Memory Care Classes and Staff Training

Proper training helps ensure memory care patients’ well-being. Employed correctly, it can even help improve memory and strengthen remaining cognitive abilities in dementia patients. Educating caregivers and staff ultimately leads to less frustration because they learn techniques based in compassion and person-centered care.

Specialized training not only lowers caregivers’ stress, but it also reduces crises for memory care patients, creating a more positive environment overall, said Pamela Atwood, a nationally recognized gerontologist and owner of Atwood Dementia Group — a consulting group based in Amston, Connecticut.

“Quality training ensures that pain is recognized and treated effectively, that behaviors are minimized with a variety of approaches, and that staff and other residents feel safe, appreciated, and cared for,” Atwood said.

In this article:

• State requirements for memory care specialist training
• Standards of care for dementia
• Common memory care training techniques
• Advanced memory care training techniques
• Memory care certification costs
• Memory care certification involves continued education
• Ensure your loved one receives person-centered memory care

In order to find the right memory care community or caregiver for a loved one, it’s good to know what qualifications memory care-specific staff are required to have in your area.

Most states require some specialized training for caregivers in memory care-licensed facilities. However, requirements vary greatly from state to state. While some states may require intensive hours of ongoing caregiver training, others have no mandated training at all.

More than half of all states don’t require memory care training for caregivers — but that doesn’t mean your family can’t find a community with trained and licensed staff. When speaking to a prospective memory care community, it’s important to ask about their specific requirements for caregivers, as they may differ from state mandates.

Many memory care communities set their own training guidelines

Even if your state has few memory care certification requirements, don’t worry. Many memory care communities offer more dementia care training than is required by state law, especially in locations with few requirements. When touring a memory care community, take note of their memory care certification process for staff. And always pay close attention to how the staff interacts with current residents.

Be sure to ask the right questions to make sure everyone working directly with your loved one is up-to-date on the latest dementia care standards:

• What specific training or certifications do their dementia caregivers receive?
• Do all members of the staff, including kitchen workers and housekeepers, receive some sort of dementia training?
• Do staff members practice person-centered care?
• Do caregivers use pharmaceutical interventions?

Overall, non-drug interventions in dementia care are greatly preferred over pharmaceutical (drug) interventions, as behavioral and cognitive interventions are safer and lead to a better quality of life for patients, according to research in Advances in Psychiatric Treatment. Memory care certification prepares staff to provide strategic, individualized care to support the dementia patient in the healthiest way possible.

Even though the U.S. does not have national requirements for memory care staff training and certification, research-based memory care methods have become the new standard. Senior living communities across the country and beyond have taken it upon themselves to uphold these standards of science-backed, progressive memory care skills through their own required classes and memory care certification processes.

“As an industry, we see a universal standard of dementia care emerging that consumers and advocates are demanding regardless of state regulator requirements,” explained Doug Oliver, lead trainer for Life Care Services’ Heartfelt Connections memory care program.

This new standard of care for dementia trains caregivers in three central tenets:

• Empathic, person-centered techniques
• Maintenance of remaining cognitive and physical abilities
• Control of the physical and social environment to promote comfort and safety

Other general areas addressed during memory care classes include:

• Specialized methods for activities of daily living (ADL) care
• Memory care-tailored activities
• Effective communication for dementia
• Common dementia responses or behaviors

No matter how many methods are covered during memory care classes, they all tie back to the three central tenets. These come from the pioneering work of the late Tom Kitwood — professor of dementia care and psychogerontology at the University of Bradford. Kitwood’s research worked to identify the person with dementia’s emotional and cognitive state at any given time and how best to communicate with them. Through this work, he developed the method of Dementia Care Mapping (DCM).

Kitwood explained DCM in his book Dementia Reconsidered as “a serious attempt to take the standpoint of the person with dementia, using a combination of empathy and observational skill.” Skillfully empathizing with the standpoint of the person with dementia is exactly what memory care caregivers and staff are trained to do for effective treatment.

Training programs for caregivers and support staff should be personalized to the resident

Memory care communities often curate resources to create their own memory care classes and training sessions specific to their facility. These classes may include videos, in-person role-playing, and formal, ongoing discussions of everyday situations with residents. Most importantly, staff should regularly meet to discuss care approaches that either helped or were ineffective at improving a resident’s ultimate quality of life.

Training of non-caregiving staff is also common within specialized memory care units. Memory care experts agree that everyone in the community, from housekeepers to chefs and servers, needs to use skilled compassion and empathy when interacting with residents.

Training seminars for memory care range from basic communication and de-escalation techniques to advanced continued education in progressive cognitive-behavioral strategies. Memory care classes prepare the caregiver to understand and interact with people with dementia. Caregivers learn “comforting ways of communicating” to the patient, explained Brenda Gurung, a certified dementia practitioner for the Alzheimer’s Association.

