Episode 6: Dementia 101
“Episode #6 – Dementia 101” by Sue Lanza and Shawn Carty. Released: 2022. Track 6. Genre: podcast.
Transcription
Sue Lanza :
Hi everyone. And welcome to another episode of House Guest, the podcast about all things related to The House of The Good Shepherd, a retirement community in Hackettstown, New Jersey. I’m Sue Lanza, the CEO. And I’m joined today by my co-host, the Rev. Shawn Carty: Carty, who is our chaplain. Please enjoy.
Started.
Rev. Shawn Carty:
And there’s a red light.
Sue Lanza :
Says right error. I don’t know what that means. But I’m going to keep going and we’re going to see what’s happened. Hey Shawn, how are you doing?
Rev. Shawn Carty:
Hello, Sue. I’m doing well. How are you?
Sue Lanza :
Delightful. And here we are back for episode number six.
Rev. Shawn Carty:
Yes, indeed. And I wanted to say thanks to at least a few people who have said how much they enjoy listening to our podcast.
Sue Lanza :
Who are these people?
Rev. Shawn Carty:
It’s nice to know … Well, coworkers and friends who’ve gone to the website.
Sue Lanza :
Really?
Rev. Shawn Carty:
Yeah. It’s nice to know that people are listening.
Sue Lanza :
I need their names. Okay. Because nobody’s telling me anything. Well, we’re trying to get them out and I have more episodes that I have to get up on the website. So we are back again and we thought we would take a different approach today. We thought we would talk about dementia.
Rev. Shawn Carty:
That’s a heavy subject Sue.
Sue Lanza :
It is. But it’s so common, especially in our work here. And everybody knows someone who’s either been touched with dementia or experienced it somehow in their lives. So we could be talking for hours, but we’re not going to do that. We’re just going to try to touch on some of the highlights and see if we can give people a little start with things.
Rev. Shawn Carty:
Yeah. It’s a subject that certainly has touched my life, both in my family, but also churches that I’ve served with, parishioners who have had dementia. And like I said, it’s a heavy subject. So perhaps today in our conversation, as we give folks a bit of knowledge that will maybe reduce some of the fear of it because the more you know, the more you can approach things in a informed way.
Sue Lanza :
Absolutely. Yeah. Education means everything. And a lot of people, when they embark on coming to find us, let’s say, at The House of Good Shepherd or any of the senior living situations that provide health care, you’re coming into a new area that you know nothing about. Same thing with dementia and you’re sort of lost and you need to know the lay of the land and what the vernacular is so you can navigate your way as best as possible through that. It’s scary.
Rev. Shawn Carty:
Well, it is. And we don’t talk about it. It’s like many subjects that we could bring up, but we don’t like to talk about it. And that just makes it, I think, more scary. So I’m glad we’re talking about it today. I’m wondering if we could start out with really a baseline of what is dementia? When we hear that word, I think a lot of us, there’s a sort of a set of assumptions we make about it and they may or may not be right. How would you say … What is it?
Sue Lanza :
Well, I’m going to rely on the Alzheimer’s Association, which the Alzheimer’s Association is in United States, it’s around the world in different various forms. Every country has sort of their own situation, but you can always find some good information. So what they try to say is that it’s really not a single disease. It’s a group of specific medical conditions and they group it under this term of dementia because it’s really abnormal brain changes, which these brain changes cause a whole decline in thinking skills, which would include things like cognitive abilities. Can you read a book and understand what it is or are you having impaired daily functions so that you can’t do your activities of daily living as we would call, which are bathing, dressing, eating? And can you function independently or are some of these brain changes causing so much problems that you really can’t even function on a regular basis?
So this also translates into problems with relationships because there are now new feelings, behaviors, and things going on and families get very fractured with some of these changes that happen. But I know you talked about, you mentioned Alzheimer’s disease and I mentioned it too, with the Alzheimer’s Association. And why do we associate that word sometimes interchangeably with dementia? And it’s because Alzheimer’s disease is the most common form of dementia. Dementia being the umbrella term that covers a few things, but there’s really four basic kinds that we see most frequently. And they have a percentage that they can occur in the general population. And it varies. So they say Alzheimer’s disease could be 60 to 80% of all the dementias that we see are Alzheimer’s disease. And they have a certain way of presenting that’s familiar that they can’t 100% diagnose it.
