Dementia by Day

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Patricia Dubroof:

Hello. Welcome to Assisting Hands Home Care’s Book Chat with your host, me, Patricia Dubroof. I am so glad you all can join us today for this informal half-hour chat of learning and enjoyment. Assisting Hands provides meaningful caregiving support to our families in Montgomery County, Maryland, and Fairfax County, Virginia. And as director of community relations for Assisting Hands, I have the honor of working closely with families and our senior community to provide information and education about home care and aging well.

Patricia Dubroof:

And say that, to that end, I am delighted to introduce Rachael Wonderlin, who created a blog in 2014 called Dementia By Day. And she wrote a book called When Someone You Know Is Living in a Dementia Care Community. We’re going to talk about her consulting world, and how she got involved in dementia care. She currently lives in Pennsylvania with her two cats. One has been rambling around behind you.

Rachael Wonderlin:

Yep.

Patricia Dubroof:

And she’s very loyal to her undergraduate program at the University of Mary Washington, but she also received her master’s in gerontology at the University of North Carolina Greensboro. Originally from New Jersey, she’s a self-described extreme extrovert. So she should have no problem answering my most difficult questions today. She was a child actor and did commercials and videos. So she’s used to being on screen. What a life. Wow.

Rachael Wonderlin:

Digital work.

Patricia Dubroof:

You’re welcome, Rachel.

Rachael Wonderlin:

So you did your homework.

Patricia Dubroof:

I did my homework. So Rachel, tell me how you first got connected with dementia. Why this career path for someone who was involved in all sorts of other things?

Rachael Wonderlin:

Sure. I’ve just always loved working with older adults. I volunteered at a skilled nursing facility when I was in high school and just connected with the residents there. I don’t know exactly when dementia became the path, but sometime between high school and graduate school. When I probably when I was in my graduate school program, I knew that I was going to do something with dementia care, but just in general, I wanted to work in the aging sector, for sure

Patricia Dubroof:

Do you have family who’ve had dementia or who are living with dementia, is it more from the nursing home experience?

Rachael Wonderlin:

Not exactly. My grandmother died from glioblastoma and is a type of brain cancer, so that could be considered a cause of dementia.

Patricia Dubroof:

Yeah.

Rachael Wonderlin:

So, that would be the only real family connection, but it’s mostly been because I love medicine and I love learning about how the brain works, and I like aging and if you combine all those things, you pretty much come up with studying cognitive health.

Patricia Dubroof:

Yeah, absolutely. And this field of really drilling into what exactly makes sense for people with dementia has become huge right now. And one of the reasons of course is because statistically more people are aging well, but ending up aging older and experiencing some form of dementia. Do you want to talk a little bit about the various forms of dementia? You mentioned in [inaudible 00:04:11] a lot of times.

Rachael Wonderlin:

Well, to put it simply, yeah. I mean the 30-second description is that there are over a hundred different causes of dementia. I go into a lot of detail on my blog and in different podcasts episodes and in both of my books, but most people just don’t even realize that there’s actually more than just Alzheimer’s disease. There’s just a myth going around that it’s also.

Patricia Dubroof:

Sorry, somebody was un-muted. So I wanted to bring to mind this page, which I think is just so interesting and we’ll flip back and forth between the book and not… But that you created this Dementia Umbrella. It’s a great visual tool. And since it’s a book about creative engagement visual tools and the book really excite me. And what you’re talking about there is what are the different symptoms caused by different types of dementia? And I think that’s where a lot of people say, “I must have dementia. I can’t remember where my keys are.” No, no, no. So, do you want to talk a little bit about the fine tune?

Rachael Wonderlin:

Well, I mean, there’s a difference between forgetting where your keys are and forgetting what your keys do. If someone is concerned that their cognitive health is declining, definitely schedule a meeting with your physician, get a cognitive exam, done. A lot of the major hospitals in this country have opportunities where you can go and actually go through the whole battery of tests. And so if you are really concerned about yourself or a loved one jumped into that a lot of times there’s a wait list for different hospitals. So you really want to try to get in there, get signed up and see if you can get in and go through that battery of tests, because there are different causes of dementia. You really need to have a number of different exams. One is not going to tell you enough information about the cause of a cognitive loss.

