We invite you to shadow Anna, a fictional resident, during a typical day in her Care Haven home. Anna lives in one of our traditional homes. (For more on the various levels of senior care, visit our page on memory care assisted living).
Today, longtime caregivers Doris (the House Manager, a Certified Medication Aide), Helen (a Certified Nurse Aide) and Marie (a CMA) give her the extra help she needs.
Anna puts on her robe and slippers, then follows the aroma of freshly brewed coffee to the kitchen. She’s rested and more relaxed than at the assisted living facility she just left.
There, the day had started nearly two hours earlier. At 6:30, aides rushed her out of bed, then through the Activities of Daily Living in her care plan. Hurried to the dining room, she joined 29 sullen seniors in their assigned seats. They fidgeted, waiting for the squeaky cart of breakfast trays to roll up, followed by a no-nonsense medication aide. Anna just wanted tea and toast, NOW — and for everyone to leave her in peace.
Doris and Helen, the daytime caregivers, greet Anna by name. Helen helps Anna to the bathroom, then to the table for breakfast.
Bringing her a hot cup of tea, Doris sees that Anna can’t wait to eat and offers a choice of two favorites: strawberry yogurt topped with granola or two eggs over easy on rye toast. Then Doris pours a glass of orange juice — with extra pulp. It’s the same brand Anna’s family requested for her first breakfast at Care Haven.
Working several days a week in this house, Doris has grown close to its residents. They find her comforting: she gives them what they need, even when they can’t tell her what that is, with a gentle touch and warm smile.
Doris also knows better than to show up with morning meds before breakfast is over. It’s best to wait till Anna polishes off the last spoonful of yogurt.
Helen escorts Anna to her room, asking whether she’d like to shower and dress for the day. Anna declines the shower but would like to change out of her pajamas. So, Helen suggests two outfits, and Anna picks her favorite. It’s the blue and gold sweater, a gift from her late husband on the last birthday they celebrated together. Anna’s caregivers know she treasures it. Every evening they make sure it’s returned, clean and folded, to her drawer.
Like many other older adults living in senior care, Anna needs help with her Activities of Daily Living. It’s hard to manipulate buttons, zippers or other closures with stiff, trembling fingers. Anna also struggles with what her doctor calls sequential tasks, or jobs that need to be done in a particular order. It’s challenging to figure out where to start and what comes next.
Helen calmly leads Anna through her personal care routine, careful not to rush. Speed means stress, which leads to anxiety and shaky hands — or hands that push away help. So Helen takes her time with Anna’s dental hygiene, carefully flossing as Anna’s family requested. Out comes the hairbrush and precious hairpins. Then the part Anna once dreaded: blush, mascara and lipstick. Grateful for Helen’s sure and gentle touch, Anna no longer worries about stray smudges or crooked lips. She’s proud of her appearance.
All smiles, with hair neatly combed, Anna is ready for whatever the day brings. She heads for the picture window to see that the flowers she planted get enough sun. Helen helps Anna into her chair, then leans over to better hear tales of Anna’s finest gardens and prize-winning roses.
What a marked contrast to life in the 30-bed unit where Anna last lived. There, the staff rushed through the morning routine, stopping only to cope with emergencies. Unless the doctor was making rounds, Anna had no idea what to do with herself. She’d wander the halls and other residents’ rooms. First bored, then anxious and agitated, she’d finally head for the locked exit — rattle the handle — bang on the door. Alarms blaring and strangers shouting at her, Anna’s morning often ended in tears.
Joyce, Anna’s physical therapist, arrives for today’s appointment. Anna once dreaded these twice-a-week stretching and strengthening sessions. But her balance and gait improve with each. More important, the stiff, sore knee that once kept her chairbound hardly bothers her.
In fact, Anna now finds it fun to move around. She looks forward to ball play, tai chi, chair yoga and impromptu waltzes during Saturday piano concerts. She’s also more confident rounding the backyard walking paths.
