SYNERGY HomeCare Magazine Summer 22

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Meet marvelous Mariatou

Caregiver of the Year

SYNERGY HomeCare Featured Expert

Dr. Macie Smith Award-Winning Alzheimer’s & Dementia Educator

Creating a

safe & familiar home Communicating with

your loved ones



Memory Care

oday, more than 6 million people are

A number of things make this program stand out

living with Alzheimer’s or another form

in the field of memory care:

of dementia. That number is estimated to climb to nearly 13 million by 2050. An estimated 70% of people living with dementia reside at home and about a third of people receiving in-home care are living with dementia. Clearly, there is an urgent need for specialized care for this growing population. That’s why I am so excited to be working with SYNERGY HomeCare on its new, comprehensive memory care offering. The Memory Care - A Convergence of Care model features a person-centered approach that leverages industry best practices, technology solutions and nationally recognized training standards to provide a holistic care plan for the entire family. As our country matures and the demand for aging resources grows, it is critical that we provide effective guidance across the long-term care continuum. I have dedicated my career in social work and gerontology to helping families preserve the quality life for those living with dementia as well as their loved ones. It has been an honor to partner with SYNERGY HomeCare on this important effort.

. Access to remote patient monitoring solutions to promote client safety from wandering and falls. . Resources and best practices related to mental stimulation to promote brain health. . Use of caregiver tools that stimulate the senses and create a sense of nostalgia through music and reminiscence therapy. . Comprehensive specialized caregiver training that focuses on a person-centered approach to caring for those living with Alzheimer’s disease or cognitive decline. . Education and support to help family members navigate the care needs of their loved one living with dementia while also caring for themselves. I invite you to learn more about SYNERGY HomeCare’s new memory care program in this issue. You’ll find helpful tips for supporting a loved one living with dementia as well as heartfelt stories of people we have cared for through their dementia journey. In health, Dr. Macie Smith



SYNERGY HomeCare leading the way in memory care


arly this summer, SYNERGY HomeCare proudly launched an enhanced memory care program designed to support people living with Alzheimer’s disease or other forms of dementia. The program is based on the recognition that when living with dementia, complex needs require specialized resources and caregiver training to truly enhance the home-based care experience.


Memory loss, cognitive impairment, Alzheimer’s disease and other forms of dementia represent a life-changing event for the individual experiencing memory loss and the family struggling to understand the disease and navigate care for their loved one. At SYNERGY HomeCare, we believe that every client and their family should be cared for with their individual needs and preferences in

mind. The new program enhancements reflect A Convergence of Care philosophy that is focused on the individual, not their condition. The memory care program combines specialized training for caregivers, a variety of engagement tools for clients, and family resources and support.



The benefits of personcentered, in-home care for people living with dementia are wide-reaching. Not only does home care provide the continuity of a familiar and private setting, it can also support ever-changing needs associated with cognitive decline and related behavior concerns such as agitation, aggression, depression and confusion, as well as mitigate safety concerns related to sundowning and wandering. In addition, family members benefit from access to resources, knowledge and support that can alleviate the stress of caregiving, including a Memory Care Family Resource Guide developed in partnership with Dr. Macie Smith, Ed.D, a highly recognized licensed gerontology social worker.

There are five pillars to the SYNERGY HomeCare memory care program. They include: 1. BRAIN HEALTH

Our caregivers create wholehearted engagement through stimulating activities to promote brain health.

2. COMPANIONSHIP & SAFETY The need for a comprehensive safety plan becomes vital as dementia progresses. Taking special measures to improve safety can prevent wandering and injuries at home. For an extra layer of support and peace of mind, SYNERGY HomeCare offers technology solutions such as an in-home medical alert and remote patient monitoring support.

3. SENSORY STIMULATION Sensory stimulation is a key component for improving the quality of life. Music therapy, conversation cards, or reminiscence therapy through a nostalgic TV show or movie can trigger positive emotions, memories and communication (verbal or non-verbal) in individuals who have lost their ability to connect with the world around them.

