What is Person-Centered Care for Dementia?

Dementia care has come a long way over the past several decades.

“After working in this field for almost 40 years, I can say that what we know now is that person-centered care is the key to working with people with dementia,” says Juliet Holt Klinger, senior director of dementia care and programs at Brookdale Senior Living.

Unlike the task-oriented, impersonal environment of 20th-century dementia care facilities, person-centered care communities foster close relationships between residents and staff, promote individuality and emotional well-being, and give family members the option to participate in their loved one’s care. In these communities, seniors are respected and valued as individuals, regardless of age and cognitive decline.

Collecting stories and memories is foundational to person-centered care for dementia. When taking a person-centered approach, memory care communities learn about an aging loved one’s childhood, hometown, hobbies, family dynamics, and traditions. They learn likes and dislikes, from favorite movies to pet peeves. They will also learn about the specific symptoms a person is dealing with. A real relationship is built between a caregiver and a senior.

The community works to create a life story that highlights achievements and favorite memories.

“We start the process early on,” says Katrina Mainetti, program director and certified dementia practitioner at JEA Senior Living. “We talk to the family and learn about the things that have meaning in their loved one’s life. The care staff all has an opportunity to read through that bio and understand where they come from.”

As the family member of a senior receiving person-centered care, your role is to tell your loved one’s story. From small traditions, like pancake breakfasts each Saturday, to bigger things, like your relative’s love of animals, you can contribute ideas to help shape their care plan.

“Being able to honor someone’s life story involves tapping into the wonderful traditions their caregivers instilled through daily routines,” says April Young, vice president of sales and marketing at JEA Senior Living.

Family history and life stories help inform activity and lifestyle choices in a person-centered community. For example, if dementia caregivers learn a new resident loves being outside, they know that garden walks may calm them down in a stressful situation or bring them joy on a bad day. These preferences develop a picture of each resident’s life, which is used to help them succeed.

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“It’s more than just knowing those small bits about people,” says Holt Klinger. “It’s understanding how the puzzle pieces fit into the whole of the person, and basing programming and assistance on that.”

Taking aging loved ones’ stories and creating a daily routine that brings them joy and fulfillment is one goal of person-centered care. A range of activities, dining options, and daily choices based on each senior’s interests contribute to care success.

Personal preferences and decision-making

Memory care communities of the past often set wake-up and lights-out times, rigid meal structures, and other one-size-fits-all protocols. A person-centered approach focuses on maintaining residents’ personal preferences as much as possible.

• Residents can set their own sleep schedules, within reason. Night owls may be able to stay up late, with programming into the evening.
• Some seniors may prefer to shower, while others choose to take baths.
• Multiple meal options and snacks enable residents to eat what they want, when they want.
• A variety of religious services and spiritual support systems cater to different beliefs.
• Living spaces can be decorated with personal furniture, artwork, and memorabilia.

Activities according to interest

Person-centered care means offering meaningful, fulfilling options for every resident.

“It’s important to have engagement that is geared toward individuals and what they like to do, rather than having everyone in one big circle playing ball-toss,” Holt Klinger says. “Each person should be able to choose from a diverse selection of activities.”

• Activities are crafted for interest and ability level. One resident may be able to play tunes on the piano, while another music lover with more advanced dementia may enjoy listening to old records.
• “Everyone wants a sense of purpose,” says Young. “Activities are useful to maintain that, whether it’s helping make snacks, spending time in the community garden, or even just performing basic tasks.”
• Noting how residents respond to certain activities is an important part of person-centered care. Regular activity assessments for each resident can update caregivers on new memory care activities, redirection techniques, and more.

Friendship and peers

Seniors with Alzheimer’s or another form of memory loss may feel isolated living at home or with family. Friendship with peers in a memory care community can combat that loneliness through shared experience.

“It’s important to be engaged with other people who know what they’re going through, and who understand their challenges at the time,” says Mainetti. Person-centered dementia care communities are often divided into “houses” or “neighborhoods,” based on residents’ ability level and interests.

When a senior moves into the community, staff members and welcome committees are there to make them feel at home. Sometimes buddy systems or small groups help new residents acclimate. “People without cognitive deficits may think it’s not possible to make new friends with dementia, or that they won’t remember, but that’s not true,” Mainetti says.

Read more:What Do Dementia Patients Think About?

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A dignified dining experience

Ensuring residents’ nutritional needs are met is a top priority. Many seniors experiencing dementia lose interest in food and eating. This can be because of appetite loss, inability to use certain utensils, or trouble with depth perception. Loss of ability to see contrasts can also make it difficult to recognize different foods. Person-centered care communities avoid bland, repetitive meals and make dining an engaging experience.

• Seniors are more likely to eat foods they’re comfortable with, like foods from childhood for which they are nostalgic. Liberal dining programs include traditional favorites like meatloaf, casseroles, and creamy soups alongside healthy dishes.
• Modified utensils and brightly colored plates encourage independence and help with food recognition.
• Multiple meal options throughout the day let seniors choose their own schedules without missing nutrition. For example, there may be two breakfasts — one for early birds, and one for late risers.
• Some communities have different dining locations for residents who are independent and those who need more support.

Staff members, caregivers, and nurses at person-centered care communities for dementia receive special training to help residents be successful. But a person-centered approach also focuses on the relationship between a caregiver and a senior in addition to their physical and mental health. Caregivers help emphasize the possibilities rather than the limitations of dementia.

“It really goes deeper than helping with routines and habits — relationships are very important in person-centered care,” says Holt Klinger.

Often, communities follow a creative, non-departmental staffing approach. Though staff members have different primary roles, they come together for an all-hands-on-deck system that enables residents to feel comfortable with multiple care partners. Biographies and care plans for new residents are shared among staff members so everyone’s familiar with residents’ preferences. At the same time, small groups may have neighborhood team leaders or individual primary caregivers to foster more personal connections.

“When a new resident moves in, everyone’s on board,” Mainetti says. “We spend time updating and briefing on that person’s unique situation and what will be beneficial for getting them settled.”

In a nursing home or long-term care facility, staff members may complete activities of daily living (ADLs) for residents. This could mean dressing, bathing, or feeding them. In contrast, person-centered care communities aim to help residents do as much for themselves as they can in order to maintain skills, according to Holt Klinger. This “do with and not for” mentality often includes extra steps, like helping residents pick out their own outfits before dressing or reading a favorite book out loud together.

There are many factors to consider when choosing a memory care community for your loved one. A person-centered care program is one of the most important, says Holt Klinger. She suggests looking for the following signs of care in a community:

• A sense of affection. Do caregivers appear genuinely invested in resident happiness and well-being?
• Eye contact. Recognizing and communicating with residents as individuals with unique identities is key.
• Personalized spaces. Are rooms decorated with personal and well-loved items from home, or does the environment feel institutional?
• A robust plan for daily activities. Does the community offer choices for daily activities? Do they appeal to a wide variety of interests?
• Style preferences. Are residents just clean and well-groomed, or do caregivers help them honor their personal style? “Many women in this generation grew up wearing panty hose or never leaving the house without lipstick and jewelry,” says Holt Klinger. “Look for those preferences being honored.” Residents expressing themselves with favorite clothing and accessories are a strong sign of person-centered care.
• Resident conversations. Ask the residents how they feel about the community, suggests Holt Klinger. Even if they struggle with communication, they’ll be able to express well-being and happiness about their living situation.

If you’re ready to explore person-centered care opportunities for your aging loved one, reach out to our Senior Living Advisors for a free consultation or to learn more and set up a tour.

Read related article:Best-in-Class Memory Care Practices: How to Run a Memory Care Unit