“It’s important to learn how to empower the person when communicating with them,” Gurung said.

Is memory care the right fit?

Some typical topics in basic memory care training include the following:

Psychology of aging focuses on typical issues that may arise in older adults. Training covers common ways to resolve these issues like facilitating specific activities, specific therapies, and social events. Any of the following topics can be covered:

• Cognitive changes of the aging mind
• Depression and disconnection
• Mental and physical exercise relative to the brain
• Activities that stimulate and support the aging brain

De-escalation techniques are an important part of basic and advanced memory care training. Gentle de-escalation techniques are taught using verbal and non-verbal cues and best learned in real-world scenario training. Caregivers are trained to empathize with the patient and to take note of the following in a crisis situation:

• The patient’s personal space
• The patient’s particular emotional or physical needs
• The caregiver’s body language and tone of voice

Redirection involves appealing to a patient’s unique interests or personal comfort objects to best reduce agitation. It is especially helpful with dementia patients, where reasoning or negotiating is not effective. For example, if a resident won’t eat what’s on the dinner menu, they can be redirected toward a personal comfort food as an alternative. If sundown syndrome is an issue, the caregiver should learn what the individual needs at that time of day to reduce anxiety before it even arises. The caregiver is taught to do the following during redirection:

• Assess the environment: Is the resident comfortable?
• Respond to the emotions behind the patient’s actions.
• Introduce meaning by addressing the patient’s unique emotions.
• Simply offer the patient some “fresh air.”

Reminiscence therapy facilitates redirection and de-escalation. It requires caregivers to understand a patient’s long-term memories and how to access them (through the five senses) to help calm the patient. Sometimes just knowing a person’s age can help the caregiver choose music, movies, or activities that may spark soothing memories from the resident’s past.

Many communities even utilize reminiscence therapy in the physical design and environment of the community. For example, artwork on the walls in memory care units — like scenes from the local area, nostalgic images, and personalized memory displays of photos outside a resident’s room — can help the resident recognize where they are.

Advanced dementia care techniques focus on connection and validation and are developed using evidence-based psychosocial interventions to improve quality of life and maintain cognitive ability. Many of these advanced techniques involve in-depth, person-centered methods, as caregivers take the time to understand a person’s history, preferences, and emotional needs in order to offer the best solutions according to their individual needs.

“We should always connect with people with dementia with an adamant belief that that person is still whole and present,” explained Gurung.

These techniques teach caregivers how to use meticulous compassion to secure a high quality of life for residents. Caregivers learn about the person they’re caring for in detail, so empathy always leads the care. The following methods are typical of advanced memory care certification courses that train professionals on how to become memory care specialists:

Validation orientation validates a patient’s emotions and re-orients them in the moment, without retraumatizing them with a reality they may not be emotionally able to face. It’s a technique which counters reality orientation and, instead, meets the dementia-affected person where they are emotionally.

“Validation orientation is the most humane way to interact with someone with dementia,” said Atwood. “We only use reality orientation if someone is asking something non-emotional, like ‘what’s for dinner, how’s the weather?’ If someone asks something more emotional — ‘where’s my mother, why am I here?’ — then we use validation.”

The idea is not to lie, but to creatively and compassionately redirect the person while validating their feelings. Caregivers should not respond with the reality that their mother is gone, but may instead respond with, “Your mother was such a great cook,” and then perhaps offer them a favorite childhood meal. Reality orientation in this instance only risks further emotional breakdown.

GEMS: Brain Change Model was developed by dementia care educator Teepa Snow. It teaches caregivers to “research” the patient to discover all about the patient’s unique personality:

• What are their likes and dislikes?
• What affects their moods?
• How do they react to their environment?

This model outlines stages to help caregivers understand the abilities of their patients at each stage of their dementia journey.

Montessori Method teaches caregivers to give memory care patients several choices in their environment. This method empowers the patient through their own preferences. It teaches the caregiver that it’s their responsibility to figure out the complete picture of the patient. DCM techniques help caregivers do the following for the patient:

• Make spaces tailored just for the patient.
• Give the patient choices in their environment.
• Help the patient to express themselves through their options.

Examples of the Montessori Method in action go from offering outfit options during morning dressing to meal and activity choices.

Bathing Without a Battle techniques focus on the difficulty caregivers and patients face during bathing time. This is a highly vulnerable time for those with dementia, as patients commonly experience fear and aggression in response to the vulnerability of being undressed and bathed. Research shows that instances of aggression were greatly reduced when caregivers were simply trained to offer a variety of bathing styles, like:

• Sponge baths
• Under-the-clothes baths
• Showers
• Singing or music baths
• Aromatherapy baths

This method teaches the caregiver that it is up to them to find the path of least resistance for the patient. So bath time is as comfortable for the patient as possible.