4. CAREGIVER TRAINING Our caregivers have completed specialized training that has prepared them to care for those living with Alzheimer’s or cognitive decline.

5. FAMILY RESOURCE GUIDE Our Memory Care Family Resource Guide equips families with a useful tool for caring for a loved one living with Alzheimer’s or dementia.

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The invisible thread that ties the program together is outstanding communication among the care recipient, their loved ones and the caregiver. Understanding your loved one’s personal preferences, background and family dynamics is the best approach for your caregiver to begin care. With that understanding, coupled with high-quality dementia care training, your caregiver can weave the tapestry for better days and a fuller life for your loved one. 7


A true story of compassionate care


on Schulman’s SYNERGY HomeCare agency had been open only a short time when a geriatric care manager referred Mr. and Mrs. Z. The couple had planned to stay in their home as they aged and had made the appropriate arrangements with a financial advisor and a power of attorney, as they had no children or close relatives.

“For a brief moment, Mrs. Z was the most present she had been in the last two years,” recalled Ron. “She held his hand and told him he had done a good job and had made a good life. She kissed him goodbye. But an hour later, she didn’t have any recollection of that touching moment.” Later that night, the evening caregiver called Ron and said that Mrs. Z was very agitated and was demanding to go home. Of course, she was already home, but the events of the day had disoriented her. Ron rushed

At the time, Mr. Z had advanced Alzheimer’s. He had just returned from a rehab facility and Mrs. Z was overwhelmed and needed some assistance in caring for him, so Ron worked with the referral partner and Mrs. Z to set up a care plan and match appropriate caregivers to the couple. They needed 24/7 care.

to the house and told her he would take her home, adapting to her current reality. After driving around the neighborhood for a while, Ron asked Mrs. Z for directions. She proceeded to guide them home. He walked her into the house and made her a sandwich for dinner. Mrs. Z told Ron her husband was away on business and would be back in a few days. Because of her advancing dementia, she was unable to retain the fact that her husband had passed away.

About a year later, Mrs. Z began to develop dementia herself, and the care plan evolved to address more specific needs for Mrs. Z, as well. Mr. Z soon received hospice care and passed in his sleep, with Mrs. Z by his side. Ron and his caregivers were there as well. He alerted the healthcare power of attorney and the geriatric care manager and, with the hospice company, the team managed the rest of the day. Two hours later, Mrs. Z was in the kitchen, preparing her husband’s breakfast. She had forgotten that he had passed. The hospice nurse told her gently that Mr. Z had passed peacefully in his sleep.

“That was her story, so we met her where she was and made it our story as well,” explained Ron. “I contacted everyone who was involved in her care, from my company to her extended team of advisors, and told them that any time Mrs. Z asked where her husband was, we would say he was away on business and would be back in a few days.”

Later, Ron brought in lunch for the extended care team that had assembled. As they gathered at the table, Mrs. Z began to make a plate for her husband. Mrs. Z was once again gently redirected by the team. When the funeral home arrived to remove Mr. Z, Ron

“Over time, we became her family,” said Ron. “She became like my aunt. This is one of the more fulfilling relationships I’ve had in my life, even though I’m not sure she remembers my name – she calls me ‘Chief.’ She trusts me and her trust in me extends to her caregivers, who she knows I have selected just for her.”

looked at Mrs. Z and compassionately talked to her about what happened and let her know it was time to say, “goodbye.” 8

“It is a great joy to ‘go to work’ with Mrs. Z,” remarked Mary, one of Mrs. Z’s caregivers. “I love our conversations as well as the times we just sit together in silence. I love her appreciation of nature, and how grateful she is when I take care of the birds that visit her yard.” Helen, another member of Mrs. Z’s care team, loves sharing stories with Mrs. Z, especially at mealtime. “Mrs. Z herself is a great storyteller, she will engage you with her expressions and calming voice, added Helen. “I can picture the places as she carries me fondly down memory lane.” Mrs. Z may not remember her own birthday, but her care team does and brings her favorite ice cream cake to celebrate. And every day, Ron and his team remember and honor Mr. and Mrs. Z’s wish to age in place. It is a big responsibility, but it is also a pleasure for them to keep the promise they made for as long as they need to.

