Aging Under the North Star banner

Share this article on social media!

 

North Star Senior Advisors recently reached a milestone with its podcast, Aging Under The North Star, which has now surpassed 2,000 viewers and continues to grow its audience of families, caregivers, and senior care professionals across Central Florida and beyond. The podcast’s latest episode, Color & Connection: Easing the Dementia Journey (Episode 10), features special guest Dr. Joshua Freitas, Chief Education Officer and Board Chair of the National Institute for Dementia Education (NIDE).

Podcast Transcript

Welcome to Aging Under the Northstar, your trusted podcast for aging, caregiving, and senior living. I’m your

host, Veronica, and today joining me is Josh, Dr. Josh Freighus. Thank you so

much, Dr. Josh, for joining me. You are a wealth of knowledge, but not only that, you’re a friend and a mentor, and I appreciate you being here.

Well, thank you for having me. Yeah, I’m excited. Um there are two important topics that I’d like to

discuss in today’s podcast. But first I want to start with the number one that really had me intrigued and it was very

eye openening for me when we were training with you. And I say we me and some of my team members were training

with you and it was the psychology of color. This was like wow like eyeopening

for me. And so research it suggests that specific colors often trigger emotional

responses for those living with dementia. Can you describe what that means and get into like the philosophy

of color? Yeah, sure thing. So, uh through the aging pendulum, uh color affects us differently. So, we might associate

things like red might be associated with eating in the middle of life, but also that can be applied later on and

providing contrast. But as we age, we also see colors differently as well. So, even things like soft greens or soft

blues might have an emotional appeal in some aspect. But then also being able to see our vision is changing. So what

happens is we get a yellow film over the eye changing the uh colors that we see. So some colors actually pop more or pop

less and that can actually trigger some of the behaviors and if we apply them the right way we can minimize some dementia behaviors as well.

Ah okay. So I’m glad you touched on that. So you mentioned the color. So in

the different stages of dementia and the different uh you mentioned aging um the

different stages of dementia. Does that also mean that the colors change with the different stages? So people become more reliant on what

they can see. So on face value, people might trigger things. So like you and I drive down the road and we see a yellow

sign. We know what it means because we’ve been conditioned. That stuff can actually return with dementia. So

there’s seven stages known as the global deterioration scale or the three phases. But as people go further in their

disease journey is they actually become more reliant on it. So if they have more color contrast, they might be actually

more drawn to things like fiesta colors or bright colors. So colored uniforms, colored plates, that might actually pull

their behavior. And I won’t go too deep, but there’s something called retrogenesis that um the first things in

life are the last things we lose. And a lot of things that we see with adolescence like bright color crayons or

bright toys that comes back, but it’s our job to make sure it’s dignified. So having a pen that might be a brighter

color for them to be able to identify or a uniform color to actually help orient who is their caregiver. All of those

things become more reliant on the person with dementia. Can you get into the actual colors, the recognizable colors, the strong dominant

colors and their meaning? Yeah, sure thing. So different colors have different behaviors. Some is theoretical and some is actually

evidence-based. So I know at Curtis what we’ve done is we’ve had each department wear different colors and observed how

we can improve care. So, for example, all caregivers wear the color lime green. And what we noticed is when we

did this is we had a reduction in sundowning behavior because people could identify who to go to. That green popped. So, it’s one of the more

prevalent colors they see. So, we actually want our caregivers to pop up more than other uh employees because

that’s where they’re going to get their help. But what we notice is dark blue will suppress that engagement. So, we put our maintenance in dark blue so

they’re not going to if they need help to go to the bathroom. And then light blue can actually foster that engagement

uh sequence to get people to engage more. And the color purple, and we won’t get into the science, but will be stolen more than any other color. So, we

actually put our nurses in that. So, the two people they’re primarily going to is caregivers in green, but then also

purple uh for their nurses. And the last one is a color red stimulates appetite. So, we put everybody that works in our

dining experience in red. And what we notice is subtle changes in everyone’s behavior. But one of the biggest thing I

thought was fascinating is the color black from the kneecap down is perceived as scary. So we actually decided to have

all of our caregivers wear tan pants and white shoes. And what we noticed is people with Louis bodies, Parkinson’s or

Huntington’s, their behaviors went away because they weren’t seeing that peripheral deficit below the knees and

they actually fostered better care. We could get closer to them. So those subtle changes though you and I would

look at them and say, “Oh, it’s just a color change.” It actually is a whole behavior change for those with dementia. That’s interesting. So, how do you know

like okay, so you have a new resident that moves in, right? How long does it take for them to understand who is who

by recognizing those colors? Yeah. So, there’s actually a length of time that people take to acclimate to a new environment. It’s about 35 days, 5

weeks. What we notice is uh some of the trigger points is people will say, I need somebody in green. I need somebody

in green. So you can see that the people even with cognitive challenges can identify that person in green can help

me and actually uh they’ll go directly to that person and ask for help. So we actually can shape that behavior. We see

that around that month to 5 week mark right that’s awesome. Okay. So, that

helps families actually and I’m sure you know when they’re transitioning their

loved one. It’s it’s a whole emotional roller coaster and a lot of families ask us like are they going to constantly

want to come home? Are they going to keep wanting to come home? Every time I come here it’s it’s been challenging and they don’t know who’s who. I think the

colors will definitely be beneficial for them in any environment that they’re at, including home. So, if they’re home, how

do you tell caregivers to address these colors within their home environment? Yeah. I’ll give you a real example. I

had somebody just recently, she said, “Well, my husband has dementia and that’s why he’s not flushing the toilet.” So, I listened to this, but

when I did the home assessment, what I noticed is that the toilet was all white. So, the flusher was white, the

top was white, and my recommendation is always to have a contrast toilet seat. But what I also recommended is what if

we popped off the flusher and painted it lime green, more prevalent color. We did that and the lady called me literally a

week later and was like, “He’s flushing the toilet all the time.” It just literally took us painting the flusher a

different color. But even the um outlets, I hear a lot of people with dementia like to sit in the dark. People

with dementia don’t like dark spaces. So that’s typically not what would be normal. Is if you even take light switches and

paint the little flicker a different color, that helps them identify a white wall with a white um light switch, they

can find it easier. So now they can actually turn it on and not be sitting in the dark. So, small features like that at home can be very powerful. A lot

of people I hear say use a black rug because people with dementia will walk across it. I don’t always like to scare

people that way. Um, but the color black from the kneecap can be perceived as scary and that could be a reason why

somebody doesn’t go into a bank or to a restaurant. They might not want to um step over that rug.

I’m glad you mentioned black rug because sometimes you go into buildings and you know the entryway has the black rug. you

know, common. I see memory care communities put the black rug or

sometimes very dark flooring and there’s a lot more falls. There’s a lot more

behavioral um what’s the word where confusion where they don’t want to step

over a certain area because of the dark rugs. What do what does the black rug do for someone with dementia?