Patricia Dubroof:

So another piece that, and I agree, and a lot of times we work as a home care Potomac provider. We work with a lot of care managers and they also have a series of tests that are not the hospital savvy series, but very different. And they can also really help a family determine whether this is leading to a longer term situation or whether this is a UTI. Urinary tract infection can cause so much memory, cognitive challenges to folks and family members freak out. They’re like, “What’s wrong with my mother? She’s not behaving her normal way.

Rachael Wonderlin:

Yep.

Patricia Dubroof:

So a lot of times you need to be able to rule out.

Rachael Wonderlin:

Mm-hmm (affirmative). Yeah. It’s important to go…

Patricia Dubroof:

So then the other part of your…

Rachael Wonderlin:

And do those tests.

Patricia Dubroof:

No, go ahead.

Rachael Wonderlin:

So you can rule out anything else that might be going on, for sure.

Patricia Dubroof:

Right. So in the 22 chapters, you outline a bunch of different, wonderful activities in creative aging… In creative engagement rather. And one of the fundamentals is a calendar. Do you want to talk a little bit about your calendar idea and how that works in a community and as for families as well?

Rachael Wonderlin:

Yeah. It depends what you’re building a calendar for and at what’s… There’s a lot that goes into it. It really depends. I’m working with a company now and we’re going through the process of all these communities are sending me the calendars that they’re working on and I’m advising on them. You really want to try to keep people as engaged as possible throughout the day. So you’re not just throwing things together at the last minute, but you’re really planning in advance, getting things on a calendar, making sure the staff is engaged. If it’s a home and you’re taking care of this person, then making sure that you do have a plan in advance. Even if it’s just a really minimal plan, that’s going to go a really long way.

Patricia Dubroof:

And part of that going along way is, self care. So if you’re the caregiver for a family and member and you put together a calendar, it’s as much to give you clear notice of what you might do in terms of frustration, or maybe you needed a qualified break during the day, what would that look like? How would your loved one be cared for while you take a minute to do the crossword puzzle or 10 minutes or 20 minutes?

Rachael Wonderlin:

All right.

Patricia Dubroof:

So that’s what I was trying to get to is, what’s the importance, what’s the value of doing a calendar?

Rachael Wonderlin:

[inaudible 00:08:56].

Patricia Dubroof:

And then of course, lots of things in this book are about activities. So how would you like to chat about that?

Rachael Wonderlin:

As long as you’re asking someone for help, you’re going to have a better time. So I always advise if it’s a family member, if it’s someone you’re working with in a community setting to ask that person for help, instead of just doing the thing or ask them if they want to do that activity, because that is not going to end well, you really need to ask people if they want to help you, even if you don’t actually need help. Again, with the planning ahead, getting together a little activity boxes, things to do, folding, sorting, anything where there’s a task based and an end goal, you’re going to have a much better day. So putting those things into even just a little calendar for yourself, if this is home situation can be really beneficial.

Patricia Dubroof:

So most of the folks that will be probably seeing this video as a useful tool will be family members. And so I was just thinking of one of the stories that you tell in your book is about a family. And it’s really, again, putting the reality check on you. What you emphasize in the book so wonderfully is that, it’s not repetitive for the person with dementia.

Rachael Wonderlin:

You’re right.

Patricia Dubroof:

You might think you’ve read this story 50 million times like you did with kids back in the day, but actually a grown up folding laundry that doesn’t need to be folded again, it’s okay. You have to get over that. The job is done and it’s done. It’s like, “No, no dump those socks again.” I love that story where you have a basket of mismatched socks.