All Care Haven residents love company. Deanna, our Activities Director, regularly invites visitors from the community. Favorites include artists, performers, young scouts and well-behaved pups.
But today, Deanna and Doris have something special in store for Anna. Three childhood friends are dropping by. Anna’s daughter set the visit up weeks ago, asking for help making the most of this rare reunion.
Deanna seats Anna’s guests in a quiet corner of the living room. With her coaching, they stay seated while Doris helps Anna to her chair. Deanna begins the “reintroductions,” and Anna’s friends present her with a scrapbook. At Deanna’s suggestion, they’ve collected photos and mementos from their long-ago trip to England.
“That’s me with some girls I used to know,” says Anna. “They were my best friends.”
“That’s us!” her visitors exclaim. “We’re THOSE girls!” And the giggling begins.
Doris and Helen prepare to serve residents their lunch. But Anna’s friends traveled several hours this morning and hope to stay longer. Helen brings out tea and fresh fruit for this small group. A healthy snack should hold Anna over for a late lunch.
Anna’s friends are surprised at how time has flown. They’d sworn off visiting Anna in her last home. She’d seemed so tired and confused, not at all herself. After the move to Care Haven, though, Doris convinced Anna’s daughter that visits like these could improve her mood. Sara, in turn, persuaded her “aunts” to try another. Everyone is glad they did, especially Anna.
After Anna’s friends leave, the aroma drifting from the kitchen draws her to the dining room table. There, she joins the other residents at their family-style lunch. She smiles as Doris delivers a warm plate of homemade chicken and biscuits.
Anna prefers blackberry jelly to butter, and Helen is happy to retrieve a jar from the refrigerator. This small indulgence is something Anna missed at her last residence. There, aides didn’t bring sides or condiments to the table. She rarely sat with people she liked or was offered a choice of beverages. Anna passed many a lunchtime pushing food around her plate.
As Doris clears the dishes, Helen begins reading today’s newspaper aloud to the group. Then she turns to everyone’s favorite, The Daily Chronicle. It’s May Day, so the conversation quickly turns to surprising friends with baskets hung on doorknobs.
Table talk over, everyone leaves in their own good time. Doris helps one of the women to the bathroom while Helen and Anna clear the table. Others settle into nearby recliners, enjoying TV or a cat nap.
Lynne, one of Care Haven’s nurses, pops through the front door just as Anna finishes stacking placemats.
“Can I convince you to put your feet up for a minute?” Lynne asks. They head to the empty front room to check her ankles, which were uncomfortably swollen until the doctor adjusted her medications. Lynne asks about Anna’s day and listens carefully for clues about her emotional, mental and physical health. Anna enjoys these regular one-on-one chats. And, of course, today, she has plenty of exciting news to report. Andrea smiles. It’s a good day.
Deanna arrives with a favorite visitor: the music therapist. Today, she struggles to carry both a stack of the residents’ favorite sheet music and her percussion instruments to the piano. Bells, maracas, tambourines, shakers — quite an assortment! Everyone reaches for their favorite as the basket comes around.
Everyone, that is, but Harold. He’s not in the mood to sit and listen, so Deanna offers to take him out for backyard bird watching. She knows Harold carries his binoculars wherever he goes. So, the two of them head out the front door as the enthusiastic sing-along/ play-along begins.
A larger senior care unit with lower staffing levels can’t offer such a customized activity program. In Anna’s former facility, only residents with visiting family members enjoyed neighborhood strolls. At Care Haven, we’re guided by a formal monthly calendar but adjust it to suit personal preferences and abilities. You’re not left out just because you don’t join in.
Anna heads back to her room for a nap. She’s calm in familiar surroundings: the dresser she shared with her husband, a picture her daughter painted in college and a photo collage of family vacations. Thinking about loved ones, Anna wonders why they haven’t visited. Her dementia is playing tricks: Sara stopped in just yesterday, as she does nearly every evening.
