Namaste Care is a program I developed for residents in nursing facilities who have advanced dementia and are unable to participate in traditional activity programs. Without this program, these residents are fed, changed, groomed and then often placed in front of a television set where they sleep. Sometimes they can be seen sound asleep on the fringe of an activity program they can no longer participate in; occasionally they are left in their rooms, isolated from others. This is not quality of life and I truly believe that people with advanced dementia can have a quality of life, with activities that are meaningful for them until they take their last breath and so does Seasons Hospice & Palliative Care.
Namaste Care is based on the power of a “loving touch”; this approach offers activities of daily living (ADLs) in a way that decreases agitation and brings smiles to the faces of residents with advanced dementia. Very quickly the program became successful, I wrote a book, “The End-of-Life Namaste Care Program for People with Dementia” and was asked to speak at many conferences. It was at a conference in 2007 that I met Dr. Russell Hilliard who was at that time the Executive Director of the Seasons Hospice & Palliative Care office in Chicago and now serves as the National Director of Supportive Care. Dr. Hilliard attended my presentation and shortly after the conference, contacted me and asked if I could adapt Namaste Care for a hospice setting. He realized that the population of patients with advanced dementia was growing and knew that unlike cancer patients they could not communicate their needs easily and some became agitated when hospice staff tried to provide ADLs, especially bathing. He felt that the Namaste Care approach to care was a perfect fit for hospice staff, and it is!
Seasons Hospice & Palliative Care staff was quick to adapt the Namaste Care program for hospice patients. Dr. Hilliard and his team decided they wanted their own name for the program; they held a contest and it became “A Touch for All Seasons” commonly referred to as “Touch”. Supplies needed for the program were gathered and a Touch bag was given to all staff so they had everything they needed when visiting patients. In-services were held for all staff and volunteers so that everyone had an idea of how this gentle approach could be a part of their services to patients with dementia.
Staff was shown how to offer Touch in nursing homes where most often the room was shared with another person. A soothing environment was created by pulling the privacy curtain around the bed and spraying it with lavender linen spray. A small CD player was placed in each bag with some appropriate CDs often selected by their board-certified music therapists. All the aides now have cell phone apps with a selection of music for their patients and the CD players are mainly used for home care patients. The education programs offered to all staff stressed an unhurried approach to care and conversation.
Hospice aides learned that a bed bath decreases the apprehension expressed by patients with dementia who are frightened by the institutional looking bathing areas found in most nursing facilities. The social worker may have pictures of where the person grew up and their family, clergy will have religious items such as a rosary for Catholics to hold, and a rabbi might offer a yarmulke for the men. Volunteers bring natural sensory objects to remind patients of the four seasons: lilacs in the spring, and fresh flowers in the summer and colorful and interesting looking gourds in the fall. One creative person even brought a tub of snow in the winter!
A Touch for all Seasons is now offered in all Seasons Hospice & Palliative Care sites across the country and provided in nursing facilities, assisted living communities and home care settings. Many of the inpatient units have a Touch cart filled with CDs, lavender hand lotion and linen spray, religious symbols, music and readings. The cart is used by staff and when a patient is actively dying, the cart might be used by families.
The Seasons Hospice & Palliative Care staff decides which patient would benefit from the Touch program and so it has grown to include patients with cancer and other terminal illnesses. One hospice aide decided that the family caregiver who looked worn out from caring for her husband needed Touch more than he did. She got the woman to sit in a lounge chair, tucked a quilt around her, sprayed the room with lavender, played soft music and gave the woman a hand massage. She fell into a much needed sleep while the hospice aide cared for her husband.
Seasons Hospice & Palliative Care is the only major hospice offering this unique program to their patients with advanced dementia. I continue to work with them because of their commitment to patients that have very special needs and their promise to have a program that has integrity. They are a joy to work for and work with.