Dagmardsminde is a small innovative nursing home in Denmark with a remarkable and life-affirming approach to dementia care. Here, founder of the home (and author of Living Normally with Dementia: One Care Home’s Story and How to Make it Yours), May Eiby, shares how they welcome new residents to their home.
A nursing home should provide proper care for a person, but it can also be a place that opens up new possibilities. What if moving to a nursing home could become a kind of adventure for people? The goal at Dagmarsminde is to make moving to a nursing home a normal, even nice, experience for new residents.
Entering a New Life
The new resident is still the teacher, man, woman, parent, and grandparent he or she always was; the person’s identity does not disappear upon moving to a nursing home. The transition to the nursing home must be accomplished with the utmost care and respect for the person moving in and for who they are. A good mantra for anyone working in the care sector is this: Let new residents sense they are welcome from the moment they arrive, even if they are old and affected by dementia.
We try very hard to put ourselves in the residents’ shoes. New residents are on the threshold of the final phase of life. They cannot take care of themselves at home anymore, or they have just left a different nursing home because they did not receive the care they needed there.
In preparing for the new resident, staff members make time to talk with the person’s loved ones. We try to find out who the person is, and what is important to him or her. We want to know about our new resident’s work life, interests and hobbies of the past and present, and any important life milestones. We also ask about the effect that dementia has had on the person and how he or she is doing at this time.
Before the resident’s arrival, we place a welcome basket on the windowsill with flowers, chocolate, some snacks, a bottle of non-alcoholic wine or lemonade, and a little card with a personal note. We write that we are looking forward to getting to know them and having them be a part of our lives. We have pre-stocked the bathroom with lotion, shampoo, fingernail clippers, toothpaste, and a toothbrush. Even if they bring their own toiletries, we are signaling to both the new resident and the family that we have everything covered. There is no need for anyone to run around at the last minute buying forgotten everyday supplies.
Most relatives are worried about the move. They assume it is better to slowly phase in their loved one by having the person visit the place a couple of times in advance. They also think they have to move all the furniture and prepare the room beforehand. However, at Dagmarsminde, we do everything on the same day. We have tried different models and time frames, but this way actually seems the least disruptive, even when boxes, nervous relatives, and an often confused new resident all arrive at the same time.
This approach works because we make sure it is well coordinated; each staff member has a specific role or set of responsibilities during the move, and takes care to adhere to them throughout the day. One staff member welcomes and stays with the resident, while the move is in progress. Another presents the room and helps carry and arrange things if needed, staying nearby and talking to the relatives, who are often so distraught by the situation that they do not always hear what we say. Our primary concern is that they feel that everything is in order and that we are honored to receive their loved one.
It is important to understand that a new resident’s life has already been dramatically affected by dementia and he or she has usually suffered considerable hardship. The person has likely lost many basic abilities. Some need a wheelchair to move around, and others have lost the ability to speak. As a result of medication they have been given, they may have mentally shut down or be disoriented and anxious. A new resident may be on high alert and stressed—another reason to ensure the move is as seamless as possible. The shift from one world to another can feel very intense for a new resident.
While all the furniture gets carried in, the new resident is introduced to our shared living room. At first we do not invite the person to sit among the others; instead, the staff member guides him or her to a cozy space in the room for a quiet chat. We do not want to overload the resident with information. In these chats we will usually just talk about the weather and other trivial subjects. We give the person time to size us up and take in his or her surroundings. Throughout this time, the staff member maintains eye contact and remembers to smile. We might also invite the new resident to take a little walk in the garden; a little fresh air usually works wonders.
New residents generally have no interest in moving to a nursing home. This is one of the reasons we do not refer to it as a permanent move, and if they ask what they are doing here, we say they are here for a while to recuperate, exercise, get their bearings, or have a nice time with some fun people. We try to align with that person’s self-perception and what he or she feels a need for here and now. Putting things this way often reassures the resident. If it does not work, we have to distract the person as well as we can with short walks, keeping up a lively conversation and avoiding anxiety-provoking empty silences.
We allow for all types of reactions from the residents. During these first hours, it is important to help minimize the stress level of the person to avoid having the transition become a traumatic experience for either the resident or members of the family. If the person tires of all our questions and walks, we suggest a little rest. By that time the bed and room are usually ready. Once the person sees his or her room filled with familiar things and senses the presence of family, the situation usually improves.
Excerpted from Living Normally with Dementia: One Care Home’s Story and How to Make It Yours by May Bjerre Eiby. Copyright © 2023 by Health Professions Press, Inc.
Read the book
Living Normally with Dementia
One Care Home’s Story and How to Make It Yours
By May Bjerre Eiby
Copyright © 2023 by Health Professions Press, Inc. All rights reserved.
Delve into the successful story of Dagmarsminde, a small innovative nursing home in Denmark with a remarkable and life-affirming approach to dementia care. This book invites you to immerse yourselves in a home that operates very differently from traditional, institutional nursing homes. Person-centered practices define the daily routines and include a focus on good nutrition, contact with nature, healthy physical activities, and as much independence in activities of daily living as possible. Envision new, more satisfying ways of working with people living with dementia and explore new approaches in your own care homes.