In spite of language losses suffered by an individual with Alzheimer’s, many skills that support communication are remarkably preserved and remain for a long time. When working with the AD individual, the caregiver should keep in mind six abilities that are nearly always preserved.

1) The Use of Procedural Memories
Individuals with AD begin to lose memory for words, information and events quite rapidly, but procedural memory, or the knowledge of how to perform familiar tasks remain relatively intact until the later stages of dementia. The research suggests that this is because procedural memory is the most elemental of human memory systems and is the only memory system capable of operating independently. This system can sustain some very complex human activity such as walking, washing hands, or even driving a car. Procedural memory is like a computer program whereas other types of memory are like data stored in the computer. Alzheimer patients begin to lose data rapidly but still function. They may forget where they are going, but they still know how to walk. They may forget what they are saying, but they still know how to talk.

• The look on the face of the five-year-old as he boards a school bus for the first time and the look of apprehension on the face of his mother.
• The last lingering touches of two lovers who cannot bear to let each other go.
• The moment when one must board that jet and fly off to a new life elsewhere.
• The apprehension that this could be the last time they shall see each other and that chill of final separation.

The following is an excerpt of a discussion I had several years ago with the daughter of a man (her father) who had recently passed away.

“The last time I saw my father I guess I knew it might be the last time. We talked a little about this and that…nothing important. It was as if we both had agreed to keep it that way because we both knew, and we knew that we knew.

Definition: Perspective “a view of things (as events) in their true relationship or relative importance” (The Merriam Webster Dictionary)

Some years ago I had a conversation with a resident in a facility where I was the head of the Nursing department. She was close to her 100th birthday. I asked her what she made of her life in general. She promptly replied: “Can’t tell yet! I am still making my life!”

A person who appears demented may be tormented by grief and anxiety. His demented behavior may have been brought about by emotional pain. A grieving person at any age is less able to pay close attention to everything that happens around him. He takes less care in grooming and dress. He has less emotional energy to welcome new opportunities or to respond to challenges. He feels uncomfortable with his body. His mind may be constantly uneasy or tortured.

Loss and grief are common in old age as death removes loved ones. An old person may have suffered other significant losses, of occupation, residence, physical mobility, belonging, or usefulness – all of which produce a grief response.

Without question, working in long term care is demanding and stressful. In addition to the intrinsic stressors staff must face daily in nursing homes, often they must also struggle with managers who add to the stress. It takes only one thoughtless supervisor to create a work environment that goes from bad to worse in an instant.

Unfortunately, there are managers and supervisors in long term care who may lack self-awareness or the desire to evolve into better leaders. They may intentionally create “power distances” between themselves and their employees. This distance may also signal that they may be unapproachable.

The new year brings new opportunities and challenges to the senior living industry. With all the changes in process, it’s a good time to revisit your strategy and evaluate what decisions can make you successful in 2018.

Investment in Senior Living