they lost their spouse. And I feel better in that chair because it almost feels like somebody up against me. You can't always identify that, or I've gotten up and I'm looking for them even if I'm not asking for them, just in that sleepy mode. There's all different reasons people get up. So letting me be the best I can. You know, maybe I'll enjoy. We have we do have a resident that has a little, keyboard that during the day, she sleeps most of the time, but she gets up and plays her keyboard at night, and she'll play for about thirty minutes, and then she goes back to bed. What cues had to happen? We don't know. But it took the care team through training that individual attention to detail and what makes somebody happy. And she is somebody that had played beautifully, then went through life and for a while would not play. But now at the later stages, she will play that little electric keyboard and enjoy it.

Yeah. And that is where, you know, having a little bit of additional help from people who've been through the training can then in turn help you as we hope this answer by Susan coming up will help this next, viewer, and their question goes along the same lines. My mom has severe dementia, is not mobile, and hardly speaks. I have no idea what is going through her head since she doesn't express herself. Any clues on how to communicate with her or what is going on in her head, she will occasionally smile. And this can be the most frustrating part for those of us who just wanna so badly help.

Well, I'm gonna start with and it is. It's like because you wanna have, you've lost your mom. Yeah. But she is still in there. So cherish those moments of spot smiles, and think about what you were saying. One of the things that can be very helpful to communicate with somebody is to write an old fashioned letter. And I suggest this really at any level of dementia once the conversation is. I stay away from what I call the did yas. When you come visit, did you eat? Did you take a shower? Did you go to the bathroom? Did you take your medicine? Did you go to the activities? I'm not a good historian because I have short term memory. So my answers may not even be factual. They're gonna be based on how I'm feeling at the moment. But I may have had a great morning and eaten a great breakfast, but I'm gonna tell you I haven't had anything to eat. So tying those things together to create moments with visiting what you used to do in the past, write that old fashioned letter so that when you go in, you can read it to them. And more importantly, it's okay to sit quiet. It's your company, and that's their level of communication. You know, if I always loved Jergens hand lotion. Go get a bottle of Jergens hand lotion and give me a hand massage. That's your visit. Or if I always loved ice cream or chocolate, and I can have that. Bring that into me, and that's what you share. Or share a story of your past in your letter, your favorite vacation, your favorite Christmas, the things that you do, and also music, singing, songs that you used to sing. And you may or may not know this, but if you, if they have siblings, you can ask this. Music that rings the most true to people is between the ages of thirteen and twenty six. That is what actually stimulates your memory and your recall in your brain. That's through music therapy, that's what sticks the most. So trying to find out what those songs were. If you think back, was there a song when you went on a road trip as you were kids and your mom would turn the radio up? That's probably one of those songs. And there may be one that you all sang in the car or something. So thinking that or maybe you can share that, or maybe a friend or something can share some of those, and that can make that visit that much more enjoyable.

I think that's a great tip. I mean, every time I host these, I hear I hear you, Susan. And then every time I hear something new, that's a new one, and I really, really like that. And then I do hope that that helps, anonymous, you to kinda find something, within your mom on the next visit, and, you know, it turns out to be enjoyable for the both of you. Next question. How do you know when it is time for memory care? And, Susan, we talk about the sort of the gem levels. We're sort of kinda lightly touching on some of these things. But, this is also a really important question because some people wait until it's really way too late, don't they?