Rachael Wonderlin:

Yeah. You can definitely do the same thing over and over again and it’s not five minutes later, but if you’re doing something the next day and that person to moderately advanced stage of dementia, they’re not going to remember doing that task. And it’s not a bad thing to say, “Okay, hey, I need your help with this.” Again, don’t feel like you’re going to bore them. You really need to focus on that moment and do what’s best for them in that moment. And really it’s going to help you in the end as well. You don’t have to keep coming up with stuff every single day.

Patricia Dubroof:

Right. And a dose of praise at the end of that activity goes a long way as well to know that they’re valued because we know that one of the things that folks with dementia feel is that they’re not valued any longer in their group. And so by asking them to help you with a task and then giving them clear support and appreciations, it makes it for a better energy field all around.

Rachael Wonderlin:

Yeah.

Patricia Dubroof:

So one of the other things you talk about, and this has always had a fair amount of controversy, but I think in the past five years, it’s gotten a little less macabre or odd, and that’s the pet dolls and the pet animals that are not real. And so how did you first get involved in that? Where did you see that the first time and went, “Oh, wow. This is really cool.”?

Rachael Wonderlin:

Probably at Brookdale. My first community that I worked at full-time after I finished graduate school. So, that’d be around when I started the blog. So 2014. I had seen it other places, but actually you doing it and using them was about that, because it was at my first Brookdale community and seeing the effects of the baby dolls and I brought the pets, and the pets was actually not something that was recommended to me. I just thought of that [inaudible 00:13:02]. But the baby dolls were something that was recommended to all the communities trying to see how well it works. And that’s something I always offer after seeing how well that went.

Patricia Dubroof:

That’s great. Well, pet visits from my pets who are authorized to go into communities is always a great thing for families who… For loved ones who are in nursing homes or in assisted living who like pets and can’t have their own there, a pet visitors always a bonus thing. There was a lady who used to bring in three Jack Russell Terriers to one of the programs I worked with. And she had a whole circus that they did and it was entertaining and loving. And then she would let everybody hold the dogs later and give them treats. But you actually find that even bringing in the stuffed dog or make pretend, I won’t say stuff because that sounds incorrect. What do you call them? Fluffy puffy.

Rachael Wonderlin:

I stopped. I call them stuffed animals. I call them stuffed animals, yeah. Because you want to make sure that your…

Patricia Dubroof:

Like most choice, whatever.

Rachael Wonderlin:

Yeah. I don’t want to say… I guess I just say stuffed animals, most of the time. Memorable pets are what I usually call them because that’s usually the brand that I recommend people use. Also because of their…

Patricia Dubroof:

And that’s because they have a lifeness. They’re weighted in a way that feels more like a real pet, right?

Rachael Wonderlin:

Yeah. Mm-hmm (affirmative). And they look real. They don’t look like stuffed animals, I think is the main takeaway. A lot of them look pretty realistic, so you’re not bringing in a Toys “R” Us pet into the situation. They really do look very real. And some of them in particular look incredibly real.

Patricia Dubroof:

That’s great. So besides pets and laundry sorting and making flower arrangements out of plastic flowers, which is all great ideas, you also emphasize the importance of exercise. And I think the data now, the research based now is huge about preemptive due to cognitive challenges is getting exercise.

Rachael Wonderlin:

Definitely.

Patricia Dubroof:

So go ahead and, and feel free to share whatever you want to share with us about that. What are the key pieces of that?

Rachael Wonderlin:

People living with dementia mimic very well. You don’t need like an exercise tape or anything. One of the things I recommend people do is sit in a chair across from the individual and do some stretching, do some exercises and encourage that person to follow along with you. That’s something that really always works. You can also if you’re planning in a group, I’ve really enjoyed doing seated soccer, you get everybody in a circle and they can kick a soccer ball between them. There’s actually in creative engagement. In my book I go through and list out all these different activities that people could try that have been really successful.