Memory care questions? Get expert help

Advanced memory care training leads to lower mortality

The important Bathing Without a Battle peer-reviewed study showed how training caregivers to use person-centered communication and validation during bath time alone reduced aggression and antipsychotic medication use by 30 percent. This reduction has a major impact, as dependence on antipsychotics for dementia care can have dangerous side effects in dementia patients, like cerebrovascular and cognitive decline, as well as an overall increased risk of mortality. This is especially important for seniors already struggling with underlying health conditions.

Since the requirements of most memory care courses vary, so do the costs. Some courses that involve online training alone may only cost around $60, while in-person seminars can cost $200 or more. Typically, certification applicants can expect to spend anywhere between $60 and $230 for their initial memory care certification training.

How long does memory care certification last?

Some programs require renewals annually, while others remain valid for years. Most memory care certificates are valid for two years before renewal is required. Oftentimes, the renewal process is quicker and much less expensive than the initial certification.

Both the health care and senior living industries are constantly changing, adding new technologies and practices while retiring old ones. Continued dementia care education is the best way for caregiving professionals to stay up to date with the latest research, methods, technologies, therapies, and overall best practices.

Memory care professionals should renew their certifications every two years unless stated otherwise and should continue to take additional training courses. A common requirement for certification renewals is the completion of a set amount of continuing education units (CEUs).

What are continuing education units (CEUs)?

A CEU is a measure used in continuing education programs to help professionals maintain their license or certification. Professionals should research whether their certification or licensure requires CEUs, and, if so, how many and how often.

There’s a vast array of continuing education courses that focus on memory care. Many options can be completed online. Lessons may offer updated techniques on topics that were covered in the initial certification training. Other lessons may include new and fresh information and progressive research in the field.

Gerontology studies continuously show that person-centered care is essential to good dementia care. When touring memory care communities or interviewing in-home care caregivers, don’t hesitate to ask questions about their memory care training requirements and certifications. Your loved one deserves the most specialized and holistic support across all stages of their dementia journey.

To find best-in-class memory care for your loved one, inquire about the following when interviewing prospective caregivers or touring a community:

• The role of memory care caregivers. Memory care caregivers should always use best dementia-care practices, with more specialized methods than assisted living caregivers.
• How nursing plans are utilized. Nursing care plans in memory care should be highly person centered and account for your loved one’s individual, specific needs.
• How patient care is approached and managed. The different techniques and care approaches caregivers use should incorporate research-backed, person-centered practices.
• The role of memory care directors. Every memory care facility has a director to ensure smooth operation. Take note of how they oversee the staff and residents and the quality of the programs they promote.

Utilize these touring checklists to keep track of important information about prospective communities. If you still need help finding high-quality memory care in your area, reach out to a Senior Living Advisor at A Place for Mom for free, local advice.

Sources:

Center for Applied Research in Dementia. (2022). Why Montessori inspired lifestyle training?

Douglas, S., James, I., & Ballard, C. (2018, January 2). Non-pharmacological interventions in dementia. Cambridge University Press.

Fazio, S., Pace, D., Flinner, J., Kallmyer, B. (2018, January). The fundamentals of person-centered care for individuals with dementia. The Gerontologist.

Feil, N. (1992). Validation therapy with late-onset dementia populations. In G. Jones, & B. M. L. Meilsen (Eds.), Care-giving in dementia: Research and applications (pp. 199 – 213). Routledge.

Gozalo, P., Prakash, S., Qato, D., Sloane, P., & Mor, V. Effect of the Bathing Without a Battle training intervention on bathing-associated physical and verbal outcomes in nursing home residents with dementia: a randomized crossover diffusion study. Journal of the American Geriatric Society.

Kitwood, Tom. 1997. Dementia Reconsidered: The Person Comes First. Open University Press.

Lucas, J. & Bowblis, J. (2017, July). CMS strategies to reduce antipsychotic drug use in nursing home patients with dementia show some progress. Health Affairs.

Mbakile-Mahlanza, L., van der Ploeg, E. S., Busija, L., Camp, C., Walker, H., & O’Connor, D. W. (2020, March). A cluster-randomized crossover trial of Montessori activities delivered by family carers to nursing home residents with behavioral and psychological symptoms of dementia. International Psychogeriatrics.

Richmond, J. S., Berlin, J. S., Fishkind, A. B., Holloman, G. H., Jr., Zeller, S. L., Wilson, M. P., Rifai, M. A., & Ng, A. T. (2012, February). Verbal de-escalation of the agitated patient: Consensus statement of the American Association for Emergency Psychiatry Project BETA De-escalation Workgroup. Western Journal of Emergency Medicine: The University of California, Irvine.

Schneider, L., Dagerman, K., & Insel, P. (2005, October 19). Risk of death with atypical antipsychotic drug treatment for dementia; meta-analysis of randomized placebo-controlled trials. JAMA.

Snow, T. L. (2012). The GEMS®: Brain change model. Positive Approach to Care.

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