They do. They do. And, you know, assisted living, memory care, those are really hard decisions that nobody takes lightly. But what happens is when you need different type of care, when is it time for memory care? When my life quality of life starts to decline. Not my physical needs. I'm not talking about the clinical physical needs, but my quality of life. Lots of times, people in assisted living will start to withdraw and not be a part of things, or maybe I just go and I sit and I watch. Also change one of the big things too sometimes is when somebody is exit seeking and cannot easily be redirected. Sometimes that is. But that's not the biggest one. That's the one that kinda jumps out at you, but we wanna do that. That needs to happen before that person gets to that point, and sometimes it doesn't because it's hard to make that decision. But finding understanding that, you know, as a team, we never our goal is not for some is not for somebody to have to live in memory care. That's not anybody's goal in life. But I'm in the right environment with my cognitive peers. If I am telling the same stories over and over and over and over, if I am living with people that are my cognitive peers, guess what? They're hearing that story for the first time, and they're listening. I've been in memory care neighborhoods where you have residents talking that I no way I could follow their conversation, but they're laughing and making verbal they are verbally inner exchanging things with each other that make no sense to me, but they're having fun because nobody's correcting them. Many times, we try to keep somebody in assisted living because we don't want the stigma that's attached to memory care, but the resident actually thrives. It's not about what your needs are. It's what their needs are. And most people are very happy once that move has been made because their loved ones dignity has been preserved. You know, if I don't if I have always had perfect table manners and all of a sudden, I'm picking up things that shouldn't be picked up with my hands socially, my social skills start to go. So from you, from a personal perspective of looking at your loved one, did the social skills, have they gone away? The manners that I had, have they gone away? You know, I mean, so I'm sitting, and that's my dignity. And that was what is important to me. So along with some physical things sometimes, but most of it is my cognitive needs. So my social skills, my ability also not to get lost in the community. Memory care neighborhoods generally are smaller so that I can independently get up and walk around. And I know lots of people wanna say, well, that's wandering. Somebody's just walking and walking. Yes. That's my activity for the day. It is okay if I walk and walk because I'm enjoying myself.

Right. What one term you mentioned there and that answer was exit seeking. Can you explain what that is? That is when somebody is determined to leave the community but doesn't understand the unsafe problems. If it's our busy street, then I would just walk out into the street. I think I'm going somewhere. You know? I'm not aware of what town I'm living in. I think that the grocery store I went to thirty years ago is right down the street, and I'm gonna walk to that grocery store. So the environment or I'm gonna walk home, or maybe I just don't know. I can't get I just get lost. Even if I was just trying to go outside, I would need somebody with me because I'm not gonna be able to find the front door again.

I wanted to get that I thought that's what it was, but I wanted to really get down and define, what that is so that our viewers can do the same.

And it's not that somebody can't go outside. I think that's you know, we want people to be able to be outside, but to be outside safely.

Sure. That makes sense. Another question here. I just wanna shift gears a little bit to, nutrition. Right? How do you ensure proper nutrition and hydration for patients with dementia, which can certainly be challenging?

It is a challenge. And I'll start with just some understanding of what happens with somebody living with dementia. Dementia, again, like I said, is not just memory loss. You can lose people living with dementia, sometimes their body parts don't talk to the brain anymore. So my stomach doesn't know whether it's full or empty, or it thinks it's empty when it's full or full when it's empty. And I've got short term memory, so I don't recall that I have just eaten. So we do have to have the oversight that we're doing it. And if I can't recall a thought that I've just eaten, we're gonna give you a smaller portion, and then we're gonna give you some more so that we make sure we get everything in. We offer in our communities, we offer fluids throughout the day and snacks throughout the day so that there's you're touched, you know, in the morning for breakfast, something midmorning, then at lunch, something midafternoon, dinner, and then again at bedtime, something, some high protein snacks and something to drink. It's encouraging. Many times, water is not something they want, and I want you to really think about that. I'm older, and when I was growing up and my kids were growing up, you didn't walk around with water bottles. Yep. Today's world, we all walk around with water bottles. So this constant trying to bring them back into what we do now may not make sense to them. We are always offering water. Another thing, people living with dementia lose their depth perception, which means I can't see water. So you may hand me a glass, and I can't see it. So maybe we're not always offering water, but we're offering other beverages because I can see that. Many times people will take if you watch people living with dementia, if glass full of water, they'll pick it up and look at it and set it back down, you're thinking they don't want the water, they can't see what's in it if it's clear.

Interesting.

Also too, like this cup of coffee that I'm drinking. Alright. It's about three quarters full, and I know that from picking it up even though I can't see inside. That's a fine motor skill. If I'm living with dementia, I have no idea whether there's fluid in here or not. That fine motor skill that instinctively lets you know even though you can't see it is gone.

Interesting. Yeah. I don't know if anybody watching that knew that because I know I I certainly didn't until just now. This is why we have you here, Susan. Another question, and I'm, again, trying to tie a couple together here. How do you involve family members in the care and decision-making process for patients with dementia, and how does a SLUMS, s l u m s, score factor into those care plans?

