The Culture of a Community

© Imelda Maurer, cdp May 11, 2015
ilmcdp@yahoo.com

Yesterday I posted “Simply Caring” which included a powerful, simple picture with an accompanying commentary.  I posted that entry just hours after learning that the woman on the left, Dolores, providing a shoulder and a place of rest and comfort, had died earlier in the day.  That news came to me via an email from Jan who quoted from an email message sent to all the staff from  Allison Dolan, the Nurse Manager for the community”

Dolores passed away today at 8:40am at St. Luke’s Hospital with her brother holding her hand. She will always be remembered as Ms. Marvelous, who consistently complimented you. We will miss her dance moves and smile.

Many aging services communities have some way in which the death of a resident is noted and ritualized in a way that acknowledges and honors the deceased while remembering that person’s unique qualities and gifts to the community.  Such ritualizing also serves as comfort to staff who also, if they open their hearts to it, experience grief and loss upon the death of one whom they had served with compassion and competence.

My reading of Allison’s message was that she is a professional who has not suppressed her human emotions or vulnerability to pain.  She nurtures and deepens the sense of community in acknowledging individual and communal grief over Virginia’s death.

Simply Caring

© Imelda Maurer, cdp May 10, 2015
ilmcdp@yahoo.com

Several months ago I was invited by Jan McGillick, a social worker, gerontology professor and colleague, to facilitate an evening event at an assisted living community which serves persons living with dementia. Residents and family members who were present were invited to gather in the living room to talk about their experience of friends and friendship throughout their life. At the end of a fascinating experience, Jan escorted me through the house to the front door.  In the foyer we both saw a sight which was literally “a Kodak moment.” I took the picture which is here.

  

Hoping for permission, which was granted, to use the picture, I articulated for the family members of each of these women the tender, personal yet powerful message of the picture:

This picture reflects simply and profoundly the human capacity to care and the human capacity for mutuality and relationships at all stages of life.  Though the disease of Alzheimer’s may prevent proper verbal articulation of these capacities and needs, they can still be experienced and expressed, particularly if the physical environment and the philosophy of services facilitates and honors the movements of the human heart.

In this aging services community, the environment is intentionally focused on “home” where individuals feel secure and have a sense of belonging. The image shows that one elder is allowing another to lean her head on her shoulder. The smaller, petite woman wants to sleep, but she does not want to go to bed. The care partners know this particular preference of the resident and it is honored. In doing so, even if by happenstance, a sense of community and of caring is experienced by the second elder in the picture.

This picture is precious for more than one reason: First, in what the picture reveals, in the stirring of the human heart upon seeing it.  Secondly, it serves as a powerful model when used to reflect how principles of person-directed living can be lived out in a setting that is home and where spontaneity is a normal aspect of an elder’s day. The picture opens the imagination of those in the helping professions who only have images or experiences of an institutional, medical-model style of “health care” where task and staff convenience take precedence over the centrality of the person.

A New Look at Thickened Liquids

© Imelda Maurer, cdp May 9, 2015
ilmcdp@yahoo.com

Dr. Alex Smith is featured in a fascinating six-minute video entitled, "The Thickened Liquid Challenge."  Similar to the popular ice bucket challenge to raise awareness about Lou Gehrig's Disease, Dr. Smith, San Francisco Veterans Administration Medical Center, challenges health care providers to take 'the thickened liquid challenge,' experiencing what it is like to drink your ice tea, coffee, coke, orange juice, or water with thickener added.  The video pictures several individuals as well as groups of healthcare professionals taking the one-time challenge. Among the responses was a comment that 'it tastes like paste.'

Dr. Smith said  very few of the health care professionals who were challenged to drink only thickened liquids for twelve hours succeeded in doing so. Smith weighed this reality against the fact that some persons, especially those living with dementia, are often prescribed 'thickened liquids only' for years!

Evidence from video swallow studies shows that thickened liquids prevent fluid from being aspirated into the lungs, rather than going into the stomach. Beyond that there is "no evidence in real life that putting someone on thickened liquids is more beneficial than harmful." There are some harms associated with thickened liquids, one of which is dehydration!

The final decision, Smith says, should be a very individualized one.

I highly recommend viewing this informative, well-done video here.






http://makingsenseofalzheimers.org/stories/thickended-liquid-challenge/