Meet Mariatou the Marvelous, SYNERGY HomeCare’s Caregiver of the Year


t SYNERGY HomeCare, our 22-year history is steeped in tradition. And the tradition we are most proud of is honoring our caregivers. Every year, our SYNERGY HomeCare agencies across the country submit their nomination for one of their very special caregivers to be considered for the prestigious Caregiver of the Year title. While all of our caregivers are committed to providing the quality of care they would give to their own loved ones, sometimes unique situations occur when a caregiver truly rises to the occasion to positively impact a person’s life in profound ways. With so many great nominations each year, it is always challenging to select our Caregiver of the Year. However, this year’s winner, Mariatou ToureCole or “Mariatou the Marvelous,” was a runaway winner hands down. We’re thrilled to share a little about Mariatou. Always willing to go above and beyond, in October 2020, Mariatou accompanied a SYNERGY HomeCare client on an out-of-town trip to handle business with her vacation home. Mariatou provided care for a whole week, allowing the client to visit with old friends in the neighborhood while she took care of her vacation home needs. In December of 2021, Mariatou once again demonstrated her dedication by providing care for a client who 9

was turned away elsewhere during the pandemic. Mariatou helped and served this client until he passed away. At 106 years old, this client turned out to be SYNERGY HomeCare’s oldest client ever. His family was so grateful to SYNERGY HomeCare for being able to provide a professional and compassionate caregiver to care for him when help was so difficult to find.

“We call her ‘Marie THE MARVELOUS.’ She is a leader to the care team, initiates activities and communication, and she has an upbeat personality. She has an excellent relationship with the staff, and she is a great cook.” - MITCH OPALSKI, SYNERGY HOMECARE OF ARLINGTON OWNER

Mariatou continuously overcame challenging situations during the pandemic in order to benefit SYNERGY HomeCare clients. We are honored she is part of the SYNERGY HomeCare family and commend her on her dedication, determination and altruistic attitude. SYNERGY HomeCare

to reach, which may prevent the person from climbing shelves or objects falling from overhead. Closely monitor the use of an electric blanket, heater or heating pad to prevent burns or other injuries.

been known to wander out of the house while searching for the kitchen. . Install remote monitoring systems. An electronic

door alarm, exterior cameras and indoor monitoring systems can alert loved ones when a person with dementia leaves the house or potentially falls.

. Assess safety hazards in the garage and/or

basement. Limit access to large equipment such as lawn mowers, weed trimmers or snow blowers. Keep poisonous chemicals, such as gasoline or paint thinner, out of reach.

Creating a safe and familiar home for your loved one with dementia

. Consider professional in-home care if your loved

one has a history of wandering but you can’t be with him or her at all times. Bringing a professional caregiver into the home will give you peace of mind, knowing that someone is watching at times when you can’t.

. Place medications in a locked drawer or cabinet.

To help ensure that medications are taken safely, use a pill box organizer or keep a daily list and check off each medication as it is taken.


. Improve laundry room safety. Keep all cleaning



o you have a loved one diagnosed with dementia? Implementing appropriate and sensitive home safety measures can ensure that an individual living with Alzheimer’s disease or related dementias can continue to remain in the familiar surroundings and comfort of his or her own home.

. Avoid safety hazards in the kitchen. Use

appliances that have an automatic shut-off feature. Prevent unsafe stove usage by applying stove knob covers, removing knobs or turning off the gas when the stove is not in use. Disconnect the garbage disposal. Discard toxic plants and decorative fruits that may be mistaken for real food. Remove vitamins, prescription drugs, sugar substitutes and seasonings from the kitchen table and counters.