It’s perceived as a hole. So, um I’m not the biggest fan. You have to weigh safety and the black rug. You know, a

black rug could be scary where if you and I felt trapped in, we might have some behaviors, too. But I can almost

predict this is if somebody walks into a community with a black rug and it’s inside, you might smell urine. And the

reason is that it’s perceived as a whole. And many residents with dementia will actually urinate on that black rug. So, yes, it’s a pro and con, but you

have to be very sensitive to who’s actually in that community. Um, and a scare tactic isn’t always the

best. Actually, research shows if you just paint the door the same color as the wall, you can reduce that wandering

behavior just as effectively without scaring people, you’re just making less um attention to it, right?

And you see things like bookshelves and other things to say. I’ve seen bookshelves. So, to me, knowing myself,

I’ve seen a bookshelf painted uh as a door. I would go over there because I’m a reader, right? I would [laughter] I

would be staying there trying to, you know, get to that book. So I like that idea of painting the the area the same

as the wall because it just blends in. You’re not going to even think to go in that direction in small features like I say things of

normaly. So you might even have a door that you can’t camouflage is you might actually make it look like a closed

booth and have a closed sign on it. People behaviorally would walk and say oh that must be closed today and walk right past it versus having that

attention. So sometimes earlier stages you can still use those. So environmental cues can be very powerful.

Yeah, that’s that’s interesting. See, it makes me want to open a memory care. [laughter]

Um, no. So, all jokes aside, I really think if we’ve had some u clients, uh,

mutual clients that have said things similar to the whole toilet flushing, but if you go into like a memory care

and some memory care directors will say, “So and so is urinating in the the tree

or in the plant.” What are some things families can do to avoid that? Yeah. Yeah. So, there’s actually a case

study that just came out that showed that u that black mulch or that black soil looks like a hole so they will

urinate. And sometimes people will say nature and trees and people want to go to the bathroom. What they showed is if

you just put white rock on it if it’s safe and maybe even glue the rock down, it deters that person to go to the

bathroom because they can see it’s not a hole. So, small things like that can be very powerful. And I also have to say

sometimes behaviors, they’re a way of communicating, but sometimes you can use them to solve issues. So I’ve had a lot

of residents that urinate in bathrooms or in their bedrooms in a residential. One thing to do is actually buy small

little track uh black trash barrels and put them out. As they urinate in them, you slowly move it to the bathroom and

you condition their uh spatial awareness to learn where that bathroom is. So then you don’t need them anymore. So you can

actually leverage the behavior sometimes to actually solve issues. You just were transitioning into my next question. Can

someone with dementia learn something new? Absolutely. I love this. This is the biggest challenge and I I

hear it from uh the medical community and I’ve had people reach out and say people with dementia can’t learn and that is completely false.

People with dementia can still learn. They learn differently. They learn on emotional based knowledge. Uh how my

environment is perceived. And that that alone can be uh really powerful. I would

argue with anybody that says somebody with dementia can’t learn. I’ll give you an example. You sit in that seat every day at lunch in a memory care community.

I come down and somebody else is in my seat. You see that aggression. Get that person out of my seat. That’s my seat.

That shows the person with dementia can still learn. It just takes them longer. And um we won’t spend too much time on

it, but we actually have three brains and that that actually gets strengthened. The emotional based knowledge is our entric nervous system

and nervascular system. So we have to think people with dementia are relying on emotional based knowledge. How I make

me feel uh my routine my approach and what a space communicates to me. That is amazing. I I have to agree with

you. Um I’ve seen those with dementia they are relearning every day right there. if

especially if they like you said there’s um consistency and that which something that they need the true consistency of

their their scheduled day or um activities things that they do on a daily basis. I was just talking to a

friend of mine because she was asking me for some of some help and she said my dad isn’t showering. um he came to

visit. He drove down or his him and her brother drove down from out of state and

he didn’t shower the whole 5 days. And I kept said saying, “Dad, go shower.” And I’m like, “Well, he’s not in his environment.” Number one, um he heard go

shower, but he doesn’t know what to do in your home. I’m like, “So next time,

like try laying his clothes out, try directing him, turn the water on for him if he can in fact still shower himself.

But if he can’t, you know, that’s a whole other topic we can get into. You know, how to shower those that are refusing to bathe. He’s not refusing. He

just didn’t really know. It’s kind of like you have to kind of redirect him and train him to do that. How does that

happen in a facility or when someone’s transitioning into a community? Um

especially the first few days that you know they’re reconditioning their their mind to know where the bathroom is from

bed and so on. So one thing is uh don’t push it. If it’s one or two days they’re not taking a shower, it’s okay. You also don’t want

to create frustration between the caregiver and the resident. So sometimes a day or two without a shower, it’s okay. Unless there’s an accident or

something like that. But I also say that we’re about 40 to 50% habit. So sometimes it’s actually showing them the

shower. So not a caregiver saying it’s time for a shower, it’s time for a shower, but actually bringing you into the shower, turning it on, putting even

some like a bottle of soap in your hands and saying it’s time to take a shower. those visual cues, they might actually

see that and know, okay, it’s time to take a shower. Um, there’s other things, too. If somebody’s not taking a shower,

they have shower in a bag. They have other things. I’ve seen people put body wash in balloons and do a balloon toss,

so it gets them wet. Um, a non-traditional thing, I’m not telling people to go out there and spill stuff on residents. Not saying that at

all, especially if it’s hot or cold. But I have in the past have had a resident that wouldn’t shower for almost

a week. And the only thing I could think of doing is people with dementia don’t like to be wet. So, I accidentally

bumped a glass, got a little bit of water on their their leg and said, “Oh, come on. Let’s let’s go get you changed.” And soon as they were uh ch uh

droing, I could bring them right in the bathroom, get them showered, and then get them out. So, sometimes you just got to think a little differently on how you

approach things. And I’m not saying to go out and pour stuff on people, but sometimes that little discomfort will allow you to trigger them into what you

need them to to do for for their hygiene, too, as well. Exactly. No, that that’s all of this is

very interesting because you can go from colors to I mean this dementia is just such an a

what’s the word? It’s it’s such an interesting um way to care for someone. There are so many ways and so many um

research and in in opinions, but things that have actually worked, you know,

especially working with Certis, we’ve seen it. And Curtis, by the way, for our listeners, is a memory standalone memory

care community, person- centered memory care community. And that’s what I enjoy most, working with Certis, because it’s

one of a kind. It really is. It’s thought out in every single corner of each crevice in that community. And it’s

cool to see like um the residents actually pick the music and they they’re helping with the menus. But one thing I

think is so fascinating is the whole industry has difficulties from time to time with hiring is we have a resident hiring committee. So the residents

actually interview all the people that come in and it’s amazing to see that a caregiver will come in and the resident

in the right environment will start asking all these questions that you would never expect. But it’s a great screening tool to see how they interact.

