Naughty people need love too!

“You better watch out, you better not cry! Better not pout, I’m telling you why…Santa Claus is coming to town. He’s making a list, and checking it twice; gonna find out who’s naughty and nice…Santa Claus is coming to town.” ~ J. Fred Coots, Henry Gillespie – 1934

As the holidays’ approach, I begin humming the old childhood songs as I go about my day.   This year as I listened to the words and the messages in my little-girl-mind, I realized that this was, indeed a strong message that was given to my generation.

  • Be a good girl or boy
  • It is best to be seen and not heard
  • Don’t cry!
  • Wipe that pout off your face!
  • You are naughty!
  • Be nice

But you know, as I have grown up, I have learned from the Elders that even those who are naughty need love! Sometimes we need to cry or pout, and express our anger and hurt!

The elders have taught me that

  • All human beings have basic human needs.
  • If those basic human needs are not met – we ‘act naughty’.  Some people say we have  ‘disruptive behaviors’ or we are ‘not being nice’.
  • If we recognize that ‘naughty behavior’ is merely an expression of unmet needs, we can respond with empathy to fill that need for the other person, and in doing so, give grace and connect with love and kindness instead of being annoyed.

Dr. Abraham Maslow created the hierarchy of needs in 1943, and I am teaching families and care team members to notice especially if a person living with a cognitive challenge is exhibiting what some people would consider  ‘naughty behavior’, to analyze and determine what basic human need is not met.

Maslow Hierarchy of needs

  • Is the person in pain?  (Physiological need)
  • Is the person frightened or afraid? (safety need)
  • Is the person lonely and longing for companionship? (Love and belonging need)
  • Is the person distressed at the loss of their purpose and status in life?  (Self-esteem need)

If you and I can understand the unmet need behind that ‘naughty behavior’ we can respond with empathy and help the person find peace.

Let me tell you a story of a man  living with dementia who was expressing  his unmet needs through outbursts of behavior, and how we discovered the solution to his needs utilizing Maslow’s hierarchy as a guide.

Paul is spending the entire morning walking the halls crying and calling out his wife’s name. “Dolly, Dolly, Dolly!”  A well-meaning care team member says, “Dolly went shopping, she will be back later.”  Paul begins to wail and scream her name, “Dolly, Dolly, Dolly!”   He is looking for her everywhere and is upset that he can’t find her. Another care team member recognizing his distress as an unmet need for the love of his wife says, “Paul, tell me about Dolly.  What color are her eyes?  What do you miss most about her?”   After a few minutes of expressing his love for Dolly, Paul says very quietly, “She has been gone a long time, I really miss her hugs.”      

The first well-meaning care team member told a ‘therapeutic lie.  Paul knows deep inside that Dolly did not go shopping, and his anxiety increased.  Paul is trying to communicate to someone that will listen that he misses Dolly.   When he was invited to share and release his deep feelings and heartbreak to the second care team member his unmet need for love and belonging was met – and he had peace.

  • Listening with empathy to determine the unmet need builds trustreduces anxiety and restores dignity
  • Painful feelings that are expressed and acknowledged by an empathetic listener will diminish.
  • Painful feelings that are ignored or suppressed will gain in strengthThe power of empathy to connect and to relieve pain that is pent up inside can bring peace of mind.

How many of us label or are labeled as  ‘naughty or nice’ based on our behaviors?  We are good just as we are.  It is ok to cry. It is ok to pout. We have been told since childhood to be happy, to be nice, to be a good girl or boy, and not to be naughty!  But sometimes, we are not happy, and we simply want someone there to hear us, and listen with empathy, and let us cry and release those painful feelings.  We can be the empathetic listener  for the elders we care for.  We can do this for family members, and we can do this for one another.

If you have friends or loved ones that are grumpy this holiday season… before you get annoyed at their ‘naughty behavior’  – think about it.  Are they expressing an unmet need?  Are they hungry and tired? Do they need a hug? Are they worried about money and finances? What is their unmet need?  Give them a little grace and a lot of love. Be there to listen with empathy, and support them to express their painful feelings.  You will make their day!


