Mr. Hudson Benefits from Tapestries® Model of Care

United Methodist Communities (UMC) is always seeking ways to increase the Abundant Life for Seniors. Thanks to the Tapestries® Model of Care, United Methodist Communities’ residents are experiencing an improved quality of life. The Tapestries® Model of Care has become the next level for improving the lives of residents with dementia.

Expressing Discomfort

Often, people with dementia cannot clearly communicate their feelings, desires, or thoughts, leading to frustration and negative behaviors. In contrast to his normal pattern, a man in the advanced stage of Alzheimer’s disease exhibited an unwillingness to bathe, toilet, and change his clothing. His caregiver declared it a new level of setback, noting both vocal and physical signs of distress.

A Team Assembles

At this point, a team with unique skill sets and perspectives formed to advocate for Mr. Hudson* and to explore the tools and interventions to improve his quality of life. It consisted of the community’s executive director, Tapestries director, and nurse; Pamela Garofolo, corporate director of Tapestries; Mr. Hudson’s aide; doctor; and his two adult children.

Seeking a better understanding of Mr. Hudson’s needs and wishes, they worked closely with him, his caregivers and loved one. They developed a dynamic and holistic approach, which improved his comfort. Here is how the Tapestries® Model of Care worked for Mr. Hudson:

Consistent with the Tapestries model of care, they reviewed the residents’ health history, previous diagnoses, psychological records, and other documents. One Tapestries’ strategy is to be well acquainted with the resident’s life history, preferences, personality, and routines. Since Mr. Hudson had a history of chronic pain from osteoarthritis but faced it without complaint in the past, they suspected it might be at the root. Before drawing any conclusions, however, the group sent Ms. Garofolo and the Tapestries director to visit Mr. Hudson.

Observation

Like detectives putting puzzle pieces together, the duo began by observing Mr. Hudson and his aide for a few days. Because people with dementia express pain through other means, they selected PAINAD (Pain Assessment in Advanced Dementia), a pain scale developed by Victoria Warden, Ann C. Hurley, and Ladislav Volicer, to provide a universal method of analyzing the pain experienced by patients in late-stage dementia.

It rates pain on the familiar 0 to 10 scale and specifically focuses on patients who are unable to participate in their own examination. In assessing people with cognitive impairment, PAINAD’s originators feel that an expressionless, non-communicative patient staring blankly does not necessarily indicate they are pain-free.

Assessment Tools

Ms. Garofolo and her assistant used a variety of concrete tools, considered Mr. Hudson’s breathing, negative vocalization, facial expressions, body language, as well as his response to being consoled. While people with advanced dementia cannot describe or rate their pain and don’t always exhibit irritability, Mr. Hudson did exhibit crankiness. This proved consistent with his lifelong pattern of expressing his emotions. Also, they noticed that he flinched when touched. They assigned his pain level at seven or eight, but also consulted several physical therapy experts.

“This process requires a lot of time, patience, communication with team members, thought, and analysis. By no means, is it magic, but a tested methodology to produce results,” reflects Ms. Garofolo.

Specialized Training

United Methodist Communities understands how important it is for older adults like Mr. Hudson to live in supportive surroundings with experienced associates. Tapestries associates receive specific training to care for seniors who suffer from various neurocognitive disorders and related dementias, exceeding that of those in other care settings. Further screening for personality, temperament, and personal preferences, helps ensure a good fit. This process enables Tapestries’ aides, LETS (life enrichment team specialists), social workers, and other staff, to make positive differences in peoples’ lives.

The Tapestries Model of Care includes staying engaged with their client, managing unpredictable behaviors, understanding body language and recognizing what the resident is communicating, breaking down activities into smaller manageable steps and honoring the unique wants and needs of the individual and allowing that to direct their care. Safety is also a substantial part of caregiver training since those with dementia may be prone to wandering.

Tapestries Environment

Similar to UMC’s other Tapestries residences, Mr. Hudson benefits from skilled, certified associates, 24-hours a day, 7 days a week. Each residence is located within an Assisted Living neighborhood, offering a specific and customized environment. Here, residents can experience life on their own terms. Because those with dementia thrive best with routines, our caregivers endeavor to respect their preferences and facilitate those routines at the appropriate times.

A Plan of Care Emerges

After collecting the data, the entire team met, looked at the case, brainstormed various strategies, and talked about approaches. With a united family focus, a direction emerged and they developed a plan of care, which included pain management and other strategies. In light of the ever-evolving nature of dementia, the plan made provisions for regular checks on Mr. Hudson to measure his status and allow for ongoing adjustments.

 Positive Results

Minor changes proved positive to Mr. Hudson’s overall quality of life. His behavior quickly signaled that he felt more at ease. He became happier, more cooperative and allowed aides to help more, especially with necessary physical contact. His caregivers were better able to meet his daily needs. In contrast to previous behavior, Mr. Hudson permitted the aide to put on his shoes each morning. His loved ones shared that they were more at peace with his improved quality of life.

His adult child, Sidney stated, “Ms. Garofolo is lovely to work with and brings her expertise and team approach to benefit Dad. UMC has sought out and achieved a dynamic and ongoing holistic approach to make a difference for the people impacted by dementia.”

* For the purpose of protecting the resident’s privacy, his name has been altered and stock photos published within this blog.