And it’s amazing to see when you hire that person, the residents remember that that’s the person they hired. And it’s

fascinating to see we say, “Oh, they have dementia,” but they remember specific things from the interview. And I think that is something to celebrate

is there is ways to help somebody remember certain things. It might always be 100% accurate, but it’s also their

right to continue to explore that. That’s amazing. I see. I didn’t even know that. That’s amazing. That’s so

impressive. So now I want to move on from uh the philosophy of colors and and

things like that and talk about what’s very important in our industry um

placement the families that we help um because as you know it’s an emotional landscape moving your person into a

memory care. A lot of times people don’t want to face memory care let alone they they don’t even want to face assisted

living without memory care. Right? So standalone memory care or memory care in general. Transitioning is often

described as like one of the most emotional and and in in some words some

people have used the word tragic decision that they’ve ever had to make because it’s very personal. It’s deeply personal. It’s their person. So

from your point of view, you’ve been working with those residents in your community and you mentioned about 35

days for them to adjust. what is going on the first few weeks in their mind, in

their in their world, in this new environment. Yeah. So, they’re changing things and

the their body is telling them a lot of things and change is really difficult. So, I say try to minimize transitional

trauma as much as possible, personalizing the room, uh giving exposure before they move in, having a

really good facade story. So, sometimes people say you’re only coming in for a period of time while we’re fixing your

house. But those therapeutic fibletts can be very powerful. And often times I

see this a lot that the the caregiver is really stressed out because they might be asked to stay away for a few days.

Um, and there’s sometimes people can come in on the first day, it’s great. Sometimes people need a week or two to really transition. Is I find that the

caregivers are more impacted than the resident. And I’ve seen this from time to time that the um resident is participating in all the programs and

then the family will come in and they’ll all of a sudden cue and say, “Why did he put me here?” and they go from enjoying

to all of a sudden uh queuing towards you that can be incredibly challenging for a caregiver to hear that. So I think

it’s getting uh familiar with that. But if also work with wherever you’re moving and see if there’s a transition program.

So maybe it’s a respbit or maybe it’s a day program that you can participate 2 three days a week. They can get in the

groove of things and then you can move in. Um, but I see that the best

transition plans are the ones where it’s created by the resident, the person, uh, the family, and also the community. If

they all work together, that’s going to be the best way. And even small things like this, Veronica, is if they bring

the same bed they’ve slept in, research actually shows they transition much faster to a new community because their

body recognizes that mattress. So, I think small things like that to be aware of can help with that process

quite a bit. That makes a lot of sense. And I’ve had families, oh, I’m going to buy a brand new bed. I have always said like like

the same thing. If you can bring something that they are accustomed to sleeping in, whether it’s their chair or

whatever the case may be, because sometimes they have recliners, bring that even if you’re in in a facility

that’s furnished, right? Bring all that stuff from home to make the familiarity and have them get used to their room and

their environment a lot like this is my space, right? like anyone that that goes for anyone, you know, in general. So,

and I I want to do this because I think it’s really powerful is for families is wherever wherever you’re looking is you

should ask the community, this is my mom, tell them about your mom and say, what residents do you think would fit

with her? Well, I noticed that if you can pair up residents with similar interests or social abilities or

capabilities and you put them at lunch together, that can be a really great quick transition is then they actually

rely on each other. Um, so that’s a great question to ask is this is my mom, this is what she likes. What other

residents could you see her connecting with and then trying to get them to connect on the first day? I love that. Yeah. So like a veteran

with a veteran or someone from Boston, you know, with another person from Boston or or something we’re familiar.

Yeah, that’s great. Actually, I had I had something which by force of nature. I’m originally

from California and I was helping a family from California and we happened

to tour this memory care community and this person went to the same high school

as my clients. Yeah. I’m like, what are the odds of that? So, another person

from California and of course they they became friends. Rumor has it they started dating. So, [laughter]

thought that was cute. Um, okay. In your opinion, um, one of the biggest fears

families have is wondering, will they ever feel at home here? That’s the whole guilt.

Yeah. And I know you said it takes up to 35 days. Do they ever feel at home? A lot of times they do. Sometimes they

will have a disconnect for a longer period of time. Uh, research shows 90 days to create a lifestyle change. So

sometimes it might go beyond that 35 days, but beyond acclimating. But I hear this story a lot in our support groups

is um I usually have the newer people in the support group share their stories and a lot of it is well are they going

to feel like home? This comes up all the time and usually the other people that have been in the support group longer are like, “Yes, let me tell you a

story.” And often times what they they share is they they feel like they’re not going to acclimate, but then they go

bring them out to lunch and they say, “It’s I want to go home.” And they specifically ask to come back to the community. And I see that more and more

that over time this person will identify this as a place of home. And I always tell people home is not always a

physical structure, but it’s a feeling. So if they can feel comfortable and they feel at home, that’s where they’re going

to want to return to. So that’s why I see a lot of people over time, they do refer to our community as home. And I’ve

had people say, “Oh, well, I actually brought them by the house.” And they said, “No, no, I don’t live there anymore. I live back at Curtis or I live

wherever.” But I hear that a lot in residential. So I feel like once they get over that threshold and they create

connection, they will associate it as home. Not in every case, but in most cases. That’s amazing. What are some things

families do that can make the transition harder? I know for example I am a big

proponent of therapeutic therapeutic fibs redirecting things like that going into their world redirecting the

conversation and oftentimes some fibs it’s not hurting them but there are

families that often say I will never lie to my parent or my person. What are some

things that some families do that make the transition harder and what do you

suggest? Sometimes um first you have to meet them where they are. So uh sometimes they

might not be able to handle the truth and it’s going to actually set us further back. And if you don’t feel comfortable giving that therapeutic

fiblet try to come up with some pocket phrases of redirection that aren’t fully lies like I’m not sure. Let me find out

more about that. Or hey I still got to call them. I haven’t had a chance. Or even just say hey I’ve been so busy with the grandkids. I haven’t had a chance to

follow up on that. Having those things where you don’t have to fully lie, but at least push it down the road a little

bit can be um can be a good way to kind of soften that. Something else that makes it a little difficult is uh

getting some education and exposure to what is going on. So, I always share like small things families don’t always

realize, but saying goodbye. When I say goodbye to somebody with dementia, they don’t remember the person saying

goodbye, but they know something’s missing. So, what happens is they’re frustrated and they’re looking. They feel like someone left or abandoned. But

research actually shows if you say see you soon, see you tomorrow or just leave a lot of times that can be a much easier

way that they’ll just go participate. So even the words that we use can actually trigger some of those behaviors. So

families really need to figure um get some exposure to what is going on. Also, there’s over a hundred different types

of dementia and knowing what type your loved one has will actually change the things that you can do. If they have

frontal temporal dementia, they’re not going to have a filter. So learning how to do that or if it’s Alzheimer’s short-term memory. So getting more aware

of the types of dementia can actually let you be part of the team. I also share with families, as hard as it is,

try to let that caregiving hat go and let the community take that and do those

things. Try to just be there and show up as the family member. Um so you don’t have to ask, “Have you taken your pills?

