Improving Dementia Care in Washington Care Communities

More than six million people in the U.S. have dementia, but many care communities dedicated to caring for people with dementia don’t have the resources they need to learn and implement best-practice care.

“There really is a lack of training opportunities and resources for staff who are looking for them and who need them,” said Jessica Welsch, who worked on a project in Washington state dedicated to changing that.

The project, spearheaded by the Alzheimer’s Association, helped Washington state communities that care for people with dementia – such as long-term care facilities – use a set of recommendations from the Alzheimer’s Association known as the Dementia Practice Care Recommendations. These research-backed recommendations focus on “person-centered care” -- which prioritizes the resident’s individual wants and needs for care instead of only thinking about their condition. Person-centered care is currently considered “the gold standard of care in any type of care community, but particularly for people living with dementia,” says Welsch.

The Alzheimer’s Association’s care recommendations are a treasure trove for these types of communities, with extensive and specific advice for the staff and administrators working there. However, it can be hard to learn the long list of recommendations and put them into practice as a team. To help care communities implement the recommendations, the Alzheimer’s Association launched the care community coaching program that Welsch joined as a coach.

Each month, Welsch met with staff from Washington care communities participating in the 6-month coaching program. The communities would decide on a recommendation to focus on with their coach and develop a plan for implementing it. The coaching program focused on transformational change by implementing actions that would change the workplace cultures in the long-term.

One person-centered care example was at a care community that started a policy of always introducing residents to each other when they sat down for lunch.

“When you are living with dementia and you get sat at a lunch table with people you may or may not know even though you knew them yesterday, you might not know them today,” said Welsch. After the staff started introducing residents every day, the energy in the lunchroom became much more fun and lively. “It doesn’t seem like a big deal, until you imagine yourself dreading lunch with strangers versus lunch with new friends with a warm handoff every day,” said Welsch.

The Alzheimer’s Association’s Dementia Care Practice Recommendations are designed for professional care providers, but many of the tips are useful to anyone who knows or encounters people with dementia on their day to day.

Welsch spoke about one recommendation, joining someone with dementia in their reality, which is relevant to clinicians and non-clinicians alike. “Because their reality can change, and their reality can be different from the people around them,” said Welsch.

She saw a great example of it early in her coaching experience. A staff member told her about a resident coming up to the staff member and giving their condolences about a recent loss. The only problem? The staff member hadn’t had a personal loss recently. But remembering the advice to join their reality, instead of correcting the resident, the two had a brief conversation where the staff member accepted the person’s sentiment.

“She reported that they both left that conversation feeling connected and validated,” said Welsch. “They had a positive experience, even though their realities were different.”

After the program finished, participating staff reported feeling happier with their jobs and like a more cohesive team. The project was considered enough of a success that it has now been brought to Montana and Ohio.

For anyone hoping to learn more about the Dementia Care Practice Recommendations, information about the recommendations can be found on the Alzheimer's Association website. Beyond that, Welsch recommends using their site, resources and helpline for anyone looking for further assistance and support.

“There’s plenty of hope and happiness that can be found when engaging with people living with Alzheimer’s and dementia, and for those people who live with it,” says Welsch.