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Elder Care Alliance Implements I’m Still Here Approach in AlmaVia of San Rafael

Application of Engagement-Centered Memory Care Philosophy a First in California

A pioneering engagement-focused memory care philosophy for people living with dementia is transforming and enriching lives in several California senior living communities, as Elder Care Alliance (ECA) announces its partnership with the Hearthstone Institute to implement the I’m Still Here™ (ISH) approach in all its communities: San Francisco, Oakland, San Rafael, and Camarillo – the first (and only at this time) communities to have it available on the West Coast.

More than five million Americans are living with Alzheimer’s disease, with many living with it for more than a decade. The shared stance of these organizations is that every person living with dementia still has a great capacity to learn and experience a high quality of life regardless of the severity of their memory loss. Opportunities for connection and empowerment are possible when the focus is on the strengths that remain, instead of dwelling on the losses of dementia.

“One of the most significant challenges for persons living with cognitive impairment is the stigma,” said Sharon Johnson, Vice President, The Hearthstone Institute. “The I’m Still Here™ approach provides us with a powerful tool for overcoming this stigma because it generates a belief that every person has an innate capability to learn and succeed, despite the severity of their memory loss.”

Founded in 1992 to provide innovative treatment programs for people living with dementia in assisted living settings, Hearthstone has become a world-wide leader in the field of caring for the memory impaired with their innovative, non-pharmacologic, evidence- and research-based approach. 

The approach represents a radical paradigm shift in dementia care by eliciting an unprecedented level of engagement from the person. Through environmental adaptions, communication and specialized learning techniques, staff training, and cultural and life enrichment programs, the approach enables people living with dementia to remain creative throughout their lives. By bringing together all these aspects of care in a coordinated, holistic approach, the resident’s function and quality of life are improved. The approach tailors activities to an individual’s cognitive abilities and strengths, and has been shown to increase self-esteem and independence in participants. Through activities that build self-esteem, the anxiety, agitation, aggression and apathy often associated with dementia-related illnesses is significantly decreased, reducing stress on caregiving staff.

How it works is residents engage in cultural experiences and cognitive stimulation through participation in socialization and physical activities. By offering choices throughout the day and encouraging independence, residents begin to learn, connect, and contribute to the world around them. 

The difference in this approach to memory care are the qualities of dignity, respect, independence, and choice embedded in every aspect of resident care, experience, and interaction, based on the belief that all, regardless of the level of cognitive impairment, have the ability to learn, connect, and contribute. It recognizes that each stage of dementia requires a different approach to maximize functioning and reduce or eliminate the symptoms, so it ensures that each resident is in the right program.

“In striving for excellence in our memory care services, we sought to create environments that foster independence to allow people to flourish despite the severity of memory loss,” said Rachel Main, Director of Life Enrichment and Memory Care, Elder Care Alliance. “By implementing this philosophy in our communities, our residents have increased opportunities for engagement, connection, and purpose, resulting in improved functioning and a higher quality of life.”

AlmaVia of San Francisco was one of the first communities to have the program implemented in mid-2012, followed by AlmaVia of Camarillo in 2013, with the roll-out continuing at Mercy Retirement & Care Center in Oakland and AlmaVia of San Rafael this month. Employees working in memory care complete a six-month on-site training program, which includes intensive training in Alzheimer’s disease and related dementias, communication techniques, and life enrichment. 

The outcomes observed at these ECA communities as a result of this applied philosophy include greater engagement, language expression, accessing of memories, emotional connectedness and short-term event memory. It has contributed to a reduction in the administration of anti-psychotic medications, behavioral incidents, and resident falls.

Stories of residents’ lives transformed include many examples of increased engagement, health, activity and joy, such as a male resident whose desire to remain in bed during the day changed to a level of participation in activities that made his son remark: ‘what you’re doing for him is what will get him to 100’. A self-organized group named themselves the ‘Friendly Club’ and made neo-natal blankets for a local hospital and dog treats for the SPCA. Residents connect with others by reading to them their memory books. Before residents were comfortable, now their quality of life is elevated by how this new philosophy taps into their potential to contribute and gives them purpose through social roles.

Caregivers are also more engaged with those they care for and to their work. Teaching Spanish, cooking demonstrations, and cultural discussions are all unique contributions they have made to forge new and deeper relationships with residents, enhancing the positive role associations between the two. A resident may not remember who the caregiver is, but they will feel the positive emotions based on the associated good interactions with them. All staff recognize that engaging residents in meaningful, life-enriching experiences throughout the day results in a thriving community where residents live to their fullest potential.

About Elder Care Alliance: Elder Care Alliance is a nonprofit integrated system committed to serving and enriching the holistic wellness of older adults and those who care for them through education, innovation and a network of professionals, care communities and partners. All Elder Care Alliance communities foster environments of tolerance that welcome residents of all faiths. Elder Care Alliance is co-sponsored by the Sisters of Mercy of the Americas West Midwest Community & the Sierra Pacific Synod of the Evangelical Lutheran Church in America. For more information, visit www.ElderCareAlliance.org.


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