Have you done this? Have you done that?” Cuz that can trigger some stuff. Exactly. Go and actually listen to their favorite song, talk about a story, bring a photo

album. Look at those things as a car. uh look as of things not as a caregiver but

as the actual family member. No, that makes a lot of sense and I love that cuz um there have been instances

where families do like you said they come in did you did you get your shower today and the person saying no when they

really had their shower that day or they’re asking them yes or no questions that they you know their concept of time

isn’t there. They’re not sure. And so you get that upset family member going to the care staff you didn’t shower my

loved one and it’s like yeah I did you know. Yeah. And don’t always believe everything your loved one says. And not saying that it’s a lie, but sometimes

their mind is processing things differently. So they might say stuff like, um, they told me I couldn’t have

any food today. I hear that a lot. But in reality, the residents had two plates of food already for lunch. So, uh, just

check in with those things. Um, because it can create some friction. Or don’t just say, “Yes, no, the staff already

told me you had two plates.” Just say, “Hey, I I’ll go check in with the staff.” You got to kind of meet them where they are. and caregivers, if you

get a chance, I think one of the best ways is as a family do some improv. Talk about how you would address questions as

a group. How would you redirect? I find that families that do that type of prep before they come in, right,

have much better visits. I love that. I I think that’s amazing. And finally, because I mean, we can go

into this all day long. This is like so fascinating. I love talking about dementia, especially with families and

and the caregivers and just from the mind of those who are living with dementia. It’s it’s very impressive to

know and kind of understand the things that like they can be retaught and they you know there was an instance at one

point I remember and I always tell families you met one person with dementia you’ve only met one person with

dementia right everyone’s story and journey is different I met this uh I was

on a tour and there was an activities director who was talking in front of the person which that’s like my biggest no

no and they were saying oh she we don’t take her for walks anymore because she just bails and she just runs and she’s

just gone and the resident there was like who me? Are you talking about me? You’re not going to take me for walks

and it stirred something up. So just watching how you say when you say and in front of your person I think is very

important because they may act like they’re not understanding you but they can pick up on certain things. They do

understand and feel. They feel a lot. So your tone, the way you approach them, there’s so much that’s going on. I mean,

when I do um my consultations with families, and my families all always

tell me on the side. They’re like, “I am so thankful that you spoke to her when you were doing your assessment. You

weren’t asking questions to me about her.” I’m like, “No, I’m here for her or him.” You know, I’m sitting there and I

am eye level to them and I’m just having a conversation with them. It’s enjoyable

and um it takes that you know because if I’m just talking to that family and about the community they’re asking

what’s going on why why are you talking about me where am I going where are you putting me I don’t want to stir stir the pot and I don’t want to set them

agitation and getting their feelings you know flustered when it there’s no need for that so the way you talk to people

is important and just don’t talk at them you know and it it’s

all of that’s very important I have to add to that too. Often times I feel like we steal the voice of the person with dementia and we lose the

ability to see where they are based on what they’re feeling. So if I just speak on their behalf all the time, we can’t

hear where their mindset is and then what we do is we automatically hold them

to our mindset and then that’s where we have friction. So I feel like sometimes um we shouldn’t be talking over or past

or having the person on the side. We should include their voice as much as possible. There are times where you’re going to have to talk to a doctor

privately, but in front of them, let the person try to answer the questions. That’s where the doctor will see them

fumbling on words, having a fasia, and they can help with a diagnostic. And I feel like, this is my own peeve, but I

feel like a lot of things get overlooked because we do all the speaking for the person with dementia. And really, we have to let them speak and then we have

to meet them where they are and then fill in the gaps. Yeah. Speaking for them or correcting in front of someone else. That’s, you know,

I love I heard this recently. It’s not about correction, it’s about connection. So, I feel like if you’re correcting

them, you’re losing that connection. And I love that phrase. I don’t know where it came from, but I love it. Well, there’s another one we got to trademark. Kick the can and

connect [laughter] don’t correct. Yeah. Connect don’t correct. And finally, I just have one more thing. Sometimes families witness increased

agitation, withdraw, repeated request to go home, which we talked about, um, or a

physible vis visible decline in their loved one shortly after a move. How

should families interpret these warning signs and when is it a normal part of the adjustment versus a genuine red

flag? So, I guess my question would be when should they have that red flag?

Because, you know, families when they first move their person in, it’s always a red flag. Everything is a red flag. They didn’t shower, they didn’t eat,

they didn’t this, you know, um when is it an a true red flag?

A true red flag, I would say, if it’s interfering with quality of life. So, if the person seems like they’re slowing down a little bit because they just

adjusted to a new place, they might be tired. You got to think of all the new faces, all that can be draining.

Um, so give it a little bit of time and then if there’s medical professionals there, work with them, take notes. What

you’re going to want to do is look for patterns. Um, so when you see something starting to surface or there’s a change,

the other thing is medications. And I think asking a medical provider, can you look at the medications? I’ve seen

changes. But I think consistency is really, really important. So, if you see that it’s happened for a little bit, now

it’s starting to bounce back, that’s a little different. Sometimes we can overreact. I’m not telling people not to, but it’s not always dementia. And I

I’ll share an example is I heard this person is always um saying people are breaking in. They’re breaking in.

They’re breaking in. And what it actually came down to was actually what the uh staff was doing. No fault of

theirs, but the company had a policy where they use flashlights for room checks. So, they would open it, shine it in, and go to each room. the resident

identified, ooh, that is them breaking in, but everybody kept saying, oh, their dementia is getting worse, they’re

getting worse, and they’re having hallucinations, but it really was being triggered by what we were doing. So, I also think we have to step back and say,

what are we doing as the neurotypical people that might be contributing to this? So maybe it’s not allowing them to

have access because one thing I see is I see this sometimes um people will move in and they’re like

they have dementia they can’t go on the outing because I don’t want them to get lost. They can’t do this. They can’t have access to this. They can’t call

people. They can’t When we restrict the brain automatically goes into defense mode. So I think that it’s finding

alternatives. So maybe the first outing is not getting off the bus but just going for a ride to see how they do with

that and then stepping. So, I think trying to allow as much freedom, safe

freedom, and try to limit the restrictions as much as possible because I think that that’s where I see a lot of

people, they’re like, “Oh, something’s wrong.” And it’s because we pulled so much away from people. And also don’t just jump to conclusions,

too. And it’s not Sometimes people just need a rest day. Um I’ve seen this too where

I had a family not too long ago. They’re like, “He’s tired all the time.” And I said, “Well, you’re coming in after work

at 6:00.” And he literally participates in the four physical activities that they have in the day. So, he is a lot.

So, I said, “Maybe try to come in really early on the days before work.” So, they would come in at 7:00 and they’re like

totally different person. So, not all the times is it the disease. They might be doing things that are

different in their lifestyle that just might make them tired. So, don’t jump to conclusions either. I love that. I definitely do. Um, well,

I really think that there’s so much we can talk about, like

I keep saying, and and if um a family member has questions, is there a way

that they can reach you? Yeah, sure thing. Actually, have them reach out to you and then you can kick them over to me. Um, but I’m happy to

answer any questions. And I volunteer every Wednesday from 12:00 to 1:00 just to answer questions for families. So

yeah, if you have something that you’re seeing or wanting to safeguard the house, just give us a call and we’ll try

to help navigate you through it. I love that. Safeguarding the house, memory care options, um, and just

answering those those confusing questions and families that blame themselves like the challenging, you

know, the challenges that they’re facing with their person. So, thank you again for joining us. Um, thank you for just

being here and I hope to have you on here soon. Awesome. Thank you. Thank you.

About the author : Veronica Quiñones

headshot of Veronica Quiñones

Owner and Senior Advisor

Aging Under the North Star banner

Share this article on social media!

