Special Precautions for COVID-19 and Dementia in Assisted Living

We all know that older adults are not only at a higher risk of developing illness, whether it be the flu or a common cold, but also more likely to develop complications and at an increase risk of death due to these complications. Corona Virus is no different. Whether you believe the media is over-hyping it or that it a reason for extreme alarm, we need to take all precautions seriously in an effort to protect our residents.
Many communities have already implemented policies increasing cleanliness, limiting visitors, and ceasing outings. However, the direct impact for residents with dementia has not been considered to the extent that it should be. Most Residents with dementia will be unable to process the change but they will certainly sense it. Any disruption to their routine is felt and can increase unwanted expressions or requires more emotional support.
In an effort to support communities, people with dementia, and their caregivers during this pandemic, I have compiled a list of tips for communities. These tips will help to prevent the spread of illness while minimizing disruption.
Tip 1: Create a hand washing schedule.
Some of your residents may already be on a schedule for toileting. Now more than ever, you need a hand-washing schedule. While this is something I recommend throughout the year, especially during flu season, it is even more important now. Hand sanitizer does not replace hand washing when hand washing is available. Remember that this is a disruption to their schedule so there may be push back or unwanted expressions.
Do you have a plan to make this an activity instead of a task?
Tip 2: Create a cleaning and disinfecting regimen.
You’re already keeping a clean community, I’m sure of it! But, this is a new ball game. We need everyone to be disinfecting and cleaning non-stop. It is also going to require safety protocol so that residents with dementia do not have access to dangerous materials that can be ingested. Some states have regulations around this, but it is something you need to implement whether it is a state regulation or not.
Do you have a way for staff to have access to cleaning supplies without sacrificing safety of your residents with dementia?
Tip 3: Create a calm environment.
People with dementia tend to be more sensitive to the non-verbal cues and “vibes” in an environment. Therefore, if there is a panic or urgency in your community, they will feel it. This may increase stress and therefore you may see residents expressing themselves differently: crying, physical aggression, depression, seclusion, decreased appetite, sleep disruptions, etc. Creating a calm environment by establishing a protocol and expectations can minimize disruptive expressions.
Have you done training and established expectations recently to equip your staff with the correct skills and protocol to remain calm and keep your residents calm?
Tip 4: Enter their reality.
Our reality is that there is a pandemic spreading across the world and it is resulting in extreme illness and death. The media is creating a grim reality, whether true or false, and our reality is a scary one. However, your residents do not share that reality. Their reality is that it’s a beautiful Thursday afternoon and the sun is shining and they want to go out to lunch. You need to pull out all the techniques: validation, redirection, and yes: maybe even lying.
Does your staff have the specific methods to correctly implement these techniques under these circumstances?
Tip 5: Put other duties on the back burner.
You may need extra staff to implement some of these new protocols and unfortunately, they may not be available. Most of your staff not only have families and their own lives, but they also may have another job (probably at another community) that also needs them to pick up extra shifts. That is going to mean your leadership team may need to put on their scrub or floor uniform and start providing care. From being a director in a community, I know this is hard. You’ve done it before for weather-related concerns, but this may last months.
Have you de-prioritized duties and created a schedule or responsibility list for leadership to help?
Trovato Can Help.
We understand this is overwhelming for many, especially communities. Given how many people are impacted by this and the vulnerable population we serve, Trovato is offering special discounted remote services while we are impacted by this pandemic.
COVID-19 Staff training: Your time is limited as you’re dealing with a pandemic. Give us 1 hour for a training call with your leadership + 30 minutes for community-specific questions.
Individualized protocol development for your community: Following the staff training, we will develop a protocol specifically for your community including how to implement the above techniques and addressing any community specific concerns.
Ongoing consulting and support: As things pop up or challenges with residents arise, it is likely that this may be due to the disruption in their routine and schedule. I will brain storm with anyone at your community to problem solve. This is billed in 15 minute intervals (0-15 minutes, 16-30 minutes..)