Though we do not yet have a cure for dementia, Joanna LaFleur is determined to find a better way to care for people suffering from this affliction. Owner of Memory Care group home in Michigan, Joanna sees two glaring problems with our typical memory care approach. First, she maintains, “We do not hire enough staff to adequately care for this population. Nor do we adequately train the staff that do work in facilities that care for the elderly. I’ve worked in elder care for fifteen years, in many facilities and home care situations. From that experience I know that our elders deserved something better.”
A Necessary Move
My family was fortunate. When my brother’s frontal lobe dementia made keeping him at home exhausting for his wife and dangerous for him, my sister-in-law found Memory Care Lane. Established by LaFleur in 2016, it is a small group home. Residents participate in household chores to the level they are able, and have opportunity to participate in a variety of social and recreational activities. The day time ratio of staff to residents is one to three. The overnight ratio is one staff for six residents. Doors are not locked, but the staff is alerted any time an outside door opens.
At one point my brother became so agitated he had to be taken to the hospital, to calm him down and adjust his medications. The hospital intended to send to him an inpatient facility some distance from my sister-in-law. Joanna stepped in and insisted he would return to Memory Lane. By then he was familiar with the home and the routines there. She had adequate staff to respond to his needs, and that staff had adequate training to help him thrive as much as possible.
A Mission to Do Better
Joanna LaFleur is on a mission to change the way to care for people with dementia. Her grandmother’s situation was part of what motivated her. Her grandmother struggled with Alzheimer’s. At first, she lived quasi-independently in a large facility some distance from her family. Joanna recalls her grandmother spent most of her time alone in her private apartment. When the family decided to move Grandma closer to Joanna’s mother, Joanna found a small group home for her. Once settled, Grandma left her room more often to sit in the living room, socializing with other residents, or out on the deck, listening to musicians who came to provide diversion.
Joanna’s grandmother’s story is part of what prompted her to take on this mission. Initially she was studying to become an elementary education teacher. That changed after she got a part time job working as an assistant activities director in an assisted living facility. She changed her major to Therapeutic Recreation. After completing her degree at Eastern Michigan University, she worked in six different nursing homes in six years.
Disgusted with Horrible Conditions
“I was disgusted with the horrible conditions I saw and was very vocal about it. Administrators said I was ‘too sensitive.’ But I knew we could do better than this. A one to four staff:resident daytime ratio is required for optimal care, with a one to six night time ratio. In some of facilities the ratio is one caregiver to thirty patients. The people providing the most direct contact do not get the appreciation they deserve. This is reflected in their low salaries and the lack of adequate training they get. No wonder there are so many incidences of abuse and neglect. Many of the care-givers are responsible for double, or even triple, the number people they can effectively manage.”
Joanna worked in home health care for a while, doing administrative work, but recalls, “I just kept thinking, we can do better than this. I took a leap of faith and spent a couple of months designing a website, preparing brochures, putting together a business plan, while working as a waitress to support my family.
A Home I’d Want for Mom
“I designed my home by thinking about what would I want for my mother or grandmother. That influences everything from how we designed the rooms, to the activities we provide, to the food we serve. Too often dementia people are evicted from a place because they get violent. Some private places charge $10,000 a month, but don’t provide a good staff to patient ratio. They have beautiful facilities with inviting entrances and all sorts of perks, but they don’t hire enough staff, don’t pay the staff according to the level of services they provide, and don’t invest in training to help them work with people who get agitated and violent. Instead they either over medicate the patient or evict them.
“My hope is that more people would understand dementia better. There’s a stigma about people who develop dementia, but they can’t help some of the behaviors they do that frustrate others. We focus too much on what they can no longer do, and we do not adequately realize this is a disease of the brain. It is an illness. They act out because they are hurting. I don’t think things will really get better unless we change the laws to regulate a better staff/patient ratio and require more training. My goal is to change the elder care industry and insist places either have the right level of care or close.
Teepa Snow has made huge strides in educating people about better approaches for working with dementia people. She provides resources for family and helps people develop more empathy for the dementia patient. https://teepasnow.com You can learn more about Memory Lane here.
If you found this blog helpful, you might appreciate these additional resources from the Mayo Clinic.