 

North Star Senior Advisors recently reached a milestone with its podcast, Aging Under The North Star, which has now surpassed 2,000 viewers and continues to grow its audience of families, caregivers, and senior care professionals across Central Florida and beyond. The podcast’s latest episode, Color & Connection: Easing the Dementia Journey (Episode 10), features special guest Dr. Joshua Freitas, Chief Education Officer and Board Chair of the National Institute for Dementia Education (NIDE).

Podcast Transcript

Welcome to Aging Under the Northstar, your trusted podcast for aging, caregiving, and senior living. I’m your

host, Veronica, and today joining me is Josh, Dr. Josh Freighus. Thank you so

much, Dr. Josh, for joining me. You are a wealth of knowledge, but not only that, you’re a friend and a mentor, and I appreciate you being here.

Well, thank you for having me. Yeah, I’m excited. Um there are two important topics that I’d like to

discuss in today’s podcast. But first I want to start with the number one that really had me intrigued and it was very

eye openening for me when we were training with you. And I say we me and some of my team members were training

with you and it was the psychology of color. This was like wow like eyeopening

for me. And so research it suggests that specific colors often trigger emotional

responses for those living with dementia. Can you describe what that means and get into like the philosophy

of color? Yeah, sure thing. So, uh through the aging pendulum, uh color affects us differently. So, we might associate

things like red might be associated with eating in the middle of life, but also that can be applied later on and

providing contrast. But as we age, we also see colors differently as well. So, even things like soft greens or soft

blues might have an emotional appeal in some aspect. But then also being able to see our vision is changing. So what

happens is we get a yellow film over the eye changing the uh colors that we see. So some colors actually pop more or pop

less and that can actually trigger some of the behaviors and if we apply them the right way we can minimize some dementia behaviors as well.

Ah okay. So I’m glad you touched on that. So you mentioned the color. So in

the different stages of dementia and the different uh you mentioned aging um the

different stages of dementia. Does that also mean that the colors change with the different stages? So people become more reliant on what

they can see. So on face value, people might trigger things. So like you and I drive down the road and we see a yellow

sign. We know what it means because we’ve been conditioned. That stuff can actually return with dementia. So

there’s seven stages known as the global deterioration scale or the three phases. But as people go further in their

disease journey is they actually become more reliant on it. So if they have more color contrast, they might be actually

more drawn to things like fiesta colors or bright colors. So colored uniforms, colored plates, that might actually pull

their behavior. And I won’t go too deep, but there’s something called retrogenesis that um the first things in

life are the last things we lose. And a lot of things that we see with adolescence like bright color crayons or

bright toys that comes back, but it’s our job to make sure it’s dignified. So having a pen that might be a brighter

color for them to be able to identify or a uniform color to actually help orient who is their caregiver. All of those

things become more reliant on the person with dementia. Can you get into the actual colors, the recognizable colors, the strong dominant

colors and their meaning? Yeah, sure thing. So different colors have different behaviors. Some is theoretical and some is actually

evidence-based. So I know at Curtis what we’ve done is we’ve had each department wear different colors and observed how

we can improve care. So, for example, all caregivers wear the color lime green. And what we noticed is when we

did this is we had a reduction in sundowning behavior because people could identify who to go to. That green popped. So, it’s one of the more

prevalent colors they see. So, we actually want our caregivers to pop up more than other uh employees because

that’s where they’re going to get their help. But what we notice is dark blue will suppress that engagement. So, we put our maintenance in dark blue so

they’re not going to if they need help to go to the bathroom. And then light blue can actually foster that engagement

uh sequence to get people to engage more. And the color purple, and we won’t get into the science, but will be stolen more than any other color. So, we

actually put our nurses in that. So, the two people they’re primarily going to is caregivers in green, but then also

purple uh for their nurses. And the last one is a color red stimulates appetite. So, we put everybody that works in our

dining experience in red. And what we notice is subtle changes in everyone’s behavior. But one of the biggest thing I

thought was fascinating is the color black from the kneecap down is perceived as scary. So we actually decided to have

all of our caregivers wear tan pants and white shoes. And what we noticed is people with Louis bodies, Parkinson’s or

Huntington’s, their behaviors went away because they weren’t seeing that peripheral deficit below the knees and

they actually fostered better care. We could get closer to them. So those subtle changes though you and I would

look at them and say, “Oh, it’s just a color change.” It actually is a whole behavior change for those with dementia. That’s interesting. So, how do you know

like okay, so you have a new resident that moves in, right? How long does it take for them to understand who is who

by recognizing those colors? Yeah. So, there’s actually a length of time that people take to acclimate to a new environment. It’s about 35 days, 5

weeks. What we notice is uh some of the trigger points is people will say, I need somebody in green. I need somebody

in green. So you can see that the people even with cognitive challenges can identify that person in green can help

me and actually uh they’ll go directly to that person and ask for help. So we actually can shape that behavior. We see

that around that month to 5 week mark right that’s awesome. Okay. So, that

helps families actually and I’m sure you know when they’re transitioning their

loved one. It’s it’s a whole emotional roller coaster and a lot of families ask us like are they going to constantly

want to come home? Are they going to keep wanting to come home? Every time I come here it’s it’s been challenging and they don’t know who’s who. I think the

colors will definitely be beneficial for them in any environment that they’re at, including home. So, if they’re home, how

do you tell caregivers to address these colors within their home environment? Yeah. I’ll give you a real example. I

had somebody just recently, she said, “Well, my husband has dementia and that’s why he’s not flushing the toilet.” So, I listened to this, but

when I did the home assessment, what I noticed is that the toilet was all white. So, the flusher was white, the

top was white, and my recommendation is always to have a contrast toilet seat. But what I also recommended is what if

we popped off the flusher and painted it lime green, more prevalent color. We did that and the lady called me literally a

week later and was like, “He’s flushing the toilet all the time.” It just literally took us painting the flusher a

different color. But even the um outlets, I hear a lot of people with dementia like to sit in the dark. People

with dementia don’t like dark spaces. So that’s typically not what would be normal. Is if you even take light switches and

paint the little flicker a different color, that helps them identify a white wall with a white um light switch, they

can find it easier. So now they can actually turn it on and not be sitting in the dark. So, small features like that at home can be very powerful. A lot

of people I hear say use a black rug because people with dementia will walk across it. I don’t always like to scare

people that way. Um, but the color black from the kneecap can be perceived as scary and that could be a reason why

somebody doesn’t go into a bank or to a restaurant. They might not want to um step over that rug.

I’m glad you mentioned black rug because sometimes you go into buildings and you know the entryway has the black rug. you

know, common. I see memory care communities put the black rug or

sometimes very dark flooring and there’s a lot more falls. There’s a lot more

behavioral um what’s the word where confusion where they don’t want to step

over a certain area because of the dark rugs. What do what does the black rug do for someone with dementia?

