Life in Long Term Care

LIVING in My Today: Transforming Dementia Care at Schlegel Villages

Empowering Residents: The Innovative LIVING in My Today Program at Schlegel Villages

Location: Schlegel Villages

Making a genuine difference in the lives of residents with dementia begins with nurturing personal, responsive and consistent connections. That’s the philosophy behind Schlegel Villages’ LIVING in My Today Program, which places people’s unique identities and their relationships with Schlegel Village staff at the heart of a continuously evolving approach to dementia care.

“LIVING in My Today is both a philosophy and a program,” explains Heather Luth, Director of Dementia Support Services with Schlegel Villages. “It’s about seeing people who are living with dementia as people first, not a diagnosis. From that starting point, it’s about delivering programming that reflects them, their story, and their strengths.”

The program is being rolled out in various steps, each designed to equip team members with the training, insights and story-sharing opportunities to put the LIVING in My Today’s principles into action. The overriding goal of the program is twofold: to ensure residents are empowered and supported to live their authentic lives in a long-term care environment and to ensure their needs and preferences are respected at every step of their ever-changing journey.

The key word is “changing,” Luth says. Often, dementia is seen as a diagnosis that leads to a series of losses: the loss of abilities, memories or social capabilities that disappear for good and cannot be retrieved. However, part of LIVING in My Today’s ethos is reframing those “losses” as “changes” to encourage caregivers to build relationships with each resident that enable them to listen, respond, and adapt their care strategies as these changes unfold.

“We have to remember that people who are living with dementia are incredibly resilient,” says Luth. “For example, their ability to eat a meal may change over time. They may go from using their cutlery correctly and recognizing their meal to not knowing which utensil to use or what’s on their plate. If we have taken the time to build a good and trusting relationship with that resident, we can work alongside the resident to create a support strategy that addresses this change in a way that respects the way they learn and adapt.”

Getting to this place of trust begins with embracing person-centered care. Schlegel Villages’ team members are encouraged to place a primary emphasis on fostering relationships with residents so that they can meaningfully contribute to their care and quality of life, no matter their capabilities.

What does LIVING in My Today look like in practice? For one, it begins with understanding each individual’s story, and using practices such as “All about Me” pages to learn who they are, where they’re from, how they prefer to communicate, and the small things that can brighten their day.

Practicing LIVING in My Today’s relationship-centered care approach means honouring residents’ individual preferences. A key focus is ensuring that residents can tailor their schedule and activities to their own preferences. “If someone wants to have tea in their room in the morning, rather than joining the home’s activities, we honour that. Historically, the long-term care system was set up to be one-size-fits-all all, with a lot of group programming. There’s still a valuable place for that, but each resident’s individual preferences trumps group activities.”

“What it comes down to is making that real human connection and letting that guide your care,” Luth says.

Shifting the culture

LIVING in My Today has its roots in Schlegel Villages’ culture change journey and began taking shape when Luth assumed her current role nearly six years ago. She started scanning the long-term care community for dementia-care strategies that leaned more into the relationship side of resident-centered care. After gathering inspiration from several programs.

Luth began designing LIVING in My Today through consultation with residents, family members, staff, caregivers and dementia care specialists.

The implementation of the program was sidetracked by the pandemic, but even throughout those difficult days there were opportunities to develop and trial program components. “As the pandemic retreated, it became an opportunity to shift our focus to introduce and train team members on LIVING in My Today,” Luth says.

With support from a grant, Luth and her team supported nine Schlegel Villages homes in trialling the Supportive Approaches to Care pillar of the program. “We designed a pathway for them to follow which focused on learning how to get to know our residents as people first and then connect that understanding to our care,” she explains.

As part of the program, team members are taught strategies on how to connect with residents who may have communication challenges due not only to dementia but to language barriers, aphasia or hearing loss. “Most of us have never learned how to do this,” says Luth.

Team members are encouraged to use a “show and tell” approach, where someone uses gestures and familiar items as well as words to help communicate their intent. An example would be bathing: Instead of saying, “Would you like to have a bath?”, staff will approach and show a resident a bath towel and soap, holding it forward so the resident can, if they choose, touch, smell and process what they are being asked. “We move away from being someone who is doing something ‘to’ them,” Luth says.

Team members are also encouraged to share their own interests to engage residents and form relationships. Luth shares that her own love of gardening – in particular, her efforts in growing potatoes – was the bridge to forming a relationship with a resident. When the woman saw pictures of Luth’s potato garden, she became animated and communicated with gestures that Luth needed to cover up her potato plants. “She was right! I took her advice, showed her what I had done, and then shared regular photos of my garden.”

“In their schooling, personal support workers are sometimes told to leave their personal lives at home,” Luth adds. “But each person needs to find their connection point with others, and that comes from being authentic.”

Significant progress has been made over the past year and results are beginning to show. Team members have reported stronger and more receptive resident interactions and less resistance to care. These early successes have given Schlegel Villages the confidence to implement LIVING in My Today across other homes.

“Those nine villages are now moving into later steps of the program, and we’re hearing stories of connections and relationships during care moments that blow me out of the water,” says Luth, adding, “Now that the magic has started, the rest will follow.”

Read the original story in the Spring/Summer 2024 issue of LTC Today Magazine.