Tips for meaningful visits with residents in memory care

Tips for Visiting Loved Ones with Dementia - From the Alzheimer's Association

Visiting a loved one in a long term care community can elicit a variety of emotions. It can be a very rewarding and joyful experience, or it may sadden or frustrate you, depending on the response of your loved one, and immediate reactions to the environment. Let’s pretend your loved one, who is your mother, has just been admitted to a Memory Care Community of a nursing home. You may love to visit with her, but are feeling unsure about what to say and do during your visit with her. You understand she may no longer remember you and rarely understands the things you say any more. You would like the visit to be meaningful and enjoyable for both you and your mother. What can you do?


Overall Guidelines for Visiting
 You are the link to your loved one’s identity as a whole person with emotional concerns, social and spiritual needs. We need to remember there is more to a person than his/her memory or ability to do specific things.
 Keep visits simple. Don’t overwhelm the person with too many tasks, activities or too many people. Tap into the remaining strengths of your loved one to draw out the person inside and create “moments of joy”.
 Find a quiet, comfortable place to spend time together. Try to limit distractions and excess noise in the environment. Many settings have porches, quiet rooms, chapels or guest dining rooms for use.
 Your expectations for a visit may be quite different than when you used to visit. Be present and live in the moment. Adjust your expectations. Looking at a flower or sipping a milk shake can be simple and pleasant things to do together. Sitting silently and holding hands may also be a very enjoyable visit.
 Be flexible. You may need to do different activities when you visit. What worked well once may not work the same on the next visit. Find out if the setting has music, memory books or other items to use during your visit.
 Remember, your loved one may respond differently than the way he/she used to. It is important to know this is part of the disease process and not what you said or did. Contact the Alzheimer's Association to seek support and information to help you understand the disease, and to gain ideas for meaningful visits
 At times, if your loved one becomes angry or upset with you --don’t take it personally. When a person is having an unpleasant reaction to something, they may be trying to communicate an unmet need. They may be tired or distracted. Quality of time together trumps quantity of time.


The following are some pointers suggested by Jolene Brackey in her book, Creating Moments of Joy for the Person with Alzheimer’s Disease.
 Begin by introducing yourself, using a familiar nickname, and address your loved one by their favorite name. If awakening them, try gentle massage, a kiss, or a warm hello.
 Visit as a third person. Instead of saying, “mom”, say her name. She thinks her kids are little and now you might be lying because you can’t be her kid…you’re old!
 Avoid conversations dealing with the “here and now”. Tap into their pleasant past memories.
 Visit in small groups. Sometimes one to one is best.
 Give your loved one enough time to respond to questions or directions – do not rush him/her.
 Consider the person’s interests and abilities and discuss what they might enjoy doing. You may have to adapt this activity depending on changes in the person’s cognitive and physical ability.
 Consider planning activities for visits ahead of time, then be flexible according to the person’s mood or level of abilities during the visit.
 When planning an outing be sure to keep it simple with little stimulation. Maybe it’s just going for a drive in the country, walking in the park or having a picnic in a quiet area. The less people involved, the simpler the tasks, the more enjoyment you will both have.


Activity Suggestions when Visiting
When you are visiting – think about activities that pleasantly engage several senses and have meaning for your loved one. Be creative and most importantly, have fun.
The following activities are divided by section to help you think of activities by categories. You can combine things, like a musical massage!


Music is magical
 Listen and find music that your loved one used to enjoy and play it during your visit.
 Use music to bring about discussion of old memories.
 Music can also make your loved one want to move and dance – encourage movement if it is safe and have fun with it. Dance for, or with them. Don’t be inhibited!
 Encourage singing and sing along – don’t worry if you or your loved one “can’t sing”.
 Just looking at old albums can be fun.


