A Day in the Life
Curious to see what a day in the life of a Care Haven resident living with Alzheimer’s or Dementia looks like?
We invite you to shadow Anna, a fictional senior who looks and acts just like a typical Care Haven resident, as she lives an ordinary day in her Care Haven home with the assistance of longtime caregivers Doris, Helen and Marie.
Rise & Shine – 8:15 AM
Anna wakes, puts on her robe and slippers, then walks down the hall to the dining room for coffee and breakfast. Anna is well rested – far more relaxed than at the assisted living from which she recently moved. There she was jostled out of bed at 6:30 every morning, hurried to the bathroom and through her dressing routine, then rushed to the dining room in an irritable mood. She joined 30 other confused residents, each quietly waiting for rolling carts full of breakfast trays and an aide bearing the platter of morning medications.
Rise & Shine – 8:20 AM
Doris and Helen, the daytime caregivers, greet Anna by name. Anna wants to eat right now, though, so Doris offers a choice of two favorites: strawberry yogurt topped with granola or an egg cooked over easy, served on a slice of toasted rye. Doris knows to serve Anna orange juice with extra pulp, too; the caregivers have kept a carton on hand ever since Anna’s family requested it for her very first Care Haven breakfast. Doris has worked in this Care Haven home, two or three days per week, for two years now. She knows its residents well. Doris understands that Anna prefers her morning medications after a meal, not before. She brings them out only as Anna polishes off her last spoonful of yogurt.
Early Morning – 9:05 AM
Helen escorts Anna back to her room and asks whether she’d like to shower and dress for the day. Anna declines the shower but would like to dress. Helen offers a choice of two different outfits from Anna’s closet and drawers, and Anna selects her favorite: a blue and gold sweater that was a gift from her late husband. The caregivers know it’s special, so they make sure to wash and return it to Anna’s drawer several times a week.
Early Morning – 9:20 AM
Helen assists Anna with her Activities of Daily Living. She takes her time so Anna feels at ease, not rushed. Anna’s family is concerned about her dental hygiene, so one of the caregivers encourages her to floss after each meal. Then comes the part Anna used to dread – applying blush, mascara and lipstick with hands made unsteady by Parkinson’s. Grateful for the sensitive aid of her caregivers, Anna no longer skips her makeup because she’s embarrassed by stray smudges and crooked lips. She’s once again proud of her appearance.
Early Morning – 9:55 AM
Hair neatly combed, Anna leaves her room all smiles, a marked contrast to the mornings spent at her former assisted living. There the staff rushed about performing morning duties for the 40-bed unit, leaving Anna feeling ignored and unsettled – uncertain of where to go or what to do. Inevitably, she would decide to get up and leave. Stymied by a locked exit, shaking the handle and banging the door, she grew fearful as the alarm rang and strangers ran at her yelling, “Stop!” Mornings often ended with Anna lying on her bed – tearful, disheveled and alone.
Late Morning – 10:00 AM
Joyce, Anna’s physical therapist, arrives for her appointment. Anna once dreaded these twice-a-week sessions. As exercise has stretched and strengthened the muscles around her left knee, though, Anna’s balance and gait have improved. More importantly, the stiffness and soreness that once kept her in a chair hardly bother her now. Anna is more comfortable and confident as she walks. She once again enjoys a late afternoon “constitutional” round the backyard.
Late Morning – 10:45 AM
Two of Anna’s longtime best friends arrive for a visit. The three women gather in chairs under the living room window and reminisce about their 1985 “girls only” vacation. At Doris’ suggestion, Anna’s friends have surprised her with an album of photos from their London bus tour. The women share memories that Anna has found difficult to retrieve or talk about as her Parkinson’s progresses.
Late Morning – 11:45 AM
Lunch is ready; however, Anna’s friends have travelled several hours for this visit, and things are going so well that they’d like to stay a little longer. Helen, who’s preparing the meal, suggests that Anna wait to eat lunch. In the meantime, Helen serves Anna and her friends iced tea, fresh fruit and whole-wheat crackers in the living room. Anna’s friends hadn’t expected the visit to be this pleasant. In fact, they hadn’t planned on visiting at all after their last trip to Anna’s former residence. They’d found their old friend almost tired of life, so different from the energetic pal with whom they’d grown old. After Anna moved into this home, though, her caregiving team convinced her daughter, Sara, that these visits really did make a difference, and Sara persuaded her adopted “aunts” to give them another try under the guidance of the new care team.
Mid-Day – 12:15 PM
Anna’s friends leave, so she sits down with the other residents already enjoying a family style lunch. Anna’s mouth has been watering all morning at the aroma of freshly prepared, homemade chicken and dumplings baking in the oven. She’s glad Helen kept her lunch hot on the stove until her friends said their goodbyes. Anna likes blackberry jelly on her biscuit, and Helen is happy to retrieve a jar from the refrigerator. This small indulgence is something Anna dearly missed at her last residence, where aides assisting with lunch never brought sides or condiments to the table. Often unable to sit with people she liked and rarely given a choice of beverage or dessert, Anna passed many a lunchtime just pushing food around her plate.
Mid-Day – 1:00 PM
As everyone finishes eating, Doris and Helen settle down at the table to read from the day’s newspaper and The Daily Chronicle. It’s May Day, so talk soon turns from current events to memories of mad dashes to hang baskets on unsuspecting neighbors’ doors.
Mid-Day – 1:20 PM
The eight residents leave the table one by one, in their own good time. Helen lets Anna and another resident, Louise, help clear the table. The others head to the family room, to their own armchairs – recliners and overstuffed rockers that were fitted to their curves long before the chairs moved with them into this home.