The best way is unfortunately through autopsy and looking at the brain changes to be able to really diagnose it, but they don’t have a way of testing for it right now. That’s the one we see most commonly and the other one is vascular dementia. And that we see somewhere between 10 and 20% of all of the dementias and it has to do with changes in the heart and the mechanisms that control the heart, all the vascular system, because if that gets, what they call plaques, tangles, could be in the vascular system or up in brain, this can cause some heart situations. So this is one that is reversible where other types of dementia have an irreversible character to them. Wat I mean by reversible, it means like it’s actually preventable in some cases, because if you monitor your health and your heart, you could now actually prevent this one from happening.
Rev. Shawn Carty:
So that’s good news because as you were saying, 20% of them are vascular, that’s 1 in 5. And so those healthy habits that we’re all supposed to be using and eating well and getting enough sleep and all those things are challenging, of course, for all of us. In that situation, if we do some things to have good health, potentially, we’re preventing that piece or that particular type of dementia. You mentioned there were four kinds though so what are the other two?
Sue Lanza :
Yes. Well, the other two are a little less known, but they are noted. One is called Lewy body dementia, and that occurs in 10 to 15%. And if you’re wondering why these don’t add up to 100%, this is again a rough range of where the population is at any given moment. The other one is frontal temporal dimension, and it has to do with changes in the frontal temporal lobe of the brain. Each of these have different presentations, although Alzheimer’s disease and the vascular and might have … Sometimes a doctor will say, well, they have a mixed dementia, meaning maybe they have some of the symptoms of Alzheimer’s disease, but they also have some vascular dementia symptoms. But Lewy body and frontal temporal have some different behavioral changes that are seen and presentations that are easier to spot and maybe you could separate them out. But they’re much more unusual.
Rev. Shawn Carty:
Sounds like they’re the types of dementia that are because of specific places within the brain that are being affected.
Sue Lanza :
Exactly. Exactly.
Rev. Shawn Carty:
Whereas Alzheimer’s is from what I’ve understood is not just one small area of the brain. It’s the whole area, the whole brain, as you were saying, plaques and tangles and those other are things that show up.
Sue Lanza :
Yeah. And the plaques and tangles, just to elaborate on that a little bit, it’s not so much with the vascular dimensions, it’s with all of them. It has to do with, you have brain signals that tell you to do pick up your spoon to eat your soup. We don’t even think about it. It happens automatically. Something fires from one neuron to the next and off we go. But what happens here is that plaques form, almost like the plaque that’s on your teeth. And it shows up in a way that it’s blocking something from happening, same thing with the tangles. There’s something that occurs. They don’t know how it occurs exactly. But it’s sort of like rubber bands or something that’s tying up the methodology from getting neuron transfer and getting your brain to do what you want it to do. So it really bogs everything down.
Rev. Shawn Carty:
Yeah. Sounds like it slows things down.
Sue Lanza :
Absolutely.
Rev. Shawn Carty:
And I know from my own experience with folks with dementia is that there’s a different pace of things. And so they don’t necessarily respond as quickly. And that’s sort of an indication of the brain working at a slower speed.
Sue Lanza :
It’s trying to process. And instead of it being an automatic thing, like you don’t think anything of just standing up when you want to. You’re not telling yourself, hey, stand up. It’s just happening automatically. So yeah, there’s a delay there for sure.
Rev. Shawn Carty:
What would we be looking for if we’re talking about dementia, what are some of the signs that people might want to be alert for?
Sue Lanza:
They don’t know really what’s causing it other than some of the plaques and tangles, but it’s just damage to the brain cells. And so you’re starting to see changes in thinking and behavior and feelings. And so some of the signs that family members might see in their loved one, and I know my mom, I saw some of these things. There’s some short term memory problems. Now I know we would all say, oh no, we have those too. We forgot our book.
Rev. Shawn Carty:
Where’s my phone? I can’t find …
Sue Lanza:
I forgot something today I needed for the podcast. So yeah, you’re paying of bills. That’s a perfect one because the paying of bills requires executive functioning. And so there’s a lot of steps that go into it. You have to make sure there’s money in the bank account. You got to get the checkbook out, if we’re doing it the old fashioned way, get a stamp, make sure you have the bill, check and make sure you can write out the check. So you got to get it out to the post office. You can’t like write it out and then leave it on your kitchen table. There’s lot of thoughts there. But even things like making sure you’re getting appointments or having milk when you need it at home, or just getting your meals prepared, and taking care of yourself, the way we all think nothing of all the tasks that we do every day.