Jean Garboden, Director of Education & Innovation at Compass Senior Living

About the Author: Jean Garboden is the Director of Education and Innovation at Compass Senior Living, located in Eugene Oregon. Jean is an Elder Advocate and Eden Alternative Educator with over 30 years’ experience in not-for-profit and for-profit healthcare organizations. She is honored to lead the mission and values culture development for Compass Senior Living. Jean lives in Las Vegas, Nevada where she enjoys the weather and volunteers with the Nevadans for the Common Good, advocating for caregivers and elders in southern Nevada

 

It ‘smells’ like a walk in the woods!

 “Smell is so powerful, you know. My grannies would both bake things like shortbreads and cookies. I think whenever I smell those kinds of things it really takes me back to my childhood.” ~ Curtis Stone

I  met with a representative from ScentAir—a company that specializes in bringing scents into a variety of environments. I felt convicted and excited about bringing this new and innovative experience into Carolina Assisted Living Community.

As my representative and I met the second and third times to explore and determine what scent was just “right,” he shared many of his own personal experiences with other Assisted Living communities where he had witnessed the remarkable results of stimulating the residents through the sense of smell.

  • In one Assisted Living, he had returned to remove a unit he had left for one month as a sample. As he came in the door, he saw a large group of residents at one end of the room all huddled around a small space. He thought it a bit out of the ordinary, but continued on to where he had left his unit. As he walked toward that area, he realized these residents were  gathered around the very unit he was coming to remove. They were  drawn to the scent that was being emitted, as it was somehow speaking to them and at some level taking them to a unique and desirous place. They knew that whatever it was, they wanted to be near it, and they wanted to be near one another!
  • In another assisted living, there was a woman who could engage in a clear  conversation, but she had no memory whatsoever of the past…not even what may have occurred just hours or minutes ago. The scent that was being broadcast through this community was “fresh cut grass.” With this scent now in the air, this woman began to speak of her grandfather on the farm. Over the next few minutes and in great detail she shared  memories that were elicited by the mere scent of this fresh cut grass. The caregivers had tears in their eyes as this was the first time they had observed her having a true memory  that she was able to share.

This is why I am so excited that our own ScentAir units were just put in place. After a couple hours of test “smelling,” we chose “A Walk in the Woods” as our signature scent.

I will be secretly observing and noting any changes in the overall mood and feel in the coming weeks!

“Nothing is more memorable than a smell. One scent can be unexpected, momentary and fleeting, yet conjure up a childhood summer beside a lake in the mountains.” ~ Diane Ackerman


The Faculty of Nursing, University of Technology, Sydney, Australia did an 18-month study utilizing aromas in the following ways– Bath, Inhalation, Diffusion, Massage, Spritzer.  Their findings included specific improvements, including:

  • increased alertness
  • self-hygiene
  • contentment
  • initiation of toileting
  • sleeping at night
  • reduced levels of agitation,withdrawal and wandering.
  • Family caregivers have reported less distress, improved sleeping patterns and feelings of calm.

We have not conducted our own studies yet. Some of us are in the process of becoming certified aromatherapists.  We have anecdotal evidence that indicates aromatherapy is effective.

But I wonder –   Is it effective because of the aromas alone? – Or could it have something to do with the intentional and empathetic manner in which the aromas  are introduced?   Our care teams are studying, investigating, and seeking solutions to meet the needs and desires of the elders.  They are noticing when an elder is demonstrating an unmet need and responding by being present, eye contact, empathetic listening, respect, and tender care.

Whether it is the aromatherapy or the intentional person-centered approach and empathetic communication – or both,  the results matter.  We know we are making connections. We are in relationship with elders in our care, and we are inspired by the opportunity to learn the lessons the elders are teaching us every day.

And some beautiful aromas make the day happier for all of us!


About the Author:  Eileen English is the administrator at Carolina Assisted Living in Appleton Wisconsin.

Eileen has worked with elders for more than 40 years and feels her work is a passion, not a job. She was born and raised in Buffalo, New York, and later became a Coast Guard wife – eileen-wilsonwhich took her all over the country. She has lived in many states but is happy to now be in Wisconsin near two of her grandchildren. In her free time, Eileen enjoys being outside hiking, kayaking, camping, and spending time with her two sons and three grandchildren. (Carolina Assisted Living is part of the Compass Senior Living family)

The Brain and Aromatherapy – 5 essential oils for Alzheimer’s symptoms

 

 

Essential aroma oil
Peppermint aroma oil  is an energizer, and can be used to stimulate the mind and calm nerves at the same time.

