Helping long term care residents with dementia feel calm, safe and happy

Dementia can be distressing to residents experiencing it as well as to their caregivers. While you can’t know what having dementia is like without the personal experience, and who wants that, you can often see visual signs of stress, anxiety, confusion, anger, and frustration. A safe and calm environment contributes to the quality of life for both long term care residents and staff.

A few weeks ago, I received a compassionate inquiry from Chantelle, who works in a residential program for residents with dementia. She emailed, “I want to learn more about keeping the residents in a calm and safe environment. What I am really trying to say is that I would like input from you on how to keep dementia and Alzheimer’s resident feeling calm, safe, and not feeling neglected in any shape or form. Sincerely, I want to keep my residents happy at all levels of care. Thanks for your time! P.S. Help Please!” (Chantelle’s name was changed for privacy.)

Be calm to create calm

Chantelle is asking how she, personally, can calm her resident’s fears – not how the facility, the management, or the government could help.  Ensuring the safety of residents with dementia is of course paramount.  However, even if you know a resident is safe doesn’t ensure that they feel safe. Feeling safe, calm and happy has more to do with who people are with, rather than their physical surroundings. There is a lot that each of us can do to shift the energy of a place from scary to safe, stressful to calm, and frustrating to happy. Research, and probably your own experience, indicates that the mood, attitudes, appearance, behavior, and energy of a caregiver impacts the one in their care.  Contemporary nursing theorists consider the caregiver to be part of the patient’s environment.

So the complex answer to Chantelle’s question is: in order to help residents with dementia feel calm, safe, and happy, YOU must feel calm, safe, and happy. This is complex because all sorts of things in a caregivers usual day may make you feel anything but calm and happy. Caregivers may be yelled at. You may be busy, sad, angry, or frustrated. Faking happiness and calmness doesn’t work; residents and family members can sense your insincerity even if you mean well. The answer to these challenges is to be aware of how you feel, and take care of your body, mind, and spirit with wellness practices.  This gives you the strength and resilience to create caring trusting relationships with your residents.

Not knowing what Chantelle had tried so far, I began a dialog with her by offering these quick calming suggestions. Professional caregivers in most any setting as well as family caregivers at home can try these simple ideas too.

• Make eye contact and sincerely smile as often as you can.
• Slow down, and modulate your voice to be gentle and relaxed. That’s tough to do if residents are hard of hearing, but a smile will soften most words.
• Practice taking deep breaths for yourself and with residents who can follow your example or direction. Click here for an example of an easy guided breathing meditation.
• Take the time to calm yourself before and during work, in whatever way serves you best. Both stress and calmness are catchy! Click here for some ideas.

Calming the environment

Creating a safe and comfortable environment in healthcare facilities has been the intention and desire of caregivers for hundreds of years. Florence Nightingale  wrote about this long ago in the mid 1800’s. She taught nurses to guide the patient to the best condition for nature to act on him or her. Nightingale stressed the properties of the patient’s physical environment: nature, cleanliness, and beauty, among others. She influenced the modern commitment to super-clean healthcare environments, art in patient care settings, and big bright windows in patient rooms, preferably with a view of nature. Each of these factors – nature, cleanliness, and beauty – can enhance a sense of well-being with those in our care. So in addition to keeping yourself calm, other things you can do for your residents include opening the curtains in their rooms, arranging for safe outdoor time weather permitting, reducing clutter in their rooms, and introducing beauty into your resident’s day, whether it be flowers, your own nice outfit or hairstyle, or a magazine with lovely photos. Little things do make a difference!

People with dementia may feel distressed and unsafe even when you know they are in a safe setting. Their caregiver’s mood greatly influences if they feel safe. Calmness is catchy – if you feel safe, calm and happy that will help your residents to feel the same. Consider developing self-help practices you can use before, after and during work to help you feel calm. Remember Nightingale’s teachings about nature, cleanliness, and beauty. Spread feelings of safety, calmness, and happiness whenever possible!

Readers, let me know what works for you and what doesn’t. Thank you for all you are doing to serve those in your care!