So well, it's the SLUMS is a clinical, and I use my gem levels when I do that. It does. They are factors on how you process information and where you are and what your recall is. So you're certainly well, I would recommend that you go talk to the nurse on the slums or your memory care director, and she can give you the more clinical because that is actually a clinical scale. I know the numbers, but I'm not gonna repeat them out in my head without it sitting in front of me, to be honest with you. But as far as the care goes, you should, you can meet, if you have questions, meet with your memory care directors or, you know, your physician if you don't have so I don't, everybody in the call may not have somebody living in a community. Check with the physicians, but let people know what the story is. I think one of the biggest hurdles is people are not always honest about everything that was going on because we wanna make sure we don't want people to know that mom hit me when she got agitated. But if we know that coming in, then we're prepared for it, and we can do it. But you should have for the Arbor company, you do have a review of care, and it's it is called the care plan, and they will review that with you and sit down. But it is a partnership. It's your sharing what your expectations are and then us letting you know as a professional what is realistic to expect from somebody living with dementia. Because I know personally, I can look at dementia, but when it comes to my own family, it's almost like you have to put a different hat on. And it's like, okay. You know? Because people people close to me will ask me questions, and it's like it's harder for me to see in my own family. But as a professional, I mean, I do see it, but it's like part of me doesn't wanna see it just like all of you. You know, you don't want to. Also to people living with dementia, it's kind of like living in and out of a blackout sometimes. So I may have moments it doesn't so much happen with Alzheimer's, but other dementias. I may have periods that I am just completely lucid. You know, I can have this great conversation about a current event that I watched, you know, maybe five minutes ago on the TV, but I I've held on to it then. I won't intend, but I can have this intelligent conversation that I used to have with you. And you're like, okay. There it is. What happened? She's okay because you want it so bad. But if you get up and go get something to drink or go to the bathroom, you may come back and that side has gone. Take those moments and enjoy them. And I kinda got off topic on the slums, but reach out. But everybody's journey is different, and the more you share with us your expectations and listen to us on what is realistic expectations, Your loved one will have an easier time, and so will you. We want to get to the point where your visits are visits with your loved one, and you're not concerned with the day-to-day care. Your mom is not always gonna get a shower when it's scheduled because they're just not in the mood. Enforcing it is not helping that person living with dementia. That doesn't mean that you can go for weeks or something without a shower, but in that moment, at that time, it was not the right time for her. Well, let's face it. We've all gotten home so night that we were really tired and maybe needed a shower. Just, ugh, just not happening. Yeah. Maybe I got up that morning, and and my knees are really killing me because I've got arthritis and I'm living with dementia, and I don't wanna stand up. We also have to dress, you know, those things too. They are a person, and that's their dignity and their stuff. Plus, I may not, in the moment, understand what it is you're doing. Why are you in there? I mean, let's face it. If you, if I showed up at your house today and walked in your bathroom while you were taking a shower, you'd be offended and yell and scream and something ugly probably happened. Right? That's what happens sometimes because the switch just doesn't flip.

Yeah. Yeah. And also when it comes to family members, as you said, if you've gotten to the point where you're getting additional help and you need to go to the your team members, tell them really what's going on so that they could they could truly help. Maybe on the family member side, you know, you choose the best family members who are gonna hold each other accountable.

Like you said, sometimes I'm like, oh, la la. No. No. No. I don't wanna listen or do this. Well, maybe that other family member brings somebody in who can hold you accountable, and then vice versa, you can hold them accountable for the weaknesses that they perhaps have in this decision making.

Absolutely.

Yeah. I love it. So, let's combine two questions here. Talking about the training that the staff receives. Somebody asked, aids say they will be there on standby or assist for my dementia family member. I don't know the difference or what that means. Can you provide insights? And, also, maybe specifically for Arbor, how do we train staff members, to deal specifically with those living with dementia?