I had learned that patchouli oil can be utilized as an insect repellant, so one afternoon I put a few drops in some coconut oil and used it on my face and arms and legs before going outside.  On my way to the park I stopped at Walmart for some water. I was standing in line when a middle aged man came up to me and said, “You smell good! What fragrance are you wearing?  It takes me back to my hippie days.” He began to describe in vivid detail where he was in his ‘hippie days’ and his experiences.   I was somewhat embarrassed that after smelling me –  he was enthusiastically  recounting his memories of the 1960’s and 1970’s in front of a long line of people!

The sense of smell is closely linked with memory, probably more so than any of our other senses.  Those with full olfactory function may be able to just ‘think’ of smells that evoke particular memories such as the gentleman in Walmart – conjuring up recollections of a whole lifetime before.  This can often happen spontaneously, with a smell acting as a trigger in recalling a long-forgotten event or experience.

After a smell enters the nose, it travels through the cranial nerve through the olfactory bulb, which helps the brain process smells. The Female Limbic System - Anatomy Brainolfactory bulb is part of the limbic system –  the emotional center of the brain.

When your olfactory receptors are stimulated, they transmit impulses to your brain. This pathway is directly connected to your limbic system in the center of your brain.   That’s why your reactions to smell are rarely neutral – you usually either like or dislike a smell. Smells also leave long-lasting impressions and are strongly linked to your memories. That’s why it is worth exploring how aromas may impact the brain and memory of those living with cognitive loss.

As noted in the Journal of Quality Research in Dementia, a limited number of clinical trials have concluded that aromatherapy provides a potentially effective and safe treatment for Alzheimer’s symptoms and related dementias.

While research on the effectiveness of essential oils is somewhat limited, some studies have shown aromatherapy can:

  • Ease symptoms of anxiety
  • Offer relief from symptoms of depression
  • Improve the quality of life for people living with chronic health conditions

In addition to the therapeutic benefits of the oils themselves, sensory stimulation   can decrease agitation, improve sleep and improve the overall quality of life for those living with memory loss.

In our community settings, we have experimented with 5 major essential oils.  We do not apply the oil directly on the skin. It is not ingested.   It is strictly used as aromatherapy, utilized through a diffuser or a few drops on a cotton ball, or in water sprayed on linens or in a basin of water with warm washcloths.

Below are the oils known to be effective for those with symptoms of dementia:

  1. LavenderLavender is thought to be calming and balance strong emotions. It has also been used to help with depression, anger and irritability, and can help in some cases of insomnia. Lavender can be directly inhaled or sprayed on linens.
  2. PeppermintPeppermint is an energizer and can be used to stimulate the mind and calm nerves at the same time. Best used in the morning, peppermint oil can be inhaled directly, diffused in a room, or  sprayed in the air.  We fill a basin with hot water and washcloths and a few drops of peppermint in the mornings, and give the warm, scented washcloths to our elders before breakfast.  It is a great start to the day!
  3. RosemarySimilar to peppermint, Rosemary is an uplifting oil.  It may even improve cognitive performance and mood. Rosemary has also been known to ease constipation, symptoms of depression and also reinvigorate the appetite. Rosemary oil can be directly inhaled, diffused through a room or as a spray.
  4. BergamotBergamot can be used to relieve anxiety, agitation, mild depression, and stress.  This mood elevating and calming oil can also be used to relieve insomnia. To use bergamot oil,  diffuse through a room or as a spray on clothing or linens.
  5. Lemon BalmWhile lemon oil may be among the more expensive oils, it is also one of the most studied and more effective oils. It has been shown to help  calm and relax those dealing with anxiety and insomnia, improve memory and ease indigestion. Lemon oil can be  inhaled directly, diffused, or  as a spray on clothing or linens.

The Faculty of Nursing, University of Technology, Sydney, Australia did an 18 month study utilizing essential oils in the following ways– Bath, Inhalation, Diffusion, Massage, Spritzer.  Their findings: ” The specific improvements for clients included increased alertness, self-hygiene, contentment, initiation of toileting, sleeping at night and reduced levels of agitation, withdrawal and wandering. Family carers have reported less distress, improved sleeping patterns and feelings of calm.”