Rev. Shawn Carty:
And as you’re describing this, I’m thinking about for those of us who have been parents of small children, the depths that need to happen for example, when you’re trying to get out the door to go to school in the morning. You need to have your shoes on. You need to find your coat. Make sure you have your lunch bag.
Sue Lanza :
Your homework.
Rev. Shawn Carty:
Exactly your homework. All of those things require a big picture and being able to sort of put all of that together. And while I think we want to be careful and not think of folks with dementia as children, there is something, at least in my observation and experience, about having to be very intentional in small steps. In other words, just as you can’t say to a 5 year old child, we’re leaving in 30 minutes, get yourself together and ready for school.
Sue Lanza :
Oh yeah. That’s going to work.
Rev. Shawn Carty:
You have to sort of help get through the various steps. And so as you say, that executive level functioning, if that’s not working right, then that’s when dementia perhaps is part of the picture, it sounds like.
Sue Lanza :
Definitely, definitely.
Rev. Shawn Carty:
Do we have any clear understanding about where dementia comes from and what sorts of things can be done to treat or even cure it? And I think I sort of know the answer to that last question, unfortunately.
Sue Lanza :
No, there isn’t.
Rev. Shawn Carty:
Where does it come from?
Sue Lanza :
They don’t know, they just know how it presents in some cases. And again, this is through the terrible way of learning things in an autopsy. But over time, they’ve studied so many people, they’re starting to see these patterns. But one of the things that’s rather new here and there’s always something new. I remember 10, 20 years ago. I don’t remember exactly when it was, but I do remember they had a vaccine and this was going to be the promise. And it’s just so funny. Vaccine. Now we think of vaccine in a whole different way, but there was supposed to be an Alzheimer’s vaccine and it failed miserably. It was not a good situation. And everybody’s on hope because the numbers of dementia folks keep climbing, but they do have something. This is a newer treatment that they’re feeling is going to remove some of these, what they call, these amyloid proteins and the amyloid proteins are the plaques and the tangles. It’s just a type of protein that adheres to the neurons.
But they have this treatment called Aduhelm is the technical trademark name. And they say it’s one of the first therapies that can remove some of these. It’s in the very infant stages so we don’t have a lot of hope for that. So right now there still is no cure. And the numbers just keep growing as this, what they call the Silver Tsunami, that’s supposed to really hit between 2022 and 2024, I think is when the big wave goes up. The care level needs for personal caregivers, as well as caregivers in a senior care setting like ours, where we have healthcare options, it’s just going to be much more needed as time goes on.
Rev. Shawn Carty:
Yeah. As you’re describing that, I’m remembering I was in college in the 1980s. And I remember at that time they were saying, oh, in the next 10 years, there will be breakthroughs. And I’ve heard that consistently over the last what? 30 years now. I guess at some level you don’t want to get your hopes up and then be disappointed, but it does seem like … I mean, we’re able, for example, to do much more precise images of the brain now, which is something we couldn’t do 50 years ago, at the level that we’re doing now.
Sue Lanza :
There is hope.
Rev. Shawn Carty:
So there is still very much hope about the treatment possibilities, but we also know it’s been a rough road.
Sue Lanza :
It’s been rough and it’s expensive too. Because I know what you’re thinking probably of is PET scans, which is a type of brain scan that can really show you what’s going on in the brain. So you can look at whatever a “normal” brain looks like. And then for somebody, let’s say your age or my age, and then they could compare it to what yours really looks like. And then they see the changes there. But PET scans are very expensive. And who knows if they’re going to be paid for in a diagnostic setting where you think, well, I think mom is having some issues. Let’s get that. I remember them being years ago, they were like five or six grand. I don’t know what they are now. So it’s just something to think about because when they do do an overview of somebody with dementia, they’re going to do a full assessment, not just neurologically, but they’re going to want to understand the whole home environment and everything. And some of these tests can be very pricey.
Rev. Shawn Carty:
Is there something about the way that dementia kind of progresses and unfolds that you can tell us about? Are there, for example, stages of the way we look at dementia that would be helpful?
Sue Lanza :
Yeah, and it’s important to know because when you know these stages and they’re very rough and there’s lots of overlaps between one stage and the next. But there really are three stages. The early, which is also called the mild stage. The middle, which is also called the moderate stage. Or the late stage, which is the severe stage. And I’ll tell you a little bit about each of them.
