Mary Immaculate Health/Care Services in Lawrence, Massachusetts, strives to excel in the care it provides its residents, especially those with Alzheimer's disease and dementia. Last fall and winter, more than 50 workers, including nurses, nursing assistants, and activity staff, completed the Alzheimer's Disease and Dementia Care Seminar offered by the National Council of Certified Dementia Practitioners. The training qualifies staff as certified dementia practitioners. There are 262 total staffers at the facility.

The training was made possible in part by a $7,500 grant from The Josephine G. Russell Trust. The seven hours of training goes beyond the four hours required by the state, explained Rebecca Alfonso, memory care program director at Mary Immaculate, which is a member of Covenant Health. The person-centered approach shows caregivers how to focus on the needs of the patient to prevent agitation and confusion, enhancing the environment for all.

Alfonso spoke with Catholic Health World about the training and the special needs of Mary Immaculate's residents. Responses have been edited for length and clarity.

Tell me about your facility and your residents.

I work on a 41-bed dementia specialty care unit. We also have a new advanced memory care unit, and 13 (residents) are there right now, out of 22 beds. I would say the change since the pandemic is they're younger. I'm going to be 55, and they're my age. It gives you a new perspective on things. I formed a bond with them because there are two younger ones on my floor, and we call ourselves the 50s chicks, and we hang out together. They're very different than my residents who are 80-plus years old. They have totally different interests, needs and likes.

Our residents tend to come in more sick now than they used to, because a lot of families try to keep them home as long as possible. By the time they come to us, they're pretty incapacitated and they don't live as long, unfortunately. The average length of stay is six months to a year and a half. Before, we'd have people living here for eight to 11 years. Unfortunately, it's a more rapid turnover of residents.

Why was it important to provide the extra training?

We wanted to give the staff more tools to use. Since we have younger residents, we wanted to learn how to provide care for them in a different way. We might have a resident who is 80 years old listen to Frank Sinatra to get him to take a shower, that's not going to work with someone my age — maybe you'll pull out Billy Idol or ABBA. It's the same thing for providing activities for them. You want to make sure that you're meeting them where they're at in their illness.

We tell staff to take the word "no" out of your vocabulary. You have to learn to kind of go where (residents are) at and change your approach in order to be successful. It's important for staff to remember that residents are adults and deserve respect. You have to find a new way to get them to do something without saying no to them. That requires a little bit more thought and a little bit more preparation in order to be successful. By preparing, you take five (minutes) to save nine. It seems inconvenient to take your time to do that, but if you don't, you spend more than double that time dealing with the resident behavior that comes up.

What kinds of things have you heard from staff since the training? Have you seen results?

Since I'm on the memory care floor, I'm always watching what staff are doing and how they're interacting with people. I've definitely seen fewer catastrophic reactions since the class. The staff are better prepared to deal with a situation if the resident doesn't want to do something. And then the staff will say, "OK, I'm going to give this person a few minutes for a break and then try to come back later."

The staff are also more confident knowing how to do some of the activities, especially at night. After the activity staff leaves, if someone's having a bad time, the staff are more confident going to the supplies and grabbing different things and interacting with them than they were before, which is great. It does take a team to engage everybody, so now the staff have a better understanding of the importance of activities.

How does this National Council of Certified Dementia Practitioners certification set you apart from other care facilities?

CDP certification is the gold standard in memory care. I've had my certification for about eight years now and I've always wanted to work in memory care. I always want the latest technology. I love how I can go onto their website, and I can pull up an online class, or I can look if there's a new medication that's come out. A family might say, "have you heard anything about this?" And I can pull up the latest information. The thing that Mary Immaculate is great about is they want to make sure the residents have the highest quality of life possible and they're willing to invest in education to help staff in providing that quality of care.

How does providing this training tie in with your mission as a Catholic health facility?

Our mission is compassion, integrity, collaboration and excellence. I think having taken that class, it helps achieve all four areas. It helps the staff understand that they need to be a little bit more empathetic with the residents. Once they learn a little bit more about dementia progression, they might think: This approach might work better than the other approach. They might not realize that they were causing the problem by how they were reacting, what their body language was saying. They now take the time to smile and perform their work with that level of compassion.

As far as collaboration, it helps if all of us work together. Sometimes you might need to tap out, because a resident is having a really tough time for whatever reason. You might say, "Gee, she's really not having me tonight, can you take over for me?"

Of course, I think it helps with excellence, because it's the gold standard for care. It shows that the staff have taken the time to show they want to improve their knowledge so they can provide better care for our residents. It helps make their lives better, it makes them safer, it helps prevent falls, it helps with customer and family satisfaction. The families feel more comfortable knowing (staff) got trained in this class and method, so we know that (residents are) being taken care of in a way that is cutting edge.