It’s perceived as a hole. So, um I’m not the biggest fan. You have to weigh safety and the black rug. You know, a

black rug could be scary where if you and I felt trapped in, we might have some behaviors, too. But I can almost

predict this is if somebody walks into a community with a black rug and it’s inside, you might smell urine. And the

reason is that it’s perceived as a whole. And many residents with dementia will actually urinate on that black rug. So, yes, it’s a pro and con, but you

have to be very sensitive to who’s actually in that community. Um, and a scare tactic isn’t always the

best. Actually, research shows if you just paint the door the same color as the wall, you can reduce that wandering

behavior just as effectively without scaring people, you’re just making less um attention to it, right?

And you see things like bookshelves and other things to say. I’ve seen bookshelves. So, to me, knowing myself,

I’ve seen a bookshelf painted uh as a door. I would go over there because I’m a reader, right? I would [laughter] I

would be staying there trying to, you know, get to that book. So I like that idea of painting the the area the same

as the wall because it just blends in. You’re not going to even think to go in that direction in small features like I say things of

normaly. So you might even have a door that you can’t camouflage is you might actually make it look like a closed

booth and have a closed sign on it. People behaviorally would walk and say oh that must be closed today and walk right past it versus having that

attention. So sometimes earlier stages you can still use those. So environmental cues can be very powerful.

Yeah, that’s that’s interesting. See, it makes me want to open a memory care. [laughter]

Um, no. So, all jokes aside, I really think if we’ve had some u clients, uh,

mutual clients that have said things similar to the whole toilet flushing, but if you go into like a memory care

and some memory care directors will say, “So and so is urinating in the the tree

or in the plant.” What are some things families can do to avoid that? Yeah. Yeah. So, there’s actually a case

study that just came out that showed that u that black mulch or that black soil looks like a hole so they will

urinate. And sometimes people will say nature and trees and people want to go to the bathroom. What they showed is if

you just put white rock on it if it’s safe and maybe even glue the rock down, it deters that person to go to the

bathroom because they can see it’s not a hole. So, small things like that can be very powerful. And I also have to say

sometimes behaviors, they’re a way of communicating, but sometimes you can use them to solve issues. So I’ve had a lot

of residents that urinate in bathrooms or in their bedrooms in a residential. One thing to do is actually buy small

little track uh black trash barrels and put them out. As they urinate in them, you slowly move it to the bathroom and

you condition their uh spatial awareness to learn where that bathroom is. So then you don’t need them anymore. So you can

actually leverage the behavior sometimes to actually solve issues. You just were transitioning into my next question. Can

someone with dementia learn something new? Absolutely. I love this. This is the biggest challenge and I I

hear it from uh the medical community and I’ve had people reach out and say people with dementia can’t learn and that is completely false.

People with dementia can still learn. They learn differently. They learn on emotional based knowledge. Uh how my

environment is perceived. And that that alone can be uh really powerful. I would

argue with anybody that says somebody with dementia can’t learn. I’ll give you an example. You sit in that seat every day at lunch in a memory care community.

I come down and somebody else is in my seat. You see that aggression. Get that person out of my seat. That’s my seat.

That shows the person with dementia can still learn. It just takes them longer. And um we won’t spend too much time on

it, but we actually have three brains and that that actually gets strengthened. The emotional based knowledge is our entric nervous system

and nervascular system. So we have to think people with dementia are relying on emotional based knowledge. How I make

me feel uh my routine my approach and what a space communicates to me. That is amazing. I I have to agree with

you. Um I’ve seen those with dementia they are relearning every day right there. if

especially if they like you said there’s um consistency and that which something that they need the true consistency of

their their scheduled day or um activities things that they do on a daily basis. I was just talking to a

friend of mine because she was asking me for some of some help and she said my dad isn’t showering. um he came to

visit. He drove down or his him and her brother drove down from out of state and

he didn’t shower the whole 5 days. And I kept said saying, “Dad, go shower.” And I’m like, “Well, he’s not in his environment.” Number one, um he heard go

shower, but he doesn’t know what to do in your home. I’m like, “So next time,

like try laying his clothes out, try directing him, turn the water on for him if he can in fact still shower himself.

But if he can’t, you know, that’s a whole other topic we can get into. You know, how to shower those that are refusing to bathe. He’s not refusing. He

just didn’t really know. It’s kind of like you have to kind of redirect him and train him to do that. How does that

happen in a facility or when someone’s transitioning into a community? Um

especially the first few days that you know they’re reconditioning their their mind to know where the bathroom is from

bed and so on. So one thing is uh don’t push it. If it’s one or two days they’re not taking a shower, it’s okay. You also don’t want

to create frustration between the caregiver and the resident. So sometimes a day or two without a shower, it’s okay. Unless there’s an accident or

something like that. But I also say that we’re about 40 to 50% habit. So sometimes it’s actually showing them the

shower. So not a caregiver saying it’s time for a shower, it’s time for a shower, but actually bringing you into the shower, turning it on, putting even

some like a bottle of soap in your hands and saying it’s time to take a shower. those visual cues, they might actually

see that and know, okay, it’s time to take a shower. Um, there’s other things, too. If somebody’s not taking a shower,

they have shower in a bag. They have other things. I’ve seen people put body wash in balloons and do a balloon toss,

so it gets them wet. Um, a non-traditional thing, I’m not telling people to go out there and spill stuff on residents. Not saying that at

all, especially if it’s hot or cold. But I have in the past have had a resident that wouldn’t shower for almost

a week. And the only thing I could think of doing is people with dementia don’t like to be wet. So, I accidentally

bumped a glass, got a little bit of water on their their leg and said, “Oh, come on. Let’s let’s go get you changed.” And soon as they were uh ch uh

droing, I could bring them right in the bathroom, get them showered, and then get them out. So, sometimes you just got to think a little differently on how you

approach things. And I’m not saying to go out and pour stuff on people, but sometimes that little discomfort will allow you to trigger them into what you

need them to to do for for their hygiene, too, as well. Exactly. No, that that’s all of this is

very interesting because you can go from colors to I mean this dementia is just such an a

what’s the word? It’s it’s such an interesting um way to care for someone. There are so many ways and so many um

research and in in opinions, but things that have actually worked, you know,

especially working with Certis, we’ve seen it. And Curtis, by the way, for our listeners, is a memory standalone memory

care community, person- centered memory care community. And that’s what I enjoy most, working with Certis, because it’s

one of a kind. It really is. It’s thought out in every single corner of each crevice in that community. And it’s

cool to see like um the residents actually pick the music and they they’re helping with the menus. But one thing I

think is so fascinating is the whole industry has difficulties from time to time with hiring is we have a resident hiring committee. So the residents

actually interview all the people that come in and it’s amazing to see that a caregiver will come in and the resident

in the right environment will start asking all these questions that you would never expect. But it’s a great screening tool to see how they interact.