So the early stage could be all the people that you see out in the supermarket right now, they’re having a little something here and there. We’re worried all the time that we have it, because we left our keys in the freezer or something. But it’s the people who are maybe starting to have more of these. These are starting to be more of a common occurrence. And I remember this with my mom. She was having issues and we were seeing them, but it’s symptoms like this where they’re having trouble getting a name or they don’t recognize somebody maybe that they used to recognize, or they have their work setting tasks or their maybe social setting tasks that they did 100 times. Mom had her bridge game and she set it out and she did her routine. Well now she can’t process, and it’s back to those executive decision making steps that you have, that maybe she’s doing it out of order. She’s bringing the dip to the table and the table hasn’t been set up yet.
So same thing with work. That’s where sometimes people notice subtleties at work because we have a lot of, we’re a family at work in a lot of cases, and we have our own little work patterns. So all of a sudden somebody’s not getting their cup of coffee as they used to every morning. Maybe they forgot where the coffee maker is. Who knows? They could be misplace things. And a lot of things with planning and organizing that have to do with all of our daily functions, they start missing some of the steps. People like this are living at home for the most part. Some may come to a retirement community at the beginning stages, but usually they’re living independently at home. It’s in the next stage where we often see people coming to perhaps like an assisted living situation, maybe even independent living. But sometimes they come further along than they should and enter a stage, let’s say, an independent living when really they’re almost at a stage where they need more assistance from assisted living.
Rev. Shawn Carty:
I think about that early stage in my own family, my grandmother. The tradition in our family was that she was the one who hosted Thanksgiving. And I’ll never forget. One year, we in our family normally, traditionally had the Thanksgiving dinner like three o’clock in the afternoon. That was just our family tradition. We got a call at about 10:00 AM saying everything’s ready.
Sue Lanza :
Oh no.
Rev. Shawn Carty:
Because she had, I don’t know, she …
Sue Lanza :
Got up at three in the morning.
Rev. Shawn Carty:
Got up early and she everything started rolling and next thing you know, the turkey was ready at 10 or 11:00 AM and I just will never forget that. And that was in fact, the last year that she hosted the Thanksgiving dinner. So there was a bittersweet sense of it, but she was able to get the dinner done. That was not the problem. It was just the [crosstalk].
Sue Lanza :
Time management piece. Yeah.
Rev. Shawn Carty:
That’s one of those, I guess one of those stories and we chuckled a little bit about it, of course, like, oh turkey’s ready.
Sue Lanza :
That’s a good one. Yeah. Everybody’s just having their morning coffee and turkey’s on.
Rev. Shawn Carty:
Time for dinner. Yeah. But that was an early … And I think shortly after that, she was probably in that middle stage that I think you’re going to describe now.
Sue Lanza :
Yeah. Probably she was probably entering into it or had crossed over and probably it hadn’t been noted because she probably lived by herself.
Rev. Shawn Carty:
She did.
Sue Lanza :
Yeah. So this middle stage, this is where things get more pronounced. People are starting have maybe some reactions to some of their shortcomings. They’re starting to notice. They’re sort of in that stage where they’re noticing them and it can be embarrassing. So they might be giving cover stories or glossing over things. But this is where they’re becoming poor historians of their own personal history. What did you eat? Oh, I haven’t had a meal in 10 years or something, stuff like that where you know it’s just completely untrue, or you say I have five kids and we really only have two so that some things happen like that. They can be withdrawn or moody in social situations because they just don’t know how to navigate it anymore. So they just sort of withdraw or act out sometimes. They might have situations where they can’t recall their address or where they went to college or things like that. Like further back memories are more intact than the more recent ones. That’s something to think about. But they might just mix up, like you mention with, was it your aunt?
Rev. Shawn Carty:
Grandmother.
Sue Lanza :
Grandmother. They mix up day and night. They get up at the wrong time or have their sleep patterns change and they might start having problems with their dressing and they’re looking a little unkempt at times when they were a put together lady let’s say. And then they could be having some behavioral changes that result in what people would call personality changes. And they see that a lot in all the dementias. But I’m thinking of Lewy body dementia is one where this is seen frequently and frontal temporal lobe dementia. They’re going to need more assistance in daily care. And so this is where it comes to that gray line, where can mom stay at home? Does she need a few hours of care with somebody? What does she really need? Is it an all day thing or is it only when she gets dressed? When she’s dressed in the morning, she can go?