Touch is healing
 Give your loved one a hand massage with some scented lotion if they like that smell. This is a chance to hold his/her hand, look into their eyes, and convey your love and care.
 Scratch his/her back. We all love our back scratched and can never get too much of it. They may even want to scratch your back too!
 Pamper with makeup, perfume, aftershave, or a manicure.
 Rub his/her shoulders in an effort to relieve muscle tension and encourage relaxation.
 Be aware of painful areas or skin lesions.

Vision is Stimulating
 Bring photos of loved ones to show and discuss. Often the older the better.
 Look at magazines that have lots of colorful pictures. Postcards and “coffee table” books work too!
 Look at items in their room, such as photographs or greeting cards they have received in the mail.
 Try a new artistic pastime together, such as drawing or painting. Just framing a picture or sorting colorful scarves or materials can be fun.


Reminiscing Triggers Memories
 Talk about favorite memories in the past. It may be something your loved one remembers, such as his/her wedding day or childhood.
 Make a scrapbook together. This will be a great tool to use for reminiscing with your loved one.
 Bring in photos, and talk about them.
 Bring a shoebox with nostalgic items to trigger memories such as seashells, medals of honor, trophies, sports items, cooking utensils, car parts, models of classic cars or hot wheels, replicas of farm animals, or other related item’s to the person’s occupation, hobbies, or favorite fashions.
 Keep a logbook of what you do or talk about during your visits – date and sign it. This may give other visitors ideas of what to do or talk about when they visit. Additionally, if the resident has trouble remembering your visits, staff can refer to the logbook to help them remember.


Spirituality Inspires
 Read from the Bible or other religious book that your loved one is familiar with.
 Play or sing spiritual music/songs.
 Celebrate religious traditions, or just recite simple prayers together.


Other Engaging Activities The following are only a few activities taken from the Alzheimer's Association handout 101 Things to DO which can be obtained from your local Alzheimer's Association.
 Bring a pet or a picture of a pet.
 Do exercises together.
 Have a grandchild bring or send along artwork or school papers.
 Tell jokes to each other. There are word pairs and other easy word games.


From the Heart
Don’t worry if your loved one won’t remember what you said or even the visit, you still created treasured moments of joy together.
 Thank your loved one for something they have said to you or done for you in the past and how much it meant to you.
 Tell the your loved one about how they have inspired you, either because of something they did in the past or are doing now.
 Share your love for that person and how much they mean to you.
 Bring the your loved one a small gift -- something you know that they will enjoy (for example a small plant or flowers, a photo, a food item that they love to eat), or a “comfort” item like a lap blanket or adult oriented stuffed animals.
 Give the person a personal inspirational card or quote that has significance or gives them hope.
 Remind your loved one of fond memories of the past, i.e. a job that they loved, or a positive family event.
 Listen to your loved one, really listen and empathize with them. Validate how they feel. You don't always have to fix them and make it all better.
 Laugh with them. Have fun and be playful, tap into your loved one’s playful inner child.

Other Tips
 Always take at least five minutes prior to coming to the nursing home to think about conversational ideas and things to do together. Use physical props whenever possible.
 Plan for periods of silence. Tell yourself that you can handle five or ten minutes of nothing but silence. Show the resident that you are quite comfortable with silence.
 Listen for the meaning or feeling behind the words. Words are a very small part of communication. Attempt to use more body language than any other kind of communication.
 Your mood affects their mood. Stay calm, even if there are problems. Always refer to their residence as “home” and a positive place.
 When dealing with issues or concerns with the care being provided attempt to major on the majors and minor on the minors – can it wait for the next care plan meeting? If it must be addressed immediately, consider approaching staff privately to address the needs at hand.
You are the key to respect and honor for your loved one; you link them into being the person they are. You see beyond the impairments --look into their heart and soul and continue seeing your loved one in a whole new way to have a fun and meaningful visit. Finally, give yourself permission to be human. You have good and bad days too. If you need to shorten, or even skip a visit from time to time to replenish yourself – that’s OK. Alerting a friend or staff member can possibly arrange a visitor in your absence.