Delivering clean clothes to residents’ rooms, Doris finds Anna tearful on the bed. Doris knocks and waits at the door for Anna to ask her in. Wrapping an arm around Anna’s shoulder, Doris consoles her. After a quiet moment, she asks about the photo collage. The two women soon are laughing over vacation misadventures.
Doris asks if Anna wants to call Sara to see whether she’ll visit this evening. Wistfully, Anna says her daughter sometimes brings a Symphony bar. A smile creeps across Doris’ face. “Give me a minute. I might have one of those!” (She knows she does; as House Manager, she stocks them just for Anna.)
Doris returns with the chocolate bar. While Anna peels back the wrapper, Helen types Sara’s number into the phone – Anna would be upset if she realized she’d forgotten it.
Sara arrives, leaving work a few minutes early to see her mother. Sara finds Anna in good spirits, tired after a big day but not overwhelmed. Helen helped Anna freshen up, changing both her sheets and her continence garment after her nap. Anna’s room smells clean, and the bed is ready whenever she wants to rest again.
Sara and Anna pass through the living room on their way to the backyard. They pass Dot and Louise working together on a jigsaw puzzle and Harold flipping through a birder’s guide. No one napped the day away in a recliner – they’ll all sleep tonight.
Sara needs to pick up her children. All the regular caregivers in this Care Haven home know Sara’s departure routine, which they helped plan. Doris convinces Anna to join Louise, Harold and Helen at the table. Restarting a favorite game distracts Anna, and she easily lets Sara go.
Sara leaves guilt-free, no longer worried and worn like when she drove home from the large memory care unit. She and her mother now share mostly pleasant moments. In the old unit, she spent visits addressing Anna’s personal care. Aides ran out of time to shower Mom after an accident, scrub her fingernails, comb her hair or track down clothes that other residents carried off.
Sara appreciates the help she gets here, especially when she leaves. Further, she’s confident that Anna’s caregivers will treat her kindly and respectfully after she goes. They’ll be there for Mom if she gets restless tonight.
Anna loves sitting down to three home-cooked meals daily — the recipes often inspired by residents’ family favorites. She joins familiar caregivers and housemates at a table like the one where she fed her children. Gone are the squeaky carts and plastic trays. In their place: serving dishes, table settings and placemats.
If Anna asks for a second helping, a little mustard or an iced tea — if she has problems swallowing or needs to leave the table — then Doris or Helen responds quickly. After all, these two caregivers assist eight residents, not 30. That’s less stressful and creates a relaxed atmosphere for everyone. Helen flits about the table pouring lemonade, and soon all are smiling.
It’s been a long, eventful day, and Anna looks forward to quiet time in her room. Marie, the night caregiver, walks her down the hall, carrying the evening medications.
The two women talk as Anna prepares for bed. Marie helps her brush her teeth and denture partials, floss, wash her face and use the toilet. Finally, Anna dons her comfy pajamas and slippers.
Marie leaves the door open a crack as Anna settles into HER chair with the Swedish newspaper Sara had delivered.
Marie checks on Anna and finds her in bed, fast asleep. Gently, she pulls up the covers, then turns on the bathroom and bedroom night lights.
Waking in the dark terrifies Anna. In her old unit, she’d panic, searching empty hallways till aides returned her to bed. Anna’s Care Haven caregivers use dim night lights to create a more reassuring environment. If she wakes, Anna sees that she’s still in her room. She can find her way to the bathroom or hallway. And when she leans out the door, she sees the friendly faces of familiar caregivers.
Marie peeks into Anna’s room. The light is back on, and Anna is busy reorganizing her closet. It’s her nightly ritual.
Anna wasn’t allowed to soothe herself this way at her former facility. As her daughter Sara discovered, many senior care providers follow rigid schedules and guidelines that don’t work for her mother.
Marie reminds Anna that she’s just down the hall, listening from the kitchen or dining room. And, of course, she’ll keep checking in till morning.
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