So, all our staff is trained. We have dementia training that all staff get when they first onboard with the Arbor company. It's an in-person training. There is also, they're given the opportunity to go through what we call dementia live. That sometimes happens there for a couple of days. Sometimes it's a little further down, but that is actually an experience that you yourself can go through, ask your community. They'll be happy to put you through it. That actually immerses you into what it feels like to be living with dementia. It alters all your senses and creates empathy and understanding to feel what it's like to do very simple things when your cognitive is altered. We alter your cognitive abilities, your vision, and your fine motor skills. So and all our teams go through that. They meet, they have what we call team huddles so that they meet each shift and review anything that's going on with the residents and what those best tips are if somebody is showing some different behaviors that they haven't or it's an ongoing behavior. And we share what worked and what didn't work because every resident is different and needs different things at different times. And then monthly, there are, trainings that they there are video trainings that they're doing along with some in person in services that are done. So that is that's the dementia piece along with all the other trainings that they get from a physical type care training too. So and also going back, the assistant, you know, assist that lets us know whether somebody is gonna require two people or one person, I think was what that question was. And then the assist does matter, and that's part of that conversation. You know? I mean, assist means, do I need two people to help me stand up because my knees buckle when I when I when I stand? You know? But that's part of our discussion so that we know what that is. So, got it.

Okay. We have about, twenty minutes left in our webinar, and we've got a lot of lot more questions left to go. So, let's get to Donna's question here. Is it common to forget how to use a computer, TV remote, write, or use cell phones as dementia progresses?

Yes. TV remotes have been one of the biggest stumbling blocks. So if you have a loved one, the simpler the remote, the better, the fewer channels somebody has. Because people with dementia start to travel back in time, and, you know, there used to be three channels, five channels. That was it. So you can program have the simple remote, and then they don't need all the extra buttons and stuff, on, off, up and down in channel. I have alright. This is kind of a strange tip. I have seen people take a toilet paper roll, an empty toilet paper roll, and slide it over the remote and then tape it. And that way you don't hit the buttons that don't that you don't want them to use because usually it's the upper part. And then just take black, electrical tape, and we've had a lot of success with that.

I hope you guys are writing this down. Okay. They're your first. That's one way to say that. Great question. Yeah. Thanks for asking that. I mean, it's just this stuff like this that could literally, like, make your day, make your week, make your year. You don't even know. So, thank you so much for that because it's gonna help somebody else.

And here's some cell phones too. You can go back go find a flip phone. Go find an old flip phone because that may be more recall Right. By doing something.

Exactly. Something they used to do. Yes. Coming from Marietta, is there a website where we can look up the different gem levels and what they indicate?

Yes. You can if you go it's actually, there is, I think, there is a presentation on senior living live with the gem levels going through the gem levels. And if not, I'm not sure where you are in Marietta, but there are I am actually from Marietta, so there are several communities, and they would be more than happy to just look up the Arbor Company communities in the Atlanta area, and they'll be more than happy to send you that information.

Yes. And just to be clear, her name is Marietta.

Her name, Excuse me.

Where she's from, but there are arbor communities across the country. And, again, as we start to close this webinar, I'll tell you kind of redirect you where you could find more of these webinars. And, Susan, is there any other place they could just quickly Google to find the gem levels?

Actually, probably just the Arbor company. And then it's I don't know which tab to hit, but it should be there.

Got it. Got it. Deborah asks, can you, how do you redirect a resident when they're inconsolable or defiant?

Not easily, if I'm honest. But inconsolable, One of the things that happens is many times people living with dementia, we're trying that those feelings come from us trying to make them be what they used to be. Stop what you're doing, repeat back what they're saying, and validate the feelings and emotions. You know, I've had I hate it here. I wanna go back to my home. I'm sorry you hate it here. That's a terrible way to feel. Then and then just be quiet. People living with dementia can't process too much information, And when somebody's upset, especially somebody we love, we try to reason with them and give them more information. People living with dementia, the ability to reason is gone, and I'm starting to lose some of my words, so it's only creating more frustration. That is that moment. I am so sorry you feel that way, and just sit quietly. Let me get those feelings out instead of trying to fix them. I'm allowed to have feelings. You and I can have our feelings hurt, and we can reset or be afraid, and we can reset. That reset, because my brain processes slower, takes a lot longer for them. Right.

Another question here. My mother is extremely opposed to leaving my home. How can I help her to understand that it's a good thing to go to a care facility and that I'm not abandoning her? And, I mean, of all the questions, this might be the number one question. Trying to get your your loved one care, and, you don't want to feel that that feeling of abandonment as she mentioned.