We have not conducted our own studies yet. Some of us are in the process of becoming certified aromatherapists.  We have anecdotal evidence that indicates aromatherapy is effective.

But I wonder –   Is it effective because of the oils alone? – or could it have something to do with the intentional and empathetic manner in which the aromatherapy is introduced?   Our care teams are studying and seeking  solutions. They are noticing when an elder is demonstrating an unmet need, and responding by being present, eye contact, validating language, respect, and tender care.

Whether it is the aromatherapy or the intentional person-centered approach and empathetic communication – or both,  the results matter.  We know we are making connections. We are in relationship with elders in our care, and we are inspired by the opportunity to learn the lessons the elders are teaching us every day. And some beautiful aromas make the day happier for all of us!


About the Author:    Jean Garboden is the Director of Education and Innovation at Compass Senior Living 11062337_10206528118188840_645394201235573404_n, located in Eugene Oregon. Jean is an Elder Advocate and Eden Alternative Educator with over 30 years experience in not-for-profit and for profit health care organizations. She is honored to lead the mission and values culture development for Compass Senior Living.

 

“You have dropped down from heaven to be here with me!”

“You are magic! You have dropped down from heaven to be here with me.” Those are the words I heard from an elder with Alzheimer’s a few weeks ago. I shared with my care team earlier in the day that I am doing aromatherapy research. We sampled a few essential oils on cotton balls during a short morning stand up  meeting. Later a care team member came to me and asked to experiment with the oils to see if we could relieve agitation for a woman she was caring for. As I approached the elder, and asked permission to put a drop of lavender oil on a cotton ball to put in her pocket, she said those amazing words, “You are magic!”  We held hands and talked for a few minutes….. that made my day!

When I do dementia training in a community, I usually do a full day of classroom instruction teaching an empathetic communication approach that is person-centered and elder-directed.  For several days after the classroom training I live in the community, doing hands-on coaching and role modeling the methods. I am present on all 3 shifts, and I learn so much from the elders and the care teams.  This is a reciprocal learning laboratory, with real life situations.

What warmed my heart that day was that the care team members were fully engaged as investigators, and solution finders.  They had learned about the basic human needs as defined by Maslow, and how to identify unmet needs.  They understood the power of touch, and being present.  They had learned how  to utilize empathetic speech, touch, and approaches. They were using the tools and tips that they had learned on that first day; recognizing that they had the ability to do critical thinking to determine  ways to support and guide  elders who are trying to find their way in a confusing world.

This work can be empowering to care team members!

  • To  have the opportunity to be instrumental in calming the unknown fears of an elder.
  • To make a truly amazing connection with a 90 year old who feels alone.
  • To recognize that the very nature of caregiving rituals: washing others, holding others, feeding others and dressing others – is intimate and sacred work that brings with it gifts of dignity, respect, intelligence, and kindness.
  • To be so in touch with another person, that you are seen as a miracle – as a gift from heaven!

Today, I got an email from one of our communities with a note from a family, that said in part:

“Our prayers were answered! Your staff made our mother feel comfortable and loved from the moment she moved in.  As her family we felt included throughout her stay. Thank you is not enough to express how appreciative we are to all of you for making her last months of her 89 years the easiest it could be as she transitioned to her heavenly home!  Forever Grateful, the family. P.S. Keep making a difference for people who need you.”

This is good work, hard work, rewarding work.   The world needs caregivers  and leaders who are enthusiastically supporting  families and elders and one another at the crescendo of an elder’s life as they prepare for their next great adventure.  In our communities, we  are guided by goodness, loyalty, faith, and fun.    It is also important that we are guided by love for one another and for the work we are all called to do.

Love, Love, Love – All you need is Love – All you need is Love, Love. Love is all you need!


About the Author:    Jean Garboden is the Director of Education and Innovation at Compass Senior Living, located in Eugene Oregon. Jean is an Elder Advocate and Ede11062337_10206528118188840_645394201235573404_nn
Alternative
Educator with over 30 years’ experience in not-for-profit and for profit health care organizations. She is honored to lead the mission and values culture development for Compass Senior Living.