Dementia-friendly communities get down to business

They say the sign of a dementia-friendly community or business is how sensitive they are to both caregivers and patients as they deal with various forms of dementia, including Alzheimer’s disease.

The condition has been called “the long goodbye,” but Wisconsin communities and businesses can make the journey less arduous by educating their staffs in what to look for in dementia patients, training them to help patrons with signs of dementia, and taking steps to make their business environments more accommodating to people with dementia.

Whether the customer is a business patron or a taxpayer inquiring about a government service, there is caregiver comfort in knowing that employees are sensitive to people dealing with dementia. Age is the most significant (and unavoidable) risk factor, and those who have reached 65 years of age comprised 12.3% of Dane County’s 2015 population, up from 10.3% in 2010, according to the U.S. Census Bureau. That represents more than 64,000 who have reached retirement age and could fall victim to some form of dementia.

Nationally, the number of people age 65 and older with Alzheimer’s disease is estimated to reach 7.1 million people by 2025, a 40% increase over the 5.1 million age 65 and older that were affected in 2015.

Bonnie Nutt, programs and advocacy manager for the Alzheimer’s Association of South Central Wisconsin, notes the dementia-friendly movement began overseas in 2010 and remains grassroots to the core. “The dementia-friendly designation can be achieved in a variety of ways,” she says. “It’s a grassroots movement and nobody really governs it.”

The community’s business

Nutt says a dozen Dane County communities have either achieved the designation or are in the process of pursuing it — Cottage Grove, Cross Plains, DeForest, Fitchburg, Middleton, Monona, Mount Horeb, Oregon, Stoughton, Sun Prairie, Waunakee, and Verona. The North/Eastside Senior Coalition in Madison also is part of that group.

The city of Middleton officially received the designation in January 2015 and the rationale for pursuing it was mission based. “We are here to serve the public and that means everyone,” says City Administrator Mike Davis. “That’s a very important part of our mission.”

A former volunteer coordinator for the local senior center, a department of the city, suggested the Middleton Common Council approve a resolution to become dementia friendly, and it obliged in 2014. “We had some businesses that got on the bandwagon right away,” Davis notes. “I know that Walgreens did and a few banks did, as well, and then we gradually got at least 50% of our employees, in each major department, the training provided by the Alzheimer’s and Dementia Alliance of Wisconsin.

Davis praises both city employees for their eagerness to learn more about serving citizens with dementia and the training provided by the Alzheimer’s and Dementia Alliance. “They came to us onsite,” he notes. “We gathered the employees and had about five different trainings in various department areas, and within a half-year we became a dementia-friendly community based on the training of our employees.”

He says that even without aging there is the prospect of dementia, and it’s become more widespread in society. “It’s important for us to be able to work with all members of the community,” he notes. “It helps not only people who are dealing with parents or themselves or maybe their spouse with dementia, it helps them to know that they live in community and do business in a community that cares about everyone.”

Diane Mikelbank, director of the Monona Senior Center, is leading the way to gain dementia-friendly status for the Monona community. Last September, the Monona City Council approved a resolution in support of this movement. “One of our goals is to encourage the practices of hospitality and inclusion to those affected by dementia by promoting acceptance and engagement in our community,” she explains. “We feel that — not only in our city government offices but also in local businesses — it’s important to give those reminders that it’s basic customer service.”

The Monona Area Dementia Friendly Coalition is trying to get as many businesses as possible to earn the dementia-friendly designation. Since a kickoff event earlier this year, it has provided dementia-friendly training in several city departments and in businesses. They include Walgreens, which staged a “Shop in their Shoes” event to give workers a better understanding of the struggles associated with dementia, plus Haskins Short LLC and Home Instead Senior Care. Walgreens also initiated some of the training, including sensitivity training, with its staff.

The state of Wisconsin has a dementia-friendly toolkit, but there are several resources to rely on. The Monona coalition developed its training program with help from the Dane County Aging and Disabilities Resource Center, which has a dementia specialist in Joy Schmidt, and it also works with a representative of the Alzheimer’s Association. “They work with several communities that are working on the dementia friendly initiative,” Mikelbank explains. “They share with us what other communities have found successful, and we created what would be the most appropriate for Monona.”

For Mikelbank, becoming dementia friendly contributes to both community and business development. One of Monona’s goals is to encourage the practices of hospitality and inclusion by promoting acceptance and engagement. “We try to tell people that it’s always good to keep in mind that some people with dementia and their caregivers are going through some extra struggles,” Mikelbank notes. “If we can be extra sensitive to them, it will keep them more comfortable in our community, patronizing our businesses for as long as possible.”

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Dementia-friendly fundamentals

There are three fundamental characteristics of a dementia-friendly business, according to Schmidt. First, at least 50% of employees have been trained in what to look for, including whether somebody has cognitive issues, struggles to communicate, or appears lost or confused. They have been trained to do things like make eye contact, pay attention to the customers’ body language, and even smile to offer reassurance.

Second, the same percentage of employees already have undergone 1) training on ways to communicate what they can do to help patrons with dementia and 2) training on how they can adjust their approach to help them.

Third, a dementia-friendly business is open to suggestions about the business or store environment, including changes to simplify signage or provide better directional signage toward restrooms, improve lighting, and install more basic carpeting without the busy patterns that can be confusing to seniors with dementia.

“Some of these suggestions are for caregivers, as well, because a lot of times, especially as the disease progresses, caregivers will be with the person most affected,” Schmidt says.

Municipal matters

Davis and Mikelbank agree with the belief that that different locales can contribute to longer and more active lifespans by establishing “micro cultures” that accommodate health and wellness.

“I’m not that familiar with the science but from what I’ve read, there are means by which to extend the lives of dementia and Alzheimer’s patients, as well as their faculty for dealing with issues,” Davis says. “If part of that is emotional wellbeing and support, then that’s the way a community can approach it and that’s what we’re trying to do. Hopefully we’re complimenting what the medical profession and health care providers are able to do.”

Mikelbank, who has worked at the Monona Senior Center for 15 years, believes the dementia-friendly approach can prevent isolation. “I hear a lot of people come in and they say that coming into the senior center just feels good,” she notes. “There is kind of a feeling that we can make happen for people who are regular attendees here. If we make you feel welcome when you come in, you are more likely to come back. If people come back more often they are likely to have a better social network, so it’s good for their mind, body, and spirit if they have friends and acquaintances and somebody to turn to.”

Word of a business that has undergone the training can spread quickly among caregivers and support-group facilitators. “They will support a business that goes through the training,” Nutt says, “versus one that has not.”

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