So people living with dementia are defiant and determined. I haven't lost totally who I am. The best conversation, first of all, is you do your research. You find where the best place for you for her to live? You know, your location, when you go in, is the staff warm and friendly? You know, I just you know, beauty is important, but how did how do how did the people treat you when you came into that community? How did you feel? That's what you're looking. That's the first line of what you're looking for. Identify that for your loved one. I mean, I prefer Arbor. I've worked for the company forever. And if I have a loved one, I really do love the care and the training we provide. But being honest, and what that means is don't tell me way ahead. Don't keep having the conversation until you're ready to do it because that just creates anxiety, and it's not like you're ever gonna be able to reason with them because they don't have the ability to reason. This is what we have to do is your conversation, and it breaks my heart. I love you. I wish there was another solution. But, unfortunately, the best I can do for you because I love you, even though you don't feel that way, this is what we need to do. Because lying, doing, you know, does not it does people I may not remember anything else, but if you lie to me, they remember your little white lies because the lies met my emotional need, not my real need in that moment. So being honest And, you know, they may get mad at you. But once most people, once they're there, well, I'm not gonna say overnight. Really, they start to make friends and do things that they've not done for a while. Or maybe all they do is just come to meals, and they make friends during meals. It is not easy. You are gonna feel bad, but process it. But continue I found this is the best place for you, and you are safe. One of the things that that fear level of someplace new and if you think about it, we all when you move, you yourself. Where's the grocery store? Where's the bank? Where's the you know, all the things that go through your head when you move. You gotta find the different things and which one and where's everything. That happens to somebody living with dementia and can't process all of it. I'm never gonna be able to find the dining room. I'm not gonna make any friends. You know? And the stigma that's attached to living in communities That stigma, it's not like it used to be. But to seniors, that's still there in the back of their mind. So that's fearful. So reminding me that once I am there, that I am safe.

Deborah has this quick question. Will this webinar be available to share with other family members? Yes. Starting tomorrow, you'll get the link to this webinar in the email you used to RSVP for this webinar with Susan today, and you can share that link with anybody you want or you can rewatch it as many times as you want. So that get that answer out of the way very quickly for Deborah. Couple of questions I'm gonna combine here. It's about how do you encourage dementia patients to take their medication? How do you encourage them to eat? How do you encourage them to shower, to, be hygienic? So maybe some tips or tricks from our staff and how we train them so that it can help somebody at home, or it can help them understand understand a little bit more what happens at our senior living communities. Yeah.

Well, one of the things medications is always tough. Like I said, don't give me glass of water with it. Give me something I wanna drink was one is is one thing. And medications are at routine times. Also, make sure do I need everything I'm taking? Go to your physician because sometimes people have a ton of things they're taking, and I'm not a physician. That's not what I'm saying but if it's a problem, do I need all these things? Because sometimes people have taken things for years. Okay. But tips to take it, you know, I mean, you can just, you know, it's a vitamin. Here's your vitamin. I mean, don't go through what all these things are. This is what your doctor ordered, and they're gonna say, well, no. He didn't order that. And it was like, he didn't? Well, let me check on it. Validate what I said. Wait a little while and then come back. Once I've said no, don't keep at me. Stop. Let some space come again, and then try again. We've had success lots of times, with showers is knowing what somebody's routine is. You know, somebody that always took a shower every Saturday night a long time ago because they went to church on Sunday. So it's Saturday night, and we're gonna get a shower. And not telling me things like you stink, you need to be clean, you gotta all the things that you say. Again, it goes back to, hey. Some of our team is like, I've got a resident that will always take a shower because when she's going to happy hour. So she gets her shower an hour before our happy hour in our community because she's gonna get dressed for happy hour and cleaned up. You know, what words are you using? You know, did I always take a bath and not a shower? So you fill and I okay. You don't want me sitting down in the bathtub anymore, but you can fill the tub with my shower chair in there and let me soak my feet and use that from the water to wash. So it's adjusting to what you're doing. Also a tip, if you're caring for somebody at home and that gets you know, sometimes it's not pleasant giving the shower. And if you give me a towel to cover me up for my dignity because I'm uncomfortable, I'm naked or not, It's not normal to have somebody in the shower with you. But if you give me a towel, both my hands are hanging on to the towel to keep it covered for me, and then I'm not gonna is apt to lash out because I'm keeping my dignity. So it's all those little things, but trying to set it up not that you need a shower. It's just time for a shower because this event is coming up. I don't have to have one every day. Actually, as you age, you actually lose the oil in your skin, and it dries it out, which makes it also thin. So a a daily shower is actually not recommended for older adults.