Patricia Dubroof:

Sorry about that. That was my bag phone call. Yes, I love that chapter. That’s chapter 12. And then you jump right into my other favorite program to do with folks with dementia and that’s music. And I know that music and memory has folded unfortunately, but the concept of having a playlist that’s appropriate for that individual is still really key. And there’s so many more ways now to get that playlist, whether it’s on Echo or Alexa, or your phone or whatever.

Rachael Wonderlin:

Yeah, absolutely.

Patricia Dubroof:

But music is… You want to talk a little bit about that?

Rachael Wonderlin:

Yeah. Music is super important, even just having it in the background, frankly, can be really great. There’s nothing worse than going into a building, especially where they don’t have any sound, no music, or anything going on.

Patricia Dubroof:

Right. But to make an important point. You said it’s important what the background music is. So I taught arts and healing for decades in nursing homes and long-term care and adult day. And it really did depend on what music I put on to make the room holy or special or sacred.

Rachael Wonderlin:

Sure.

Patricia Dubroof:

And then everybody knew, Patricia is in there. The music’s on. We don’t need to go in there and disturb our residents.

Rachael Wonderlin:

Right.

Patricia Dubroof:

It was like, it sets a mood. And obviously, depending on your group would depend on what kind of music would be best for them.

Rachael Wonderlin:

Yeah, definitely. You don’t want to be playing music that they’ve never heard before.

Patricia Dubroof:

Right. No, unfortunately, there’s a lot of technology tips out there now, even more than when you wrote this book in 2016, I guess, right? Or is this the newer one? This is the newest.

Rachael Wonderlin:

So, creative engagement just came out in this past August.

Patricia Dubroof:

That’s right. But even since then, there’s something called a grand pad that’s out now, but honestly they’re really not for even medium to moderate dementia folks. They’re really made more for folks who are looking for connection, who can clearly use an iPad or tablet of some sort, but there are other technologies that are really cool out there. And some of them that you mentioned from the virtual aquarium, which I thought was pretty cool. And of course the virtual pets.

Rachael Wonderlin:

Yeah.

Patricia Dubroof:

Anything where you can do an interactive… If you’re the person using the technology, the computer, and you’re helping the person with dementia that you can’t expect the person with dementia to… That’s what I gleaned from this. Go ahead.

Rachael Wonderlin:

Right, yeah. A lot of these tech companies will make things for the person living with dementia with the concept that they’ll use it independently of a caregiver, like an app that reminds them of something. And that’s just not the way we should be utilizing that kind of technology. If we’re using it to help the caregiver, help the person living with dementia, I think that’s a great technique, but just making apps for people living with dementia to remember a thing it’s not going to happen. It’s not solving the innate problem, which is that a person doesn’t even remember to look at the app to remember that thing.

Patricia Dubroof:

Right.

Rachael Wonderlin:

So it’s not solving the inherent problem.

Patricia Dubroof:

Right. And then you go on to talk about creative art classes and classes, or programs for folks with hospice. And you just have a ton of fantastic ideas. So I highly recommend anybody who’s working in the field or has family members who need a little extra support, get this book now. It’s great. But I’d like to talk a little bit more about what you actually are doing now.

Rachael Wonderlin:

Sure.

Patricia Dubroof:

I’m sure you have another book in the wings because that sounds just like [inaudible 00:20:28].

Rachael Wonderlin:

Yeah. It’ll be out January, 2022. Obviously it was supposed to be, well, not obviously, but it was supposed to be out this year, but with everything with COVID, even my second book got pushed. The creative engagement was supposed to be out in June, it came out in August. So my third book is in the works right now. I am done writing it. I’ve been done writing it for a long time, but it is being reviewed. It’s peer-reviewed. It goes to the whole gamut of things. So that will come out in January

Patricia Dubroof:

And what’s the subject of that one?

