The Colorado State Veterans Center at Fitzsimons offers a secure, 21-bed memory care unit, or “neighborhood,” with spacious rooms, recreation areas and outdoor gardens.
An in-house pharmacy enables staff to become familiar with residents’ conditions and history, to communicate this information to physicians and to respond quickly to medication order changes. Also, pharmacists and nursing staff maintain close, ongoing communication to provide the best possible care for our residents.
In addition, Fitzsimons works to provide a home-like environment. Residents who live throughout the nursing home are encouraged to bring in familiar items such as personal belongings and even their own furniture if desired.
From the first day a new resident comes to live at Fitzsimons, the staff gathers detailed information about the person’s history. Fitzsimons caregivers use this information to help make the resident’s life as meaningful and enjoyable as possible. After this initial assessment, our nursing staff continues to complete periodic reviews to screen for possible depression and to evaluate each person’s ability to learn new information and tasks.
Recreational programs are a very important part of the daily care for residents with dementia. On our secure neighborhood, recreational and music therapists trained in dementia care design a wide range of programs adapted to individual abilities and tailored to residents’ interests and needs. A few examples of these programs include pet visits, sing-alongs, drumming circles, moving to music, finish-the-phrase/trivia games, chair exercises, birdhouse assembly, quilt making, balloon volleyball, cooking groups, bread tasting, church services, reminiscing and barbecues.
Activities programs also can help our elders successfully engage in familiar tasks and past leisure interests, work life, family roles and everyday routines. Examples of these activities may include washing dishes, raking the yard, watering the plants or organizing their space. Outings such as scenic drives, dinners and museum visits also are available with assistance from family members and volunteers.
Effective communication is another important aspect of caring for individuals with dementia. We work to communicate in ways residents can understand, separating tasks into manageable segments, slowing the pace of speech and movement and reducing levels of stimulation as needed.
Residents also are given many choices, including their preferred times for getting up in the morning and going to bed at night. They have dining options that include choosing between main dishes or hot grilled items such as burgers, hotdogs, grilled cheese sandwiches and bratwurst. Ice cream and other snacks also are available.
Because bathing can be a difficult process for some residents with dementia, we have bathing rooms throughout the nursing home that are equipped with whirlpool tubs, showers, heated towels and a choice of music to provide a soothing environment. In addition, the nursing staff follows the principles of the “Bathing without a Battle” approach, which provides ways to ease residents through this activity.
Staff longevity is a strong point on our dementia care neighborhood, with some caregivers having worked on the unit since Fitzsimons first opened in 2002. Also, a team of nurses, certified nursing assistants (CNAs), recreational therapists, music therapists and a clinical neighborhood coordinator work exclusively on this neighborhood, providing consistent, familiar staffing.
Overall staffing is another asset on our memory care neighborhood, which maintains a ratio of one staff member to every five residents. This ratio is higher than industry standards and exceeds the ratios of many long-term-care settings in the area.
Family members can stay informed of any changes in residents’ care needs and can provide helpful information for Fitzsimons caregivers by participating in care conferences, either in person or by phone. Attended by a nurse, CNAs, neighborhood coordinator, a recreational therapist and dietary staff, care conferences are scheduled quarterly or more often if needed. In addition, residents have direct, round-the-clock access to CNAs and nurses, whose stations are right on the unit, not in separate, centralized areas. Physicians and nurse practitioners also see residents at Fitzsimons Monday through Friday and are available by phone 24/7.
All of the Fitzsimons nursing staff attends specialized two-day dementia training developed by experienced Fitzsimons staff. Participants receive a 40-plus page training manual and 10 different PowerPoint presentations about memory care. The training begins by explaining the 10 warning signs of Alzheimer’s disease: Memory loss, challenges with planning and problem-solving, difficulty with familiar tasks, confusion about time and place, trouble understanding visual images and spatial relationships, problems with words in speaking or writing, misplacing things and losing the ability to retrace steps, decreased judgment, withdrawal from work or social activities and changes in mood and personality.
The training then teaches staff to create meaningful interactions, maintain a positive approach, communicate in engaging ways, slow down to enable the resident to track and understand information, eliminate stress in the environment, avoid stimulation overload, provide activities that focus on their remaining abilities and help meet residents’ nutritional needs. In essence, the training helps participants provide care based on the needs of each individual and to understand that difficult behaviors are signs of unmet needs.
Admission to our secure memory care area may be appropriate for individuals with Alzheimer’s disease or another form of dementia who have unsafe wandering behavior and are considered a danger to themselves or others.
Other individuals with dementia who do not require a secure setting are served throughout our nursing home.
As with other services offered by the Colorado State Veterans Home at Fitzsimons, residents must be honorably discharged veterans, veterans’ spouses or “Gold-Star Parents,” any of whose children died while serving in the Armed Forces.