Right. Right. Good great great tips as always.

And also too, sometimes there's, you know, if I have incontinent issues, maybe that's the only area we're gonna be able to get washed. Call that a success. And the next time, you know, you need to get the upper body a little better. And you can wash through a towel too to get my back and under my arms.

Yeah. Yeah. And, again, great tips that many probably haven't even thought of. We can get this question out of the way really quick. From Melissa, saw this advertised on the Facebook page. Is the Arbor Terrace Facebook site the best place to hear about these types of webinars?

Go to w w w dot senior living live dot com, all one word. That will show you what the upcoming webinar is going to be for the next month and how you can sign up to watch each and every one of those and where to find the old versions of all of our content. Okay. Shelly asked, how do you have your parent tested for dementia, or express your concerns with their doctor with your parents' cooperation? So now we're going back to the very beginning. How do you even get the diagnosis.

Well, first, you need, for a diagnosis, a geriatric neurologist that specializes in dementia. I'll just be very honest. All neurologists don't specialize in dementia. And, again, it goes back to being honest with them because your loved one's gonna deny it. They don't need it. So your primary physician, you don't have to say you're going to have a cognitive test because you're gonna get that pushback. But you go for a regular checkup, and that's they've referred you because that's actually how it all works anyway to get into somebody. And it's just the next doctor's appointment. Not making a big deal about it. I don't know why you gotta see them either. It doesn't make any sense to me, but let's just go ahead. Instead of, well, now do you know you've been a little forgetful in pointing out all the shortcomings? Because when somebody points out your shortcomings, what do you do? You retreat. I don't wanna be around you. And if they say things, well, you just think I'm crazy. No. I don't think you're crazy. I don't know. But I just know what the doctor says to do something, we should do it.

K. Another question from Marietta. What are the different neighborhoods for different levels of dementia at Arbor, and how does the care level change as dementia gets worse?

Well, we do them by our gem levels. We have both neighborhoods and programs. Sapphire's, Diamonds, that's you and me. Sapphire's are you and me, and our diamonds are that early stage of dementia. And that is where our assisted living residents, along with some sapphires that just may need some physical oversight, live. Now I can live in assisted living and still need a wheelchair because that's about my physical. So our neighborhoods address the cognitive and along with then we we care for the physical, but our neighborhoods are based on our cognitive. Then we have what either a Bridges neighborhood or Bridges programming. And this is our emeralds. That's that in between stage where I no longer know. When I'm a diamond, I'm aware that I'm forgetful. I don't like it. I may try to hide it, but I'm aware of it. By the time I'm at Emerald, I don't know there's anything wrong with me anymore. I think I am perfectly fine. I don't know and my short term memory is gone, and I need to be set up for success. This is where I can still do the things I used to do, but you need to change them. A great example is I had a group of residents that we used to play UNO. There were emeralds. But we played UNO by me telling each one of them what to play. You know, throw down a yellow or a two. Throw down, and what would happen is and why the different programming is, our diamonds would come and join us and then get mad because I was telling them what to do. That was cheating. And then they would get mad. They don't play well together because of their cognitive deficits. And because with dementia, you lose your filter, so if you think it, you're gonna say it. And that never goes away. And that's hard on families too. And then our memory care neighborhoods can take that same thing, but we would no longer be doing numbers with Uno. We would just be doing the colors and playing or maybe just sorting in front of ourselves. So I need that different setup so I can still do all the things I used to do with the setup to be successful and sometimes more hands on.

K. Mary says, sorry. Can you repeat about the clothes to wear for the day and rewearing the same outfit? My mom says she wants to go to assisted living her own apartment. My sister says let her go there. She has mild dementia. How do I know what she really wants?