Rachael Wonderlin:

That is essentially my first book and my second book combined. It is going to be about moving someone into a care community again, but it’s going to cover a lot more. It’s going to be a lot more expansive and I’m going to dive into some things that I didn’t really dive into at all in the first one, and didn’t dive in with a lot of depth. So, it’s going to be bigger. It’s going to be more.

Patricia Dubroof:

That’s great. And you’ve been very fortunate to get support from Johns Hopkins for publishing.

Rachael Wonderlin:

Yeah.

Patricia Dubroof:

And so that’s fantastic. And of course, Hopkins represents two of the big hospitals or three of the big hospitals in our area. And so it’s really great to see that, that institution is producing such great material.

Rachael Wonderlin:

Yeah. Mm-hmm (affirmative).

Patricia Dubroof:

So I guess the other thing is how do you offer support one-to-one for counseling? You offer direct support, is that what I’m understanding? You talk to the families or just with communities?

Rachael Wonderlin:

I work mostly with senior living companies. So in a company like a home care company or someone that provides assisted living needs advice. They need someone to come in and create a program for them that they can roll out to all of their buildings. That is mostly what I do. I do offer a little bit of family. If somebody reaches out and says, “Hey I have a specific question.” I have phone call consultations. They are paid. Because otherwise I’d be giving out free advice all the time. And I do have a ton of free advice on the podcast. And if you could.

Patricia Dubroof:

Your website is very excessive.

Rachael Wonderlin:

I do sometimes sponsored webinars about once a month where someone will buy a webinar with me and then I’ll put it out to my audience. So there’s a lot of opportunities for people to get information from me. So when I do work with families, it’s typically because someone is reaching out to me directly. I do have an online class and forum. So if someone wants to learn more about what I teach, they need more guidance. There’s a program where they can sign up online, take a whole class from me and then be able to write in a forum, ask me questions. And that does come with a 30-minute chat on the phone with me, where they can go through specific issues. So typically that’s what people will do. It’s really the best way to get all my info in one goes around.

Patricia Dubroof:

Yeah. No, I think that sounds great. And what is next for… You also have been doing some… You mentioned online training. Do you have a program coming up soon that you want to tell us about?

Rachael Wonderlin:

I have one in February. So, I have one next month in a few weeks. If you’re on my email list, you’ll get updates about that. Just go to my website, rachelwonderlin.com and you can sign up for emails. I send out one every Monday. So Northstar Senior Living is sponsoring a webinar with me next month. I have my podcast, finishing that up and then I’ll be moving back to blogging. So we can get back to written blogs in March.

Patricia Dubroof:

Well, Rachel, you really are bringing an amazing amount of information to the community at a time when it really needs it. I’ve interviewed a couple of other folks who are experts also in this field, Loretta Veney, whose mother has Alzheimer’s disease. And she’s basically written a book called Becoming My Mom’s Mom. And she has gotten connected with the LEGO company because she found that LEGOs were a great distractor for her mom. And now she represents LEGO for seniors. It’s hysterical how this thing moves, right?

Rachael Wonderlin:

Cool, yeah.

Patricia Dubroof:

And this is a woman who’s got a full-time job with the feds as well. So she’s multitasking galore. I see Kris Colwell is on the line. She’s actually using humor as a healing modality in assisted living in long-term care. And she is a great storyteller and always has a smile on her face. Trying to see who else… I just noticed there were some other folks on here. I wanted to ask if… I see somebody, I need to say something about, too. But first let me ask if there’s any questions real quickly before we have to do our close up?

Patricia Dubroof:

I see somebody is hopping up there in the chat. Let’s see what we got. I get thanks from Kris. Thank you. But if you want to write to me and chat, or if you just have a quick question you’d like to ask Rachel or myself, I did want to mention that… It’s hard to multitask, I’m trying to speak. Who’s the name of the LEGO lady? That’s her last name is Loretta Veney, V-E-N-E-Y. I can give you her contacts, Mary, you would love working with her, she’s a [inaudible 00:26:28]. I wanted to mention that Irene Shere is on our chat today and she’s going to be my next book chat special guest.

