What Is Person-Centered Care for Dementia?

Claire Samuels
By Claire SamuelsSeptember 14, 2020
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Person-centered care for dementia is a relationship-based approach to supporting adults in memory care communities. By understanding a person’s past, preferences, and emotional needs, a community can provide the type of care that best fits their personality, abilities, and care needs.

A person-centered approach focuses on the relationship between a caregiver and a senior in addition to their physical and mental health. By emphasizing possibilities and emotional well-being rather than limitations from dementia, person-centered care enables seniors with cognitive decline to maintain a sense of self.

Dementia care has come a long way over the past several decades, says Juliet Holt Klinger, senior director of dementia care and programs at Brookdale Senior Living. “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.” This means helping seniors maintain their own identities instead of treating them like patients.

Unlike the task-oriented, impersonal environment of 20th century dementia care facilities, a person-centered care approach fosters close relationships between residents and staff, offers activities and amenities to promote individuality, and gives family members the option to participate in their loved one’s care. In person-centered care communities, seniors are respected and valued as individuals, regardless of age and cognitive decline.

Memories and identity in person-centered care

Collecting stories and memories is a foundational part of person-centered care for dementia. When taking a person-centered approach, communities ask about an aging loved one’s childhood, hometown, hobbies, family dynamics, and traditions. They learn likes and dislikes, from favorite foods to pet peeves.

What we know now is that person-centered care is the key to working with people with dementia.

Juliet Holt Klinger, senior director of dementia care at Brookdale Senior Living

From there, 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. “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. 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.

Family history and life stories help inform activity and lifestyle choices in the 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. “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.” 

Features of person-centered care for dementia

Taking aging loved ones’ stories and creating a daily routine that brings them joy and fulfillment is one meaning 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 had 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 it.
  • 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,” says Holt Klinger. “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 activities, redirection techniques, and more.

Friendship and peers

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

Everyone wants a sense of purpose. Activities are useful to maintain that, whether it’s helping make snacks or spending time in the community garden.

April Young, vice president of sales and marketing at JEA Senior Living

“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.

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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,” says Mainetti.

A dignified dining experience

Many seniors experiencing dementia lose interest in food and eating. This can be because of appetite loss, inability to use certain utensils, and trouble with depth perception and seeing contrasts that make it difficult to recognize different foods. Person-centered care communities avoid bland, repetitive meals and make dining an engaging experience.

  • Ensuring residents’ nutritional needs are met is a top priority, but seniors are more likely to eat foods they’re comfortable with from childhood, and weight loss can be dangerous for seniors with dementia. 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 with dementia 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.

What makes person-centered caregivers different?

Staff members, caregivers, and nurses at person-centered care communities for dementia receive special training to help residents be successful. “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 allows 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 their preferences. “When a new resident moves in, everyone’s on board,” says Mainetti. “We spend time updating and briefing on that person’s unique situation, and what will be beneficial for getting them settled.” At the same time, small groups may have neighborhood team leaders or individual primary caregivers for more personal connection.

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 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.

How to choose a person-centered care community for dementia

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. “You can see person-centered care in the relationships between the caregivers and the residents.” She suggests looking for the following signs of care during your virtual or in-person tour:

  • 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 they reflect care that’s honored 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 virtual tour.

Claire Samuels
Claire Samuels
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