You don't. If I didn't have dementia, she would be able to state firmly what it is she wants or what she needs. This is where the family comes in and helps make those decisions based on what you know is best for her. It's not easy, but they are not working with a full set of reasoning abilities because that's part of the dementia. Doesn't mean I can't still carry on a conversation, but I don't reason well, I don't sequence well, and I start to lose my understanding of safety. So it's making that best decision for that person. I love to see people come live with us sooner rather than later because it allows us to get to know that person and what their needs are and what their habits are. So as the disease progresses, we can help them that much better. And it allows them to make social friends as they move through the dementia as well. Whereas I'm not gonna make as close friends because there are times that they make really good friendships.

One note, Marietta had for everybody talking about phones. There's a special cell phone for people with dementia called a RAS phone. It has no Internet connection. Only click on the picture of who you want to call, and the phone is programmable, by a family member. So thank you for that tip. I wanted to get that in.

Thank you.

Yes. The final, two questions here. The suggestions for friends, family, of mom that continually question decisions of memory care, ideas for support of caregivers, living with great guilt. So kind of when not everybody can agree on what's best for the loved one.

Okay. The fact that it is a brain disease that you can't actually see makes it much harder. There's not a pill that you can take that's gonna make it go away or fix it. But if you think about memory care as the pill that makes their life better, if your loved one had cancer, you would do everything you possibly could to get them the chemo, the radiation, whatever it was that doctor said that that they needed to fix the cancer to make their life better. Memory care is chemo for somebody living from dementia. It's changing your mindset. It is a disease. Living in memory care allows us to take care of those day-to-day things that you shouldn't have to take care of a loved one for. You know? You shouldn't have to take your loved one to the bathroom or give them a shower. If they had their way, they wouldn't want you if they could still say what they want, they would tell you they don't want you to have to do that. So you're actually providing them the care that they need. It's just not in the shape of a pill, but it's what provides them with the best life. Family members are never, you know, not always gonna agree. Families that have a hard time agreeing is a good trick that can be very helpful is everybody in your family has a skill set, and each person can take a role. Yep. Somebody's gonna take care of doctor's visits. Somebody's gonna come and take visit with them. Somebody's gonna make sure they have all the supplies that they need. Somebody's gonna take care of the financial part of it. Find out what your skill set is, if you're the primary person, and then give the rest of the family assignments of how they can best help.

Yeah. And then the final question is about financial. What resources are available to help with the financial aspect of memory care? It feels incredibly unaffordable.

Or as at Arbor, we are all private pay. And I know lots of times people feel like, you know, is Medicare gonna cover this? No. It does not. There are you can reach out because state by state, it is very different on what resources are out there. If you reach out to any of the Arbor communities, they in your area, you can reach out, and they can refer you to somebody in that area that can help with other you know, if private pay is not an option, what are the other options that are out there? One thing people don't always realize is there are a lot of veterans benefits that are covered if somebody doesn't have long-term or short-term care insurance. But the VA is also, very helpful. It's not a hundred percent, but it is a big a big chunk of what it costs to limit memory care. So that's a that's a resource to supplement out. And, again, I you know, it's blanket. It's state by state. So reaching out to that community, and they can get you in touch with the right agencies if finances are tight. They can be. And a lot of times, the sale of a house, you know, or the items Yes. You know, Somebody on can also, help fund that, and it does for quite a few people as well. And speaking of the VA benefits, we have quite a few webinars on our website, that you can watch that will tell you, and, Emily Schwartz is excellent with that. We'll break it all down for you to tell you if you're eligible, what you're eligible for, and how to get started there.

Guys, we have gone the full hour. We've had thirty questions just coming in. We got to one question of our our pre questions before the webinar. So, it's always such a popular topic because there still feels like there's so much unknown about it, and, people just want as much information as they can because they everybody wants to help their loved ones, at the end of the day, and they wanna understand this, disease as best that they can. And we're all still trying to understand it, each and every day. Susan, again, thank you so much for being here. Your knowledge of all things related to dementia has helped so many people in the past, and I know that today you were able to help at least one person as well. So thank you so much.

Yeah. Well, thank you, and thank you all for coming and asking your questions.

Absolutely. Yes. Thank you for being a part of the conversation. And it's been asked a couple of times, but then I'll reiterate, for those of you watching, if you are interested in watching more webinars just like this one, including a couple with Susan talking about dementia, please head on over to our website. It is w w w dot senior living live dot com. All of our videos, all about senior living, they're available on demand twenty four seven, and they are all free. Thank you so much, everybody, for being a part of Senior Living Live. Have a great day.