Patricia Dubroof:

And her book is on a very different subject called the Care And Feeding Of The Aging Human Male Species. And I think it’s going to be a hoot and I’m dived into it. So I’m getting ready to mark my pages. And then I just wanted to mention that for those of you who don’t know me as director of community relations for Assisting Hands Home Care, I have been in the arts and healing world for over 35 years. And so my work was all based on the Seminole research of Dr. Gene Cohen, whose legacy is in everything that Rachael has been doing in terms of creative engagement, using music, using story. There’s just so many wonderful things that came from that because he created the field of geriatric psychiatry. And without that, nobody would have done the research into all of this.

Patricia Dubroof:

So hats off to Gene, always appreciate that. This is a photo of my mom and dad at their wedding. My mom’s still going strong at 93 years young. And my dad who passed away due to complications from a stroke survived three years and had quite a bit of dementia, and we were doing all sorts of creative engagement with him. Didn’t realize that he would respond to sign language. The man was a terrible linguist. He could never speak other languages. He always made mistakes. But towards the end of life, we realized that he could gesture. And if only we had known more sign language or more ways of understanding what his gestures were, because there was always a kiss at the end of the visit, which was just so sweet and little things like that, that you just don’t know are going to be there.

Patricia Dubroof:

And of course, music hugely was a real positive force for him. So the other thing I wanted to let you know is how to get a hold of our dear wonderful guest. My computer keeps moving and I’m not doing anything. I’m so sorry. Come back. Okay. I’ll try that again. So you can see here, you can go to Dementia By Day and up pops, Rachael Wonderlin and her website are full of material. You could spend hours going through all of her pieces. And then of course she’s got what? Six books.

Rachael Wonderlin:

No, I have two books. Two published books with Johns Hopkins, a third coming out. I have an audio book version of my first book. And then I have a couple of e-kits, a couple of eBooks kind of things on my site.

Patricia Dubroof:

That’s great.

Rachael Wonderlin:

That’s six books, not yet.

Patricia Dubroof:

It just seems like there was a lot of content on there.

Rachael Wonderlin:

There is a lot of content on there. They went through it, it was like 900 blog posts, including comments and outreach.

Patricia Dubroof:

Yeah.

Rachael Wonderlin:

I have a ton of content, but not six books yet.

Patricia Dubroof:

Okay, well, they’re getting there. And what did the light, and so glad to see this generation of folks getting interested, like our first book chat. Tom. What’s her first name? She wrote about… Because she cared for her grandparents and it’s so sweet. Wrinkles. Something about wrinkles. Shoot, brain freeze. Anyway, I’ll remember. And so it’s nice to see this generation picking up a ball because after being in it for 35 years, I realized that I was your age when I started in this field. And that’s scary and wonderful all at the same time. So thank you so much, Rachael.

Rachael Wonderlin:

Yeah.

Patricia Dubroof:

It’s lovely to chat with you and to meet you finally. And again, thank you for doing all this great work. Coming up next for Assisting Hands, free to you on Zoom is what’s your plan with our senior care specialist, Steve Lorberbaum, owner of Assisting Hands Home Care. And he’ll be with Odile, who is the director of the Office of Aging for Montgomery County. And then we have our self-care yoga. Everybody’s invited, spread the word. It’s a wonderful, gentle, and easy yoga class that we all love.

Patricia Dubroof:

And then we’ll be doing Death Cafe again on the 16th and as I said before, our next book chats with Irene Shere and learning about the aging male world. What fun is that? So again, I want to thank you all for attending. It’s a pleasure and I wish you all safe and healthy days ahead. Go get your COVID-19 vaccine.

Rachael Wonderlin:

Thanks.

Patricia Dubroof:

Thanks, everybody.

If you would like to schedule an appointment to discuss your Alzheimer’s and Dementia care needs or to set up a free in-home evaluation with one of our nurses, call us today in Potomac (301) 363-2580.