Involve everyone in memory care

Gather regularly, and nurture a feeling of purpose in residents who have dementia. That’s the advice that Johnna Lowther shares with staff members of Tutera Senior Living & Health Care. As director of life enrichment for the Kansas City, Mo.-based company, she is educating administrators, directors of nursing, social service coordinators, marketing coordinators, direct caregivers and others via dementia-related training at 47 senior living communities in 13 states across the country; 11 of those communities offer memory care programming.

“When you look at educating the staff, you’re trying to change a culture and an approach to dementia care, and that has to be a continuous message that is carried out throughout the whole community, whether the entire community is devoted to memory care or whether it just has a small unit within that community devoted to memory care,” Lowther tells Long-Term Living. “It’s a message that has to resonate with all the staff in that building.”

Tutera’s evolving approach to memory care and related training “is accomplished in the context of what the entire organization stands for and the direction we are going as an organization,” says Randy Bloom, right, the organization’s president and chief operating officer (COO). That approach is evident in the “We’re inspired by you” message on the company’s website, he continues, adding that the concept is meant to stress that each resident is a unique individual.

“ ‘Inspired by you’ speaks not just to our attempts to understand how our residents experience things; we also recognize that our employees, our families and the members of the community are inspirations for it as well, because each is unique,” Bloom says. “It’s our responsibility to ask the question, understand how individuals are unique and use that information to develop our programs and our philosophies within our organization.”

In her work, Lowther emphasizes:

• Inclusion. “You’re really including everyone and what’s going on in the circumstance,” she says. “It’s a form of direct engagement that places a high priority on group activity and social interaction.”
• A dementia-specific curriculum. Lowther revamped policies and procedures to include new goals and expectations related to Tutera’s memory care communities.
• Softer sounds. “One of the key techniques you can use in memory care is slowing and softening sounds around residents, which also means slowing your approach, slowing down your speech and lowering your voice and finding ways to make the environment not as loud and stimulating,” Lowther says. Communities, she adds, “are living environments for our residents, but they’re also working environments for our staff, and it’s really easy sometimes for staff to get focused on the tasks of their job and not recognize how much noise they’re contributing to the environment.”
• Activities and dining. “We implement a lot of recreational therapeutic programming in dementia, and residents need someone to help them engage and participate in life,” Lowther says. “So when we’re implementing activities of daily living in certain therapy groups and in exercise group, they need that presented to them in a very specific manner that enables them to participate, so that they don’t get confused by what they are being asked to do or over-stimulated by too many options in front of them.

“That also can carry over to your dining experience with those residents, too, or the way that staff members are helping them get dressed for the day,” she continues. “You have to limit their choices to a degree while still offering them an opportunity to make a choice. It’s a fine balance.”

Lowther holds certificates as an Alzheimer’s disease and dementia trainer, certified dementia care manager and certified dementia practitioner from the National Council of Certified Dementia Practitioners. She also became a certified activity director through the state of Missouri and went through the Kansas assistant living home operators course.

“The theory of memory care and the way in which we need to approach it is fairly well known,” Bloom says. “The piece that really sets us apart, to me, is about execution. We are putting the time and energy and resources into the education component and really getting to all [staff] levels of a particular facility. The other unique component to this…[is] that we are tying our message of how we approach the care and treatment of these individuals to the overall company message. All of these things are important for us to create what we believe to be a unique experience for our residents that coincides with what we believe as people and as an organization.”

Tutera is relatively unique in that its president and COO has a PhD is in psychology. Bloom began his association with Tutera in 1995 as regional marketing coordinator, where his role included implementing memory care units in each community. “I did precisely what Johnna is doing,” he says. Except for a two-year absence, Bloom has been with the company ever since, subsequently as regional director of operations for Kansas City, then director of operations for the company, then the vice president of operations and then the senior vice president of operations. He’s been in his current role since 2009.

“I am very proud of the work that has happened, but this is just the beginning,” Bloom says of Tutera’s current efforts in the area of memory care. “A lot of hard work needs to occur in that process. Culture changes takes time.”

Lois Bowers

Lois A. Bowers was senior editor of I Advance Senior Care / Long-Term Living from 2013-2015.