And it’s amazing to see when you hire that person, the residents remember that that’s the person they hired. And it’s

fascinating to see we say, “Oh, they have dementia,” but they remember specific things from the interview. And I think that is something to celebrate

is there is ways to help somebody remember certain things. It might always be 100% accurate, but it’s also their

right to continue to explore that. That’s amazing. I see. I didn’t even know that. That’s amazing. That’s so

impressive. So now I want to move on from uh the philosophy of colors and and

things like that and talk about what’s very important in our industry um

placement the families that we help um because as you know it’s an emotional landscape moving your person into a

memory care. A lot of times people don’t want to face memory care let alone they they don’t even want to face assisted

living without memory care. Right? So standalone memory care or memory care in general. Transitioning is often

described as like one of the most emotional and and in in some words some

people have used the word tragic decision that they’ve ever had to make because it’s very personal. It’s deeply personal. It’s their person. So

from your point of view, you’ve been working with those residents in your community and you mentioned about 35

days for them to adjust. what is going on the first few weeks in their mind, in

their in their world, in this new environment. Yeah. So, they’re changing things and

the their body is telling them a lot of things and change is really difficult. So, I say try to minimize transitional

trauma as much as possible, personalizing the room, uh giving exposure before they move in, having a

really good facade story. So, sometimes people say you’re only coming in for a period of time while we’re fixing your

house. But those therapeutic fibletts can be very powerful. And often times I

see this a lot that the the caregiver is really stressed out because they might be asked to stay away for a few days.

Um, and there’s sometimes people can come in on the first day, it’s great. Sometimes people need a week or two to really transition. Is I find that the

caregivers are more impacted than the resident. And I’ve seen this from time to time that the um resident is participating in all the programs and

then the family will come in and they’ll all of a sudden cue and say, “Why did he put me here?” and they go from enjoying

to all of a sudden uh queuing towards you that can be incredibly challenging for a caregiver to hear that. So I think

it’s getting uh familiar with that. But if also work with wherever you’re moving and see if there’s a transition program.

So maybe it’s a respbit or maybe it’s a day program that you can participate 2 three days a week. They can get in the

groove of things and then you can move in. Um, but I see that the best

transition plans are the ones where it’s created by the resident, the person, uh, the family, and also the community. If

they all work together, that’s going to be the best way. And even small things like this, Veronica, is if they bring

the same bed they’ve slept in, research actually shows they transition much faster to a new community because their

body recognizes that mattress. So, I think small things like that to be aware of can help with that process

quite a bit. That makes a lot of sense. And I’ve had families, oh, I’m going to buy a brand new bed. I have always said like like

the same thing. If you can bring something that they are accustomed to sleeping in, whether it’s their chair or

whatever the case may be, because sometimes they have recliners, bring that even if you’re in in a facility

that’s furnished, right? Bring all that stuff from home to make the familiarity and have them get used to their room and

their environment a lot like this is my space, right? like anyone that that goes for anyone, you know, in general. So,

and I I want to do this because I think it’s really powerful is for families is wherever wherever you’re looking is you

should ask the community, this is my mom, tell them about your mom and say, what residents do you think would fit

with her? Well, I noticed that if you can pair up residents with similar interests or social abilities or

capabilities and you put them at lunch together, that can be a really great quick transition is then they actually

rely on each other. Um, so that’s a great question to ask is this is my mom, this is what she likes. What other

residents could you see her connecting with and then trying to get them to connect on the first day? I love that. Yeah. So like a veteran

with a veteran or someone from Boston, you know, with another person from Boston or or something we’re familiar.

Yeah, that’s great. Actually, I had I had something which by force of nature. I’m originally

from California and I was helping a family from California and we happened

to tour this memory care community and this person went to the same high school

as my clients. Yeah. I’m like, what are the odds of that? So, another person

from California and of course they they became friends. Rumor has it they started dating. So, [laughter]

thought that was cute. Um, okay. In your opinion, um, one of the biggest fears

families have is wondering, will they ever feel at home here? That’s the whole guilt.

Yeah. And I know you said it takes up to 35 days. Do they ever feel at home? A lot of times they do. Sometimes they

will have a disconnect for a longer period of time. Uh, research shows 90 days to create a lifestyle change. So

sometimes it might go beyond that 35 days, but beyond acclimating. But I hear this story a lot in our support groups

is um I usually have the newer people in the support group share their stories and a lot of it is well are they going

to feel like home? This comes up all the time and usually the other people that have been in the support group longer are like, “Yes, let me tell you a

story.” And often times what they they share is they they feel like they’re not going to acclimate, but then they go

bring them out to lunch and they say, “It’s I want to go home.” And they specifically ask to come back to the community. And I see that more and more

that over time this person will identify this as a place of home. And I always tell people home is not always a

physical structure, but it’s a feeling. So if they can feel comfortable and they feel at home, that’s where they’re going

to want to return to. So that’s why I see a lot of people over time, they do refer to our community as home. And I’ve

had people say, “Oh, well, I actually brought them by the house.” And they said, “No, no, I don’t live there anymore. I live back at Curtis or I live

wherever.” But I hear that a lot in residential. So I feel like once they get over that threshold and they create

connection, they will associate it as home. Not in every case, but in most cases. That’s amazing. What are some things

families do that can make the transition harder? I know for example I am a big

proponent of therapeutic therapeutic fibs redirecting things like that going into their world redirecting the

conversation and oftentimes some fibs it’s not hurting them but there are

families that often say I will never lie to my parent or my person. What are some

things that some families do that make the transition harder and what do you

suggest? Sometimes um first you have to meet them where they are. So uh sometimes they

might not be able to handle the truth and it’s going to actually set us further back. And if you don’t feel comfortable giving that therapeutic

fiblet try to come up with some pocket phrases of redirection that aren’t fully lies like I’m not sure. Let me find out

more about that. Or hey I still got to call them. I haven’t had a chance. Or even just say hey I’ve been so busy with the grandkids. I haven’t had a chance to

follow up on that. Having those things where you don’t have to fully lie, but at least push it down the road a little

bit can be um can be a good way to kind of soften that. Something else that makes it a little difficult is uh

getting some education and exposure to what is going on. So, I always share like small things families don’t always

realize, but saying goodbye. When I say goodbye to somebody with dementia, they don’t remember the person saying

goodbye, but they know something’s missing. So, what happens is they’re frustrated and they’re looking. They feel like someone left or abandoned. But

research actually shows if you say see you soon, see you tomorrow or just leave a lot of times that can be a much easier

way that they’ll just go participate. So even the words that we use can actually trigger some of those behaviors. So

families really need to figure um get some exposure to what is going on. Also, there’s over a hundred different types

of dementia and knowing what type your loved one has will actually change the things that you can do. If they have

frontal temporal dementia, they’re not going to have a filter. So learning how to do that or if it’s Alzheimer’s short-term memory. So getting more aware

of the types of dementia can actually let you be part of the team. I also share with families, as hard as it is,

try to let that caregiving hat go and let the community take that and do those

things. Try to just be there and show up as the family member. Um so you don’t have to ask, “Have you taken your pills?

