Webinar Replay Pillar 4: Exceptional Caregiving

Including your own self-care!

This is part 4 in a 4-part series on the 4 Pillars of the Marama Alzheimer’s reversal lifestyle. 

At Marama caregivers are on site, awake and available 24 hours a day 7 days a week. There is always someone in the building who can help and always someone in charge. 

The training at Marama is specific to our expectations. So many times, when a patient moves into a residential care facility, the expectation is that they will get worse. The story that we’ve heard over and over again, is that my loved one moved into an assisted living facility and they immediately went downhill: their cognitive function, their health, their movement, their heart disease.

And part of that is the diet—it’s not a brain healthy diet at typical facilities. The average amount that is spent per day on resident meals in the state of California is seven dollars for an entire day. We spend about $10 per meal, per resident at Marama, or $30 a day. That is because we are committed to getting an organic ketogenic diet with very, very high quality, nutrient dense foods. When there’s king salmon in season it’s on the menu at least twice a week. 

So the expectation at Marama is people get better when they move in. When staff expect it, residents will rise to that expectation. When the expectation is that someone will get worse, they will often succumb to that. Our residents and our staff expect to get better, and they do! I think that’s a big part of it.

The other benefit that we have is that we are NOT family. Our team does not take things personally. We are not remembering something that happened 20 years ago and making what mom just forgot about that incident from decades before. We all have dynamics and patterns in our families and when the resident is separate from that, in an environment expecting improvement, it is fun to watch what is possible.

We also want to inspire you at home. Here are some really great tips for how to engage, how to redirect, and how to encourage people.

Something that we do is whenever a resident walks into the room, we say, “I’m so excited you’re here! I’m so happy to have you here—I’m so happy to see you. We all want you to be here!” And we have residents say, “Thank you for saying that! That means so much to me.”

When someone gets up and starts to leave an activity and we want them to participate we use language like “where are you going? We’re going to miss you. We don’t want you to leave. And oftentimes, they will turn back around and respond, “oh, I’m gonna be missed!? I’m going to stay right here.”

Being seen, heard, feeling included and involved is so important for every human. In order to get the benefits of being at Marama residents need to be engaged and participating. We put a lot of effort into supporting that with our attitudes. An excited, positive, uplifting attitude and behavior around them, that’s going to bring their mood up, and they will want to stay and want to be with the group. 

Medications & Supplements

Medications & Supplements can feel very overwhelming. What to take with food? Away from food? Together? Apart? Before bed? On waking? Need refills? Can I get them in time? Do I keep taking this? There are so many questions and concerns that understandably come up when it comes to the complex supplement and medications typical of the Bredesen approach. 

Lexi and Joann help us keep all of this organized and on schedule at Marama. Lexi doubles as  a fabulous keto dessert chef. She’s doing double duty much of the time as many caregivers all over the world are. Lexi’s primary job is to make sure that we are following your doctor’s orders to a T.

A couple of the residents at Marama have been my patients. Lexi and I have had countless opportunities to clarify and talk about why certain medications need to be at a very specific time. They just won’t work as well if we aren’t properly following the directions. 

For example, thyroid medication needs to be taken well before breakfast—30 minutes to 45 minutes before breakfast and before any other supplements. Our residents who need it are getting their thyroid medication at the right time in the morning away from everything else, so that it works best. 

They’re also getting the right medications with food, the right medications away from food. I have closely followed the work of Dr. Neil Nathan and like Dr. Bredesen’s protocols, Dr. Nathan’s approach to recovering from mold can feel complex. It is still worth it because it is effective! On Dr. Nathan’s protocol there are a lot of binders with mycotoxin detox, other detoxification, and heavy metal detox. Those need to be away from food. This is really important so they aren’t binding the nutrients in your meals and they get a chance to bind the toxins they are meant to. At Marama, our caregivers know what’s best taken away from food, what’s with food, what’s before bed. All of these things are quite nuanced and can be a bit challenging to implement at home at first. It is hard work and it is worth it! If you need extra help I suggest reaching out to a nursing school near by to see if anyone is looking for part time work and to get experience helping with med management. 

Lexi and Joann don’t just make sure the residents are getting their medications and supplements as the doctor intended, they are also doing the time-consuming tasks of getting things refilled, contacting the doctor’s office, following up with the pharmacy, and making sure it will arrive before we run out. 

For all of you caregivers at home, you know how much time and effort this takes. And she is meticulous about making sure everything is recorded. That’s also part of our licensing, that everything is centrally stored, managed and documented.

This can be frustrating for our more independent residents. They want to keep their supplements or keep their medications in their room. With our license, under the state of California and under the law, we need to have everything in a locked cabinet. This is to keep everyone safe. We are responsible for preventing residents from taking the wrong medication at the wrong time or in the wrong amount. Our MedTech team takes full responsibility.

COVID Prevention at Marama

All of our activities have fluctuated at Marama with COVID. Our number one priority is patient safety and general mental health. We don’t want to negate all of the great benefits of the program having residents completely cut off from loved ones and the activities that make life enjoyable. 

We currently test staff and guest teachers or musicians regularly and more frequently than suggested or mandated by the state. We really aim to keep this exceptionally safe. We also ask any visiting family to test after travel and before entering the facility. We host shared meals outside. Staff and visitors are required to wear masks anytime they are on the property. 

We were very fortunate this past year that not one resident got COVID.

We did have six staff over the course of the last 18 months who suffered with COVID. We are grateful they have all fully recovered and we were able to keep it out of the building and from affecting residents, thanks to our testing and safety protocols. While we can make no promises as COVID variants arise and the world continues to change, we remain vigilant against COVID. We greatly appreciate everyone’s support protecting our elders, those most vulnerable to COVID. 

Read all 4 Pillars: 

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