Safety becomes massively important because leaving the stove on is a problem or going out and locking your door when it’s 20 degrees is also an issue and driving. Driving also something that comes up frequently. So this might be the time when someone could be referred for assisted living or even skilled care or adult daycare, something like that so that they can manage.
Rev. Shawn Carty:
Well one of the things I’ve noticed in those situations that you were mentioning kind of having a cover story for things. In my experience, I’ve notice there’ve been a couple situations thinking of parishioners and churches that I’ve served, who were just lovely, gracious people.
Sue Lanza :
Oh, I know what you’re going to say.
Rev. Shawn Carty:
Any social situation, could find a way to sort of carry on a conversation with anybody. And in some cases that actually kind of masks some of the situations. Like they aren’t tracking really, but they still have a smile on their face. And they’re still saying very gracious kinds of things. Now the flip side, which is what you’re referring to.
Sue Lanza :
Yeah, that’s what I was thinking of. Yeah.
Rev. Shawn Carty:
Is that that disappears. And then it becomes very angry and bitter, and that actually is something I’ve seen in other situations. And you have as well where somebody who was previously quite pleasant and easy to get along. And then within the mix of their own frustrations of not understanding why don’t I understand what’s going on, or what happened, they become quite angry at themselves and also at others around them. And then of course, that just complicates caregiving for all sorts of reasons.
Sue Lanza :
Oh yeah. And that’s also one of the reasons why some of the people in the middle stages wind up needing some assistance because the daily caregiving needs just accelerate. I have some friends who are coping with this right now and they had the mother-in-law living with them. And she just advanced quickly to a point where they were convinced they were going to be able to manage her all the way through to the end. And not any kind of shame that they should feel. They were admirable about all the things that they did, but they just reached a point where they couldn’t be up all night and then try to go to work during the day and do other things. So yeah, you’re absolutely right. It becomes really challenging for the caregivers.
Rev. Shawn Carty:
Yeah. What about that later stage? Can you tell us about, which I know that’s probably the more …
Sue Lanza :
That is a very challenging stage because that’s really the end stage. And the person I was just mentioning to you, my friend’s, this family member of theirs, the mother-in-law, she just advanced quickly, very quickly went through the middle stage and then got to the end stage and they’re having to deal with it. This is the severe part where they’re really losing the ability to carry on a conversation, recognize people, recognize where they are in time and space and eventually to control movement, meaning they’re going to have difficulty swallowing or moving their bowels or doing basic things. So providing food is going to become difficult to keep them alive and hydrated and drinking. They’re not going to do this routinely. They’re going to need to be fed. They may say words and phrases, but they call it like word salad because it’s just a mixture of all kinds of jumbly things.
The family I was just speaking about, I was talking to them and this happened so frequently. The grandson who lives in Canada, they just told me, came for visit. Now, grandma does not recognize anybody. Not her two sons, the daughter-in-law who she sees all the time. Doesn’t really recognize them. The grandson comes marching in and she opens up and has a beaming smile. And there he is. And that’s so typical that could happen, it triggered a memory to her. She hasn’t seen him for a while and boom, there she is. And she was back and they were all … She kind of had her rally day, they call it where she rallies. And I know your wife knows this because she’s in hospice care where the family gets all excited because the person is really in the end stages towards dying and could be on hospice. They just get to a point where all of a sudden they have a great day and it looks like mom is turning around. This is wonderful. And really it’s just like a moment in time and it’s going to fade.
Rev. Shawn Carty:
And that’s been my observation with folks with dementia is there are good days and there are bad days and to be able to sort of take those as they come and not necessarily extrapolate from them, what the next three weeks are going to be. It’s like it’s a good day or a good morning even.
Sue Lanza :
Right. Or a good moment. And just take it from what it is. Definitely.
Rev. Shawn Carty:
What kind of care do we give to folks with dementia in places like The House of the Good Shepherd? I know we don’t specifically have a memory care unit. I know that’s a very specific kind of care.
Sue Lanza :
Sure. Sure.
Rev. Shawn Carty:
But how would you describe that kind of care that get given to folks for who dementia is part of their life?
