Developing a different approach to dementia care
DAWN method creator stresses client well-beingApril 21st, 2016
Senior caregiver Judy Cornish realized a few years ago that her dementia patients relaxed more if she chatted with them regularly about what was happening.
Her friendly bantering used intentional words giving clients needed information to offset their loss of memory and rational thought processes, says Cornish, owner of two Moscow, Idaho-based businesses related to dementia care.
Since 2010, Cornish has developed dementia-care methods and training she says differ from a majority of others in the industry because of a focus on the clients’ own sense of well-being. Her approach offers ways to help them feel safe and healthy at home as long as possible.
Cornish operates Palouse Dementia Care LLC, a Latah County in-home caregiver service, and the Dementia & Alzheimer’s Wellbeing Network (DAWN) LLC for widespread education, training, and consulting services. She teaches about her methods in both Moscow and Spokane.
“The DAWN method itself is a set of tools,” Cornish says. “I define the problem differently than the rest of the country.”
For dementia patients, their inability to understand and complete activities often leads to confusion, irritability, frustration, even fear, Cornish says. “I started managing moods so there’s always a pleasant frame of mind, and they start to feel secure with me.”
Cornish says she’s witnessed multiple times how dementia patients still enjoy beauty in their surroundings and joy in the moment, after feeling more relaxed with a caregiver. The patients have retained those intuitive thought processes, although they’re losing logical thinking skills.
She adds, “One of the women I cared for, she loved the scenery of the Palouse. She’d get out of the car and say, ‘Judy, look at the sky.’ She was an artist and she’d tell me, ‘That’s cerulean blue or robin’s egg blue.’ As years went by, she’d say ‘Look at the clouds, they’re pretty,’ and then, ‘Look at the fluffies.’”
When she later wouldn’t say any words at all, Cornish would point the sky out to her. “And she just lit up. She didn’t lose the ability to enjoy it, but the words went away.”
Though people with dementia lose the ability to see cause and effect, call up facts, organize those facts and see correlation, they can still be made to feel more comfortable, Cornish adds. If a caregiver takes someone with dementia to buy food, the client might forget why they’re in the car by the time they reach the grocery store.
“The person might look up at Safeway and not remember that name means a grocery store,” Cornish says. By then, she adds that the caregiver might say, “Here we are at the grocery store. I just love Safeway,” while mentioning items inside. “While you’re chattering away, what you’re really doing is giving them all the facts.”
Another example gently leads the person in deciding what to wear. The caregiver could point at snow outside a window, among other conversational clues.
“You’re giving them what they’re losing,” Cornish says. “That’s how you’re giving them more security. You’re presenting the facts when they need them, as they need them. It gives them some peace. They get comfortable, especially when family is doing it as well as the caregiver.”
In 2013, up to 5 million Americans were living with Alzheimer’s disease, the most common form of dementia, according to the Centers for Disease Control and Prevention. People in early and moderate stages of dementia suffer cognitive problems to a varying degree, including memory loss, personality changes, and difficulty expressing themselves.
Cornish has developed a series of eight one-hour PowerPoint training classes she teaches to families and their professional caregivers. She travels usually twice a month to Spokane at the request of families, and she also regularly instructs in Moscow.
The DAWN training has an introductory “Dementia Care 101,” a topic Cornish separately gives as a singular speech without charge for church and civic groups. Additionally, the series covers seven tools: mood management, security in confusion, security in care, social success, sense of control, sense of value, and secure future.
Cornish’s background is as an elder law attorney licensed in Idaho and Oregon. She also previously worked in vocational rehabilitation with people who have brain injuries and as a qualified mental health associate working with the mentally ill.
“I have a background in language, and the errors people make are always logical,” Cornish says. “When I began providing dementia care, I came at it from a different perspective.”
She also considered emotional needs driving behavior under psychologist Abraham Maslow’s hierarchy of needs in “A Theory of Human Motivation.” They include a person’s desire for individual growth or self-actualization, but also basic needs such as for food, shelter, safety, love and belonging.
“We still have those primary security needs,” Cornish says, and the DAWN method defines the emotional distress that comes from cognitively-impaired problems because of dementia. “The majority of the industry defines the problem by the behaviors, and the behaviors look random. If you define the problem as emotional distress, you can respond appropriately.”
In 2010, Cornish hadn’t planned to shift careers into senior care after a move from Oregon to Moscow. A family hired Cornish to take care of her friend and neighbor who had Alzheimer’s. Within two weeks, word-of-mouth spread, and Cornish began caring for a second neighbor who had the condition.
She soon realized her work centered on dementia care so people could stay longer in their homes, so Cornish wrote a business plan by fall 2010 and initially formed Hearth & Home Senior Care Services LLC.
By 2014, Cornish split her business focuses, changing the Hearth & Home name to DAWN to develop a formal training program and consulting services. Separately, the caregiver services became Palouse Dementia Care, and it has five caregiver employees in addition to Cornish. Overall, the caregiver business has provided services in homes for 35 cases since 2010.
“I trained my own staff to use the same approach and tools I used,” she says. “Then I started training the families, so they could support the caregiver and their loved ones in the same manner as the caregiver.”
Cornish says the eight-class DAWN series costs $1,050. She doesn’t limit the number of family members attending. Cornish also uses an online meeting service so family members living remotely can participate, seeing both the presentation and onsite participants.
In Spokane, she has taught on the South Hill in the Forza Coffee conference room and at Manito United Methodist Church.
“When I’m training a family, I keep it specific to family needs,” she says. “Dementia care is personal, so I don’t like mixing two families.”
She currently handles Palouse Dementia Care’s case management. Separately, her consulting has helped about 10 to 12 families without actual in-home care. She also has written a book, under the working title “Dementia With Dignity,” and is now seeking an agent and publisher.
“The name DAWN is to focus on hope and a new method for dementia care,” Cornish says. A friend encouraged her to expand it as a network and write the book for families. “It’s a way to put off long-term care in a facility.”
She adds, “I’m an elder law attorney, and elder law attorneys have known for decades the tremendous financial burden placed on families from putting one person into long-term care.”
Enabling people to stay in homes longer is especially beneficial in rural areas such as the Palouse, which has minimal care facilities, she adds. Her next plan is to create an online DAWN training program, a project she currently is developing.