Have you done this? Have you done that?” Cuz that can trigger some stuff. Exactly. Go and actually listen to their favorite song, talk about a story, bring a photo

album. Look at those things as a car. uh look as of things not as a caregiver but

as the actual family member. No, that makes a lot of sense and I love that cuz um there have been instances

where families do like you said they come in did you did you get your shower today and the person saying no when they

really had their shower that day or they’re asking them yes or no questions that they you know their concept of time

isn’t there. They’re not sure. And so you get that upset family member going to the care staff you didn’t shower my

loved one and it’s like yeah I did you know. Yeah. And don’t always believe everything your loved one says. And not saying that it’s a lie, but sometimes

their mind is processing things differently. So they might say stuff like, um, they told me I couldn’t have

any food today. I hear that a lot. But in reality, the residents had two plates of food already for lunch. So, uh, just

check in with those things. Um, because it can create some friction. Or don’t just say, “Yes, no, the staff already

told me you had two plates.” Just say, “Hey, I I’ll go check in with the staff.” You got to kind of meet them where they are. and caregivers, if you

get a chance, I think one of the best ways is as a family do some improv. Talk about how you would address questions as

a group. How would you redirect? I find that families that do that type of prep before they come in, right,

have much better visits. I love that. I I think that’s amazing. And finally, because I mean, we can go

into this all day long. This is like so fascinating. I love talking about dementia, especially with families and

and the caregivers and just from the mind of those who are living with dementia. It’s it’s very impressive to

know and kind of understand the things that like they can be retaught and they you know there was an instance at one

point I remember and I always tell families you met one person with dementia you’ve only met one person with

dementia right everyone’s story and journey is different I met this uh I was

on a tour and there was an activities director who was talking in front of the person which that’s like my biggest no

no and they were saying oh she we don’t take her for walks anymore because she just bails and she just runs and she’s

just gone and the resident there was like who me? Are you talking about me? You’re not going to take me for walks

and it stirred something up. So just watching how you say when you say and in front of your person I think is very

important because they may act like they’re not understanding you but they can pick up on certain things. They do

understand and feel. They feel a lot. So your tone, the way you approach them, there’s so much that’s going on. I mean,

when I do um my consultations with families, and my families all always

tell me on the side. They’re like, “I am so thankful that you spoke to her when you were doing your assessment. You

weren’t asking questions to me about her.” I’m like, “No, I’m here for her or him.” You know, I’m sitting there and I

am eye level to them and I’m just having a conversation with them. It’s enjoyable

and um it takes that you know because if I’m just talking to that family and about the community they’re asking

what’s going on why why are you talking about me where am I going where are you putting me I don’t want to stir stir the pot and I don’t want to set them

agitation and getting their feelings you know flustered when it there’s no need for that so the way you talk to people

is important and just don’t talk at them you know and it it’s

all of that’s very important I have to add to that too. Often times I feel like we steal the voice of the person with dementia and we lose the

ability to see where they are based on what they’re feeling. So if I just speak on their behalf all the time, we can’t

hear where their mindset is and then what we do is we automatically hold them

to our mindset and then that’s where we have friction. So I feel like sometimes um we shouldn’t be talking over or past

or having the person on the side. We should include their voice as much as possible. There are times where you’re going to have to talk to a doctor

privately, but in front of them, let the person try to answer the questions. That’s where the doctor will see them

fumbling on words, having a fasia, and they can help with a diagnostic. And I feel like, this is my own peeve, but I

feel like a lot of things get overlooked because we do all the speaking for the person with dementia. And really, we have to let them speak and then we have

to meet them where they are and then fill in the gaps. Yeah. Speaking for them or correcting in front of someone else. That’s, you know,

I love I heard this recently. It’s not about correction, it’s about connection. So, I feel like if you’re correcting

them, you’re losing that connection. And I love that phrase. I don’t know where it came from, but I love it. Well, there’s another one we got to trademark. Kick the can and

connect [laughter] don’t correct. Yeah. Connect don’t correct. And finally, I just have one more thing. Sometimes families witness increased

agitation, withdraw, repeated request to go home, which we talked about, um, or a

physible vis visible decline in their loved one shortly after a move. How

should families interpret these warning signs and when is it a normal part of the adjustment versus a genuine red

flag? So, I guess my question would be when should they have that red flag?

Because, you know, families when they first move their person in, it’s always a red flag. Everything is a red flag. They didn’t shower, they didn’t eat,

they didn’t this, you know, um when is it an a true red flag?

A true red flag, I would say, if it’s interfering with quality of life. So, if the person seems like they’re slowing down a little bit because they just

adjusted to a new place, they might be tired. You got to think of all the new faces, all that can be draining.

Um, so give it a little bit of time and then if there’s medical professionals there, work with them, take notes. What

you’re going to want to do is look for patterns. Um, so when you see something starting to surface or there’s a change,

the other thing is medications. And I think asking a medical provider, can you look at the medications? I’ve seen

changes. But I think consistency is really, really important. So, if you see that it’s happened for a little bit, now

it’s starting to bounce back, that’s a little different. Sometimes we can overreact. I’m not telling people not to, but it’s not always dementia. And I

I’ll share an example is I heard this person is always um saying people are breaking in. They’re breaking in.

They’re breaking in. And what it actually came down to was actually what the uh staff was doing. No fault of

theirs, but the company had a policy where they use flashlights for room checks. So, they would open it, shine it in, and go to each room. the resident

identified, ooh, that is them breaking in, but everybody kept saying, oh, their dementia is getting worse, they’re

getting worse, and they’re having hallucinations, but it really was being triggered by what we were doing. So, I also think we have to step back and say,

what are we doing as the neurotypical people that might be contributing to this? So maybe it’s not allowing them to

have access because one thing I see is I see this sometimes um people will move in and they’re like

they have dementia they can’t go on the outing because I don’t want them to get lost. They can’t do this. They can’t have access to this. They can’t call

people. They can’t When we restrict the brain automatically goes into defense mode. So I think that it’s finding

alternatives. So maybe the first outing is not getting off the bus but just going for a ride to see how they do with

that and then stepping. So, I think trying to allow as much freedom, safe

freedom, and try to limit the restrictions as much as possible because I think that that’s where I see a lot of

people, they’re like, “Oh, something’s wrong.” And it’s because we pulled so much away from people. And also don’t just jump to conclusions,

too. And it’s not Sometimes people just need a rest day. Um I’ve seen this too where

I had a family not too long ago. They’re like, “He’s tired all the time.” And I said, “Well, you’re coming in after work

at 6:00.” And he literally participates in the four physical activities that they have in the day. So, he is a lot.

So, I said, “Maybe try to come in really early on the days before work.” So, they would come in at 7:00 and they’re like

totally different person. So, not all the times is it the disease. They might be doing things that are

different in their lifestyle that just might make them tired. So, don’t jump to conclusions either. I love that. I definitely do. Um, well,

I really think that there’s so much we can talk about, like

I keep saying, and and if um a family member has questions, is there a way

that they can reach you? Yeah, sure thing. Actually, have them reach out to you and then you can kick them over to me. Um, but I’m happy to

answer any questions. And I volunteer every Wednesday from 12:00 to 1:00 just to answer questions for families. So

yeah, if you have something that you’re seeing or wanting to safeguard the house, just give us a call and we’ll try

to help navigate you through it. I love that. Safeguarding the house, memory care options, um, and just

answering those those confusing questions and families that blame themselves like the challenging, you

know, the challenges that they’re facing with their person. So, thank you again for joining us. Um, thank you for just

being here and I hope to have you on here soon. Awesome. Thank you. Thank you.

Article by:

Veronica Quiñones

Owner and Senior Advisor

headshot of Veronica Quiñones