It is important to create a safe home environment that supports the person’s needs without feeling too restrictive. Additionally, the home should encourage independence and social interaction and provide clear areas for meaningful activities that align with the person’s interests and abilities.

. Watch the temperature of water and food. It may

be difficult for the person living with dementia to tell the difference between hot and cold. Consider installing an automatic thermometer for water temperature.

Alzheimer’s disease causes a number of changes in the brain and body that may affect safety. These recommendations from the Alzheimer’s Association take into consideration that people living with dementia may have altered judgment, forget how to use certain items, become easily confused, lose a sense of time or place, and have trouble with balance.

. Assess bedroom safety. Provide seating near the

bed to help with dressing. Ensure closet shelves are at an accessible height so that items are easy 10

. Remove tripping hazards. Remove throw rugs,

products, such as liquid laundry pods and bleach, out of sight or secured to avoid possible ingestion of harmful chemicals. Consider installing safety locks on washing machines and dryers to prevent inappropriate items being put in or taken out too early.

extension cords and excessive clutter. . Keep walkways and rooms well-lit. Changes in

levels of light can be disorienting. Create an even level of lighting by adding extra lights in entries, outside landings, and areas between rooms, stairways and bathrooms. Use night lights in hallways, bedrooms and bathrooms.

WANDERING . Wandering often occurs because a person with

. Avoid injury in the bathroom. Install grab bars

dementia becomes distracted while looking for someone or something, is looking to get away from an overwhelming situation or because of an old routine he or she once followed. Understanding the reason can be helpful in removing the trigger.

for the shower, tub and toilet to provide additional support. Apply textured stickers to slippery surfaces to prevent falls. Consider installing a walk-in shower. . Keep stairways safe. Provide handrails on BOTH

sides of stairs. Install a light at the top and bottom of staircases and throughout hallways. Paint or place bright tape on the edge of steps to delineate where one step ends and another begins. Keep stairs clutter-free.

. Install locks out of sight. Place a latch or

deadbolt either above or below eye level on all doors to deter unlocking the door. . Label rooms in the house with words or pictures

that clearly display what the main purpose of the room is. Individuals living with Alzheimer’s disease or other forms of dementia have 11


Understanding Alzheimer’s Disease and Dementia


any people wonder what the difference is between Alzheimer’s disease and dementia.

According to the Alzheimer’s Association:



the disease

A type of brain disease that causes damage to nerve cells in the brain – is one cause of dementia. It accounts for somewhere between 60-80% of dementia cases. brain changes include:

. Accumulation of abnormal proteins called beta-amyloid and phosphorylated tau . Degeneration of nerve cells brain changes are the most common contributor to:

1. Dementia (first symptom) 2. Apathy 3. Depression



disease symptom

Dementia is an overall term for a particular group of symptoms. The characteristic symptoms of dementia are difficulties with memory, language, problem-solving and other thinking skills.

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Alzheimer’s disease is a progressive disease. Later symptoms include impaired communication, disorientation, confusion, poor judgment and behavioral changes. Eventually, the damage to the brain’s nerve cells affects basic bodily functions such as walking, speaking and swallowing. One area of special concern is preventing falls, which can cause head injury, fractures and hospitalization. Preventing wandering is another area of special concern. Wandering refers to individuals walking away from a particular location and being unable to retrace their steps. Individuals become

lost, putting them at risk of significant injury and even death. This is one reason that a person living with Alzheimer’s disease benefits from a regular caregiver, either a member of the family or a professional caregiver. It is important to note that the differences between normal age-related cognitive changes (changes in memory, language and thinking) and the cognitive changes of Alzheimer’s disease can be subtle. The Alzheimer’s Association recommends that people experiencing cognitive changes should seek medical help to determine if the changes are normal for one’s age, are reversible (for example, caused 13

by a new medication or vitamin deficiency), or may be a symptom of Alzheimer’s disease or another form of dementia. Whether your loved one has been diagnosed with Alzheimer’s disease or another form of dementia, understanding the disease and identifying the right family caregiver resources and support can leave you feeling overwhelmed and stressed. Rest assured, SYNERGY HomeCare is here to help you navigate through uncharted waters and create peace of mind in caring for your loved one experiencing dementia or memory loss.



