By Alden Kizer
It often begins as simply as forgetting where you left your car keys. Over time, Alzheimer’s or dementia progresses until an individual can no longer care for themselves.
With an aging population, there’s a growing need for specialized care for people diagnosed with Alzheimer’s and dementia. The Alzheimer’s Association estimates 5.5 million Americans are living with the disease. Even more staggering, they require an estimated 18.2 billion caregiver hours each year.
To meet the needs of those in the advanced stages of the disease, nursing homes across Alabama have special units with staff members uniquely trained to meet the needs of Alzheimer’s and dementia patients. As part of Alzheimer’s and Dementia Staff Education Week, we’re highlighting the system Aliceville Manor Nursing Home uses to educate its staff.
Aliceville Manor Nursing Home didn’t have to look far for staff training when it opened an Alzheimer’s and dementia care unit, Countryside Garden Memory Care Unit, in 2016. Pickens County native Vicky Noland Fitch is a Certified Dementia Practitioner and Social Worker. She instructs all the dementia care staff on the GRACE system.
“When I think of the meaning of GRACE, I define it as an elegant way of existing in the world. Smooth, stylish, sophisticated,” said Fitch. “As I was thinking of a way to capture the essence of my caregiving style, that is what I aimed for. GRACE, a sophisticated, but simple, way of interacting with people with dementia. I think all caregiving, in essence, is simple. Treat the person for whom you are providing care to with love, respect and honor for the person they are; not the disease they have. While meeting their needs to the best of your ability.”
Employees of nursing homes with memory care services complete the DETA Care 12-part educational series and testing. In addition, Certified Nursing Assistants preparing to work in Aliceville Manor’s Countryside Garden study Fitch’s Behavior Management System GRACE: gather details, reminisce, assess, calm, and excite.
“This is layered on-top of basic education of dementia and the 12-part discs. Everyone who comes in the nursing home gets trained on dementia basics. If you work on the unit specifically you must complete the additional training,” said Fitch.
Gathering information, the “G” in Fitch’s GRACE system, is the key to be a successful staff member working in a memory care specific unit. This gives certified nursing assistants the information necessary to interact with residents living with the disease.
“We train around this information,” Fitch said. “Gathering important details is critical because you need to know them to be able to provide an individualized plan of care.”
The beneficial information is obtained through a special “Life History of…” document. During the training process, the new CNAs learn to evaluate an individual’s life with one-another. Once this packet is complete, Fitch creates a scenario. Each portraying a resident who might be physically and emotionally uncontrollable. Using both specific and detailed information, they can interrupt the behavioral loop.
“It works,” CNA and Memory Care Activity Director Lesley Owens said. “The residents sit down and talk with you. It is one of the tools I always use to help calm them down. And they enjoy talking about themselves.”
This first step of training teaches CNAs how to react during a behavioral outbreak situation with grace and without the need of medication.
“We do it because we do not want to use psychotropic drugs. We want to use behavioral management interventions,” Fitch said. “Often, a person with dementia is not very ‘sick’ per say. They need more social and behavioral support than physical at times. Yes, they have function loss such as forgetting how to bathe, and that requires physical support. But overall, our CNAs are trained to provide mental well-being, socialization, behavior management and routine structure.”
Overlaying the GRACE system with DETA Care training is an additional step and requires more time. However, the benefits to the residents and staff are worth it as Aliceville Manor strives to provide a much-needed service in a rural area.
“Vicky is a wonderful teacher and has a huge heart and passion for educating others and assisting facilities to care for residents with dementia,” RN, LNHA and Aliceville Manor Nursing Home Administrator Ashley McGee said. “She has been instrumental in the success and care of our residents on the unit.”
Editor’s Note: Alden Kizer is Marketing Director of Aliceville Manor Nursing Home and a graduate of the University of Alabama.