dementia care, cognitive decline

Dementia care – it’s 4:00 and what’s happening?  In a nearby memory care unit in an Assisted Living community, the movie has ended, the credits rolled. Next up – visitors hear loud yelling and observe a staff member separating and redirecting an able-bodied resident. Count the number of residents in wheelchairs -- nearly half of the unit -- awaiting some physical care before dinner. These residents seem ever-more frail -- likely because they are delaying move-in until the need is urgent. Often it appears that staff is supplemented with home health or companion services -- note that these providers are assigned to individual residents, not the group -- just like the resident-specific role played by visiting hospice workers. It may appear that there are many staffers around, but minus the one-on-one folks, there aren't enough staffers to keep everyone else occupied. Now consider the dependency on staff to engage these otherwise-bored and idle residents. Soon it will be dinner time and the activities person will have left for the day. Staff members (who earn a national average of $11.10/hour) get busy with ADL-related chores before/after meals and before bed.