Early Afternoon – 1:30 PM
Lynne, Care Haven’s nursing supervisor, comes through the front door just as Anna finishes stacking clean placemats. “Can I convince you to put your feet up for a minute?” Lynne asks. The two of them head to Anna’s room to check her ankles, which were uncomfortably swollen until the doctor adjusted her medications. Lynne asks Anna about her day and listens carefully for clues about her emotional, mental and physical health. Anna enjoys these regular one-on-one chats.
Early Afternoon – 2:00 PM
Kat, one of the Care Haven activities assistants, arrives for her afternoon visit with a stack of the residents’ favorite sheet music. Anna, two other women and one of the men enthusiastically join a piano sing along in the living room; several others nod along from their chairs in the family room. One of the residents isn’t in the mood to sit still and listen, though. Doris offers to take Harold on a walk around the neighborhood for a little bird watching – she knows Harold carries his binoculars wherever he goes. In Anna’s larger memory unit, this sort of afternoon stroll was available just to residents whose families took them out in the afternoon. Other residents could only escape chattering visitors and staff, buzzing alarms, slamming doors, squeaky cart wheels and other noisy nuisances by sitting or sleeping alone in their rooms.
Late Afternoon – 3:40 PM
Anna heads back to her room for a nap. She’s calm in familiar surroundings: bedroom furniture she shared with her husband, pictures her daughters painted in college, a photo collage of family vacations. Thinking about her loved ones, Anna begins to wonder why they haven’t visited. Her dementia is playing tricks; one of her daughters stopped in just yesterday, as she does nearly every evening.
Late Afternoon – 3:55 PM
Delivering clean clothes to residents’ rooms, Helen finds Anna tearful on her bed. Helen knocks at the door, and Anna asks her to come in. Putting an arm around Anna’s shoulder, Helen consoles her. After a quiet moment, Helen asks about the collage. Soon the two are comparing vacation adventures. Helen asks if Anna would like to call her daughter, Sara, to see whether she’ll visit this evening. Wistfully, Anna tells Helen that Sara sometimes brings a Symphony bar, her favorite candy. A smile creeps across Anna’s face at the thought. “Give me a minute,” says Helen. “I think I might have one of those!” (She knows she does; as house manager, she keeps the chocolate bars on hand just for Anna.) Helen makes a quick trip to and from the kitchen, and Anna smiles as Helen hands her the candy. While Anna peels back the wrapper, Helen dials the phone – Anna would be upset if she realized she’s forgotten Sara’s phone number.
Late Afternoon – 4:45 PM
Sara arrives, having left work a few minutes early to see her mother. She finds Anna a little disoriented after a big day, but not overwhelmed or frightened. Doris has helped Anna freshen up and has changed the sheets onto which her continence garment had leaked while she napped. Anna’s room smells fresh, and the bed is ready whenever she wants to rest again. The residents who Sara and Anna pass on the way to the backyard are busy putting together a puzzle or flipping through magazines. No one is napping the entire day away in a lounger – they’ll be able to sleep through the night.
Evening – 5:30 PM
Knowing it’s been a tough afternoon, Helen encourages Anna’s daughter, Sara, to stay for supper. Sara loves the home cooking and sharing dinner with her mother’s housemates; she tries to make time to join their family style dinner once a week. Sara also jumps in to help whenever the caregivers and residents bake together. She enjoys making new memories with her mother in the kitchen. Dinner is delicious, and the whole group laughs at Helen’s humorous banter as she flits about the table making certain everyone gets enough to eat.
Evening – 6:25 PM
Sara must leave to take care of her children. All seven of the regular caregivers in this Care Haven home know Sara’s departure routine, which they helped devise: immediately, to distract Anna, Doris convinces Anna to come to the card table and shuffle her old deck of cards. Restarting a standing card game with Anna, Louise, Harold and one of the caregivers redirects Anna’s attention from the anxiety of letting Sara go.
Evening – 6:30 PM
Sara leaves free of the guilt and exhaustion that dogged her when her mother lived in the larger memory unit. Sara appreciates spending time with her mother this way instead of providing the physical care for which aides at the larger memory unit seemed to run out of time: giving unscheduled but necessary baths, scrubbing fingernails, tracking down a favorite nightgown carried off by another resident. Most of all, Sara appreciates Doris’s help as she says goodbye and the confident feeling that Doris will be just as kind if Anna feels restless later tonight.
Night – 7:35 PM
Anna grows sleepy and asks if she can get into her pajamas. The nighttime caregiver, Marie, is ready with Anna’s evening medications. She accompanies Anna to her room, where the two talk quietly as Marie helps Anna get ready for bed: brushing her teeth and denture partials, flossing, washing her face, using the restroom and, finally, putting on her comfy pajamas and fuzzy slippers. Anna sits down in HER chair in HER room and opens the Swedish newspaper that Sara has arranged to have delivered weekly.
Night – 8:00 PM
Marie peeks her head into Anna’s doorway and finds her reorganizing the closet and dresser drawers. This is a nightly ritual, as Anna likes to keep her belongings tidy and well organized. Marie asks Anna if she needs anything else for the evening and reminds her that she will be just steps away, listening from the lighted kitchen or dining room, checking in throughout the night.
Night – 8:40 PM
Marie peeks her head into the room again to find Anna sleeping on top of her bed. Marie gently pulls the cover over Anna, then turns on the night-lights in her bathroom and room. All the caregivers understand that Anna doesn’t like a dark room when she sleeps. In her old unit, she used to wake unsure of where she was, then grow more frightened as she searched down the long, empty hall for someone she knew. These dim night-lights will guide Anna to her bathroom or, if she needs reassurance, to the hallway. There, as she peeks outside her doorway, she’ll find the friendly faces of familiar caregivers.