Sue Lanza :
And we have people with dementia in all levels of our facility right now, in independent, assisted living and in skilled. All different types and require all different levels of care, of course, but mostly in the earlier stages, the first stage and the second stage, the early and the middle stage, we’re providing a lot of support care because their bodies are intact in a lot of cases, medically. This isn’t a medical situation for the most part, not until later in the disease. So we’re providing support with the environment, we’re supporting by providing cues, clues, way finding, how to get around, how to just keep them going so they can maintain whatever independence they still have. So if let’s say they can’t speak, but they can still feed themselves. Well, we’re going to work hard to make sure that they can keep that skill because that’s one of the few they have left.
So our staff is going to be providing support and a feeling of love and comfort for them so that they can feel like this environment isn’t as scary as it could be because they look around and they don’t recognize anything. So picture that every day. You wake up and you have no idea where you are.
Rev. Shawn Carty:
Yeah. I have noticed over the years too, that ritual and familiarity are helpful tools. A little example of that from my own work, as a chaplain. Most folks who have been part of churches through the years know by heart, the Lord’s Prayer. And I can’t tell you how many times I’ve been visiting with someone and this predates my time here as chaplain also. But I’ll visit somebody who has dementia and during the course of our visit, we will pray the Lord’s Prayer. And all I have to do is get the first couple words out and [crosstalk]
Sue Lanza :
Right. And off they go. Yeah.
Rev. Shawn Carty:
And they’re is something valuable about those kinds of rituals that keep us grounded and connected. Music is the other one. And actually I was just witnessing that today here. There was a group that was able to kind of gather around and sing some songs that were some of those, what we think of as the golden oldies. And it was just clear to me that they were, and folks of all different levels of abilities and things. But it was just clear that touches something deeply within most all of us.
Sue Lanza :
It does.
Rev. Shawn Carty:
And we try to connect with that somehow.
Sue Lanza :
Yeah. Because it’s when you lose the ability to communicate. And that’s the hardest thing for caregivers, whether they’re a professional caregiver or a family caregiver, you lose that ability. So you have to find something. So it’s touch, it’s music, the universal language, it’s ritual, like your church work is such a great example of that because for some of the folks, they may not be able to take in what exactly you’re doing, but that whole presence of being in that situation that feels familiar to them. It feels safe. It’s a sanctuary for a moment or two. So it’s so, so important.
Rev. Shawn Carty:
You mentioned the stress on caregivers. I wonder if we could talk a minute or two about that?
Sue Lanza :
Sure.
Rev. Shawn Carty:
Because what I know from again, from my own family experience, and then also in my professional work, that often goes unseen.
Sue Lanza :
It does. There’s so many family caregivers out there who are struggling and picture all of this going on, dealing with someone at home, doing all the caregiving details that I mentioned, maybe they’re in the middle stage of dementia, advancing, and then COVID hits. And you have even more isolation. That little respite that you used to take, where you would go out to Walmart or something, whatever was the thing for you. You don’t even have that anymore. You don’t have anybody you’re talking to. So this has been quite difficult. And then you have with … I always was amazed by this great term that described it so perfectly, the sandwich generation. So you’re in the sandwich as the caregiver. You’ve got your kids on below you that you’re caring for. And now you have your elderly mother, adult, cousin, whoever it is. And somehow in there, you’re working usually a full-time job and you’re juggling all of this. How?
Rev. Shawn Carty:
And trying to take care of yourself at some level too.
Sue Lanza :
Yeah. How are you doing that. And then I just think of the COVID tsunami thing comes on top of you, like these poor people, what they’ve been through, that’s why the resources and the support groups that are offered by any Alzheimer’s Association or dementia organizations around the world. There’s so many benefits out there that caregivers can reach out to because they’re struggling mightily. It’s very, very difficult. They have some of the highest stress that others have. Professional caregivers have it as well, but they can clock out and go home. So family caregivers don’t have a place to go, so they need this.
Rev. Shawn Carty:
But I would also say too, is that the professional caregivers, it is stressful. And that’s one thing I’ve really come to appreciate in my work here at the House is that we just have a remarkable staff in so many different ways. One of the ways that I see it is the care that gets expressed in those challenging situations. And I think, for example, one example for me personally, is that there are a couple of residents who, whenever I see them will always ask me the same question.
Sue Lanza :
You have to be patient.
Rev. Shawn Carty:
Well, initially I have to admit, I’m not proud of this, but I have to admit that I thought I’ve already answered that question.
Sue Lanza :
Shawn.
