Dementia care at a distance: The balance between health and safety and human rights

Abstract

Background Health practices to fight the transmission of Covid‐19 in long‐term care settings are now well established with staff being continually reminded to wash hands and sanitize surfaces. Seeking to reduce risk, long term care communities are also: ending group dining and group activities, prohibiting family visits, turning to dedicated staffing for the memory care neighborhood, and assuring that staff wear PPE even as residents typically won’t keep masks on or necessarily respect social distancing. The CDC has issued its recommendations relating to safety in memory care settings related to Covid‐19 here and supports many of these practices, but that also calls for ongoing activity programming. https://www.cdc.gov/coronavirus/2019‐ncov/hcp/memory‐care.html.While health and safety concerns are of great urgency, “dementia care at a distance” raises concerns for the emotional well‐being of people living with dementia. Sam Fazio and his colleagues write eloquently about the importance of person centered care and therapeutic environments (including meaningful engagement and caring relationships) in The Fundamentals of Person‐Centered Care, Gerontologist, 2018, Vol. 58, No. S1, S10–S19 https://doi.org/10.1093/geront/gnx122. Without disease modifying medication, this presentation will argue that socialization, in many ways, is the “treatment” for Alzheimer’s disease and other dementia. With innovative thinking, “social distancing” can become “sociable distancing.” This session will offer strategies for maintaining person centered approaches in long‐term care settings during this challenging time. Innovations include: staff training focused on caring approaches and the benefits of short moments of engagement throughout the day; the importance of unplugging from negative news in order to support positive emotion; activities that can be safely conducted in small groups (6 feet apart) and one‐on‐one; ways to make personal care more of a social experience; strategies to utilize the resident’s social history or life story to make connection and provide needed clues and cues; and innovative uses of technology to keep the resident connected with friends and family. The presentation will end with some further techniques for resident care during the Covid‐19 pandemic and argue that the medical model and social model must both be present to provide quality of life for persons living with dementia.