lzheimer’s disease and other dementias gradually diminish a person’s ability to communicate. According to the Alzheimer’s Association, communication with a person with Alzheimer’s requires patience, understanding and good listening skills. Using a person-centered approach can be very effective. Person-centered care emphasizes the individual’s unique needs, personal experiences and strengths rather than focusing on their declining or lost abilities. This philosophy not only values and respects the individual with dementia but also promotes well-being and health by ensuring that every experience and interaction is seen as an opportunity to have authentic and meaningful engagement. This, in turn, helps create a better quality of life for the person living with dementia.

Effective communication with a loved one diagnosed with dementia

The communication strategies below can help both you and the person living with dementia understand each other better.







People in the early stage of Alzheimer’s disease are still able to participate in meaningful conversation and engage in social activities. However, he or she may repeat stories, feel overwhelmed by excessive stimulation or have difficulty finding the right word. Tips for successful communication: . Don’t make assumptions

about a person’s ability to communicate because of an Alzheimer’s diagnosis. The disease affects each person differently. . Discuss which method

of communication – face to face, phone calls or email – is preferable. . Make sure to include the person living with dementia

in conversations.

. Address the person directly,

rather than to a caregiver or companion. . Give the person plenty of

time to respond. Don’t interrupt unless help is requested. . Take time to listen to the

person express his or her thoughts, feelings and needs. . It’s OK to laugh. Sometimes

humor lightens the mood and makes communication easier. . Ask what activities the

The middle stage of Alzheimer’s is typically the longest and can last for many years. As the disease progresses, the person will have greater difficulty communicating and will require more direct care. Tips for successful communication include: . Engage the person in

one-on-one conversation in a quiet space that has minimal distractions. . Speak slowly and clearly. . Make and keep eye contact.

It shows you care about what he or she is saying.

person is still comfortable doing and what he or she may need help with.

. Be sure to allow plenty of time

. Maintain your connection; your friendship, understanding and support are more important to the person

encourage the person to explain his or her thoughts.

for the person to respond. . Offer reassurance and

. Use yes or no questions.

For example, “Would you like some coffee?” rather than “What would you like to drink?” . Avoid criticizing or correcting.

Instead, listen and try to find the meaning in what the person says. Repeat what was said to clarify. . Try not to argue. If the person

says something you don’t agree with, let it be. . Simplify instructions for

tasks. Lengthy requests may be overwhelming. . Give visual cues. Demonstrate

a task to encourage participation. . Write notes when spoken

words seem confusing.

The late stage of Alzheimer’s disease may last from several weeks to several years. As the disease advances, the person with Alzheimer’s may rely on nonverbal communication, such as facial expressions or vocal sounds. Aroundthe-clock care is usually required in this stage. Tips for successful communication: . Approach the person from

the front and identify yourself. . Encourage nonverbal

communication. If you don’t understand what the person is trying to say, ask him or her to point or gesture. . Use touch, sights, sounds,

. Consider the feelings

behind words or sounds. Sometimes the emotions being expressed are more important than what’s being said. . Treat the person with dignity

and respect. Avoid talking down to the person or as if he or she isn’t there. . It’s OK if you don’t know

what to say; your presence and friendship are most important. At every stage of Alzheimer’s disease, effective communication can go a long way in providing a person with unwavering emotional support and a deeply comforting sense of security.

smells and tastes as a form of communication with the person.

. Ask one question at a time.

than ever. 14




Mariatou the Marvelous our 2021 Caregiver of the Year If you have a calling to care then apply to join a SYNERGY HomeCare care team near you.


Proud Caregiver of SYNERGY HomeCare of Arlington


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