Training Tool Kits (Contents)
Acknowledgments
Dedication
Introduction

The Best Friends Model

• Staff with Knack: Being Well Informed
• Having Empathy
• Respecting the Basic Rights of the Person
• Maintaining Caregiver Integrity
• Employing Finesse
• Knowing It Is Easier to Get Forgiveness than to Get Permission
• Using Common Sense
• Communicating Skillfully
• Maintaining Optimism
• Setting Realistic Expectations
• Using Humor
• Employing Spontaneity
• Practicing Patience
• Developing Flexibility
• Staying Focused
• Remaining Nonjudgmental
• Valuing the Moment
• Maintaining Self-Confidence
• Using Cues that Are Tied to the Life Story
• Taking Care of Oneself
• Conclusion

Staff Recruiting, Training, & Development

• A Day in the Life of a Skilled Nursing Facility Administrator
• Recruitment and Hiring: Potential Employees
• When Staff Fail
• Training and Retention: Training Programs that Do Not Work—The Old Idea Care Center
• Training Programs that Work—The New Idea Care Center
• Ideas for Training Programs that Work
• Conclusion
• Training Tool Kit

Medical & Scientific Basics

• What Does the Word Dementia Mean? Is It the Same as Senility?
• What Is Alzheimer’s Disease?
• What Is the Difference Between Alzheimer’s Disease and Normal Age-Associated Memory Loss?
• What Are the Related Irreversible Dementias?
• What Are the Most Common Irreversible Dementias in Older Adults?
• What Are the Related Reversible Dementias?
• Should Everyone Who Has Symptoms Get a Thorough Diagnosis?
• Are All Persons with Alzheimer’s Disease Alike?
• Can Alzheimer’s Disease Be Inherited?
• Can Alzheimer’s Disease Be Prevented?
• How Can Excess Disabilities be Prevented?
• Do Sudden Changes Suggest Problems Other then Alzheimer’s Disease?
• What Is the Role of Psychotropics and Other Drugs?
• Resources for the Best Friends Staff
• Conclusion
• Training Tool Kit

The Experience of Alzheimer’s Disease

• When Staff Don’t Get It
• The Best Friends Way
• To Know Someone, You Must Walk a Mile in His or Her Shoes
• Person-Centered Care Is Central
• Losses Caused by Dementia Can Evoke a Wide Range of Distressing Feelings and Emotions
• Persons With Dementia Can Experience Joy, Love, and Happiness
• The Feelings of Persons with Dementia Are as Real as Yours and Mine
• Behaviors that Seem Out of Place Are Not
• Feelings and Behaviors Can Be Changed by Meeting the Needs of the Person
• Conclusion
• Training Tool Kit

Assessment & Expectations

• Why Assessments Often Fail
• The Best Friends Assessment: Review Physical and Mental Health
• Review Cognitive Health
• Assess Who the Person Is
• Assess the Care Environment
• Emphasize Remaining Strengths
• Do Not Overemphasize Stages
• Individualize Care Plans
• Assess Frequently as a Caregiving Team—Persons Vary from Day to Day
• Assess Combative Behavior Carefully
• Set Realistic Expectations
• Share Information with Families and Other Visitors
• Conclusion
• Training Tool Kit

Friendship

• Friends Know Each Other’s History and Personality
• Friends Do Things Together
• Friends Communicate
• Friends Build Self-Esteem
• Friends Laugh Together Often
• Friends Are Equals
• Friends Work at the Relationship
• Friends Show Love and Affection
• Friends Can Overcome Social Barriers
• Conclusions
• Training Tool Kit

The Life Story

• Every Program Should Obtain a Person’s Life Story Before Admission
• The Life Story Should Be Accessible to Staff and Volunteers
• Every Dementia Care Program Should Have on File a Written Life Story on Each Member or Volunteer
• Use the Life Story to Greet the Person and Improve Recognition
• Use the Life Story to Introduce and Reintroduce Residents to Individuals Around Them
• Use the Life Story to Reminisce About the Person’s Life
• Use the Life Story to Provide One-to-One Comforting Care
• Use the Life Story to Improve Communication Through Clues and Cues
• Use the Life Story to Improve Activities
• Use the Life Story to Point Out Accomplishments
• Use the Life Story to Prevent Challenging Behaviors
• Use the Life Story to Incorporate Past Daily Rituals
• Use the Life Story to Broaden the Caregiving Network with Volunteers
• Conclusion
• Training Tool Kit

Communication

• Check the Environment
• Remember the Basics of Good Communication
• Use the Person’s Preferred Name
• Make a Good First Impression
• Keep Language Simple
• Ask Questions Using Discretion
• Employ Good Timing
• Be Conscious of Nonverbal Communication
• Do Not Argue With or Confront the Person
• Remember that Behaviors Communicate a Message
• Treat the Person as an Adult
• Use the Life Story Often
• Maintain Caregiving Integrity
• Respond to the Persons’s Emotional Needs
• Screen Out Troubling Messages or News
• Speak Using Positive Language
• Employ Humor
• Turn “No” into “Yes”
• Do Most of the Work
• Conclusion
• Training Tool Kit

Being Together Using Best Friends Activities

• An Activity Philosophy
• Purpose of Activities
• The Art of Activities Is Not in What Is Done; It Is in the Doing
• Activities Should Be Individualized and Tap into a Person’s Past Interests and Skills
• Activities Should Be Adult in Nature
• Activities Should Include Pets and Other Animals
• Activities Should Recall a Person’s Work-Related Past
• Activities Should Stimulate the Five Senses
• Doing Nothing Is Actually Doing Something
• Activities Should Tap into Remaining Physical Skills
• Activities Usually Are Initiated by Others
• Activities Should Be Voluntary
• Everyone Can Still Engage in Some Form of Activity
• Intergenerational Activities Are Especially Desirable
• Activities that We Think Will Never Work Sometimes Do
• Activities Should Appeal to the Staff as Well as to the Person
• Personal Care Is an Activity
• Activities Can Be Short in Duration
• Activities Can Happen Day or Night
• Activities Can Fill a Spiritual Need
• Activities Are Everywhere
• Conclusion
• Training Tool Kit

Caregivers as Members of the Best Friends Team

• The No-Clue Day Center
• The Best Friends Way
• Understand that the Definition of “Family” Is Changing
• Remember that Each Family’s Response to Alzheimer’s Disease Is Unique
• Realize that Placement Does Not Always Make Things Easier, Only Different
• Share a Defined Philosophy of Care with Families
• Believe that Most Families Are On Your Side
• Create a Care Plan for Families
• Never Give Advice
• Involve Families in Care Decisions and in the Program
• Develop Honest, Effective Dialogue
• Handle Conflict Appropriately
• Encourage Use of Services
• Help Families Recast Relationships
• Conclusion
• Training Tool Kit

Conclusion

• Invest in Staff
• Treat Staff with the Same Respect that Good Programs Give Their Residents or Participants
• Recognize that Staff Have a Desire to Be Part of a Caring Community
• Give Staff the Tools that They Need to Build Effective Job and Life Skills
• Involve Staff in Decision Making
• Recognize that Leadership is Vital to a Program’s Success
• Encourage Staff to Be Involved with Residents and Participants Through Group and Individual Activities
• Assign a Best Friend to Each Staff Member
• The Best Friends Model as a Tool for Change

Notes and References
Appendix A: Programs Featured in The Best Friends Staff
Appendix B: Professionals Featured in The Best Friends Staff
Appendix C: Suggested Resources for Trainers
Index