Rev. Shawn Carty:
But being here has opened up my perspective on that. And I think anybody who’s working here has learned you either learned how to do that or you don’t stick around in this environment.
Sue Lanza :
Right. You don’t stick around. Exactly.
Rev. Shawn Carty:
I just know that when I see a certain resident, that resident’s going to ask me, how long have you been chaplain at The House of the Good Shepherd? And I have my answer ready. And then we move on to whatever the next question or the next topic may be. And that’s, in a way, it’s almost become its own ritual to go back to what we were talking about earlier.
Sue Lanza:
It’s true. And you made me just think of something. We have somebody who works closely with me who’s been training to be a nursing assistant and learning and going through this. And she was telling me about some of the tricks that some of the other seasoned nursing assistants were telling her. And these were about some of our folks maybe that are up on our skilled unit who have more serious demand. And the tricks that they’re telling her, tricks, they sound evil, but it’s not a trick in a bad way. It’s a trick of learning all the little nuances of this particular person that you’re caring for. Listen, if you just open the curtain a little bit, that’s all she wants. Do not open it all the way. Helen is going to be so upset by this. Or don’t bring her a cup of coffee, she needs a cup of tea. And when you put it down, please put it on the left side. And I know all this stuff sounds ridiculous, but the person who was telling me this was eating it up because she tried it for different people.
Rev. Shawn Carty:
And it works.
Sue Lanza :
It worked. And one of the nursing assistants was kind of rushing through things, knew all her little tricks and did all her things, but wasn’t sharing them. And she finally got her to stop enough to share them. And boy, did she have some gems for her on how to care for somebody. And it’s all about a connection on a relationship level of somebody understanding who they are, what they need. And sometimes it’s just so simple, don’t open the curtain more than five inches. That’s it. And she’ll be as happy as could be. But if you have blast it open, you’re in for trouble.
Rev. Shawn Carty:
That’s right.
Sue Lanza :
Yeah.
Rev. Shawn Carty:
I’m wondering are there some resources that we can share as part of our podcast today too?
Sue Lanza :
Definitely, definitely.
Rev. Shawn Carty:
Point people toward.
Sue Lanza:
Actually in the United States, for sure, go to alz.org. So that’s the Alzheimer’s Association. There are chapters all over. There are plenty of other dementia organizations so that’s not like that’s the only one, but they have support groups, they have resources, they have booklets and information. But you can also call, there’s a 24 hour hotline. So you can get connected to somebody who will connect you to somebody else who can get you the answer. So it’s 800-272-3900, and there’s support groups all over the place. And that would be probably the best thing to, as a starting point for anybody who’s struggling. We’ve covered a lot of ground here.
Rev. Shawn Carty:
Well, the only thing I would add as we conclude this is something that we in the Episcopal church take very seriously. And it’s actually one of the promises that we answer whenever there’s a baptism. And I know I’ve shared this with you before Sue. But one of the questions we ask, whenever someone is baptized and it’s not just the person being baptized, but the whole congregation responds, will you respect the dignity of every human being? And that word every is pretty significant. And I think in terms of folks for whom dementia is part of their life, what we do, and I see this here over and over is that we respect their dignity and that’s at the core of what we do here.
I just think that’s important to say that out loud because just because someone’s cognitive abilities or memory are different than they were when they were younger or at a different point in their life, does not mean that they’re not a person who’s worthy of respect and dignity. And so I think, for me, that would be kind of a last word of something to keep in mind as we …
Sue Lanza:
I agree with you. I agree with you on that. Sometimes it’s the simplest things to show that dignity too. Somebody was walking down the hall and you could see a resident maybe is just a little off or agitated. Take two seconds from your busy schedule, sit down for two seconds, hold their hands. And you’d be amazed at what happens. It just stops. So it’s all good stuff. So I would encourage anybody who has additional questions, reach out, there’s resources all over, and we’re here for you if you need us. Another great episode Shawn. Thank you so much.
Rev. Shawn Carty:
You’re welcome. Thank you. Good conversation.
Sue Lanza:
It always is. So we’ll see you next time from House Guest. Thanks for joining us. Bye.
Thanks for listening to this episode of House Guests, the podcast, which is dedicated to all great things about The House of the Good Shepherd, a retirement community in Hackettstown, New Jersey. To learn more about us, please visit our website, hotgs.org. Thanks for listening. See you next time.
