Technology has come such a long way and has provided us with so many life changing conveniences, many of which I never thought would even exist today. We have computers, cell phones and my all time favorite, the internet! Not to forget all the apps that simplify processes and makes life so much easier, right? Are these conveniences really making our lives easier or does it seem to be keeping us from one of the greatest things that life has to offer?

As I sometimes observe people (of all generations), I think about how these life conveniences have taken over our lives, often keeping us from interacting with anyone or anything besides our technological devices. It surprises me that people in general would choose spending a significant part of their day interacting with an inanimate object versus another human being.

Working with seniors has taught me valuable lessons throughout my career, often creating these moments of what I call, “Epiphanies of a Caregiver.” It’s that amazing moment when you realize something makes total sense and how could it not before? For those who know me, reading or learning something new must always be reinforced through some sort of “hands on” experience, thus creating that “epiphany!”

It All Started with Helen

One evening, while working late, I sat in the office (at my computer, haha…) completing the many assessments that came along with the everyday responsibilities of being a manager at an assisted living company. It was a long day after overseeing our residents’ care, putting out fires and guiding our team members…which was a pretty normal day for me. I was exhausted, but focused on getting things done for the night. Later that evening, Helen (names changed for privacy) walked into the office and as we made eye contact she said to me, “Why are you still here? It’s late and you’ve been here since early this morning.” I was speechless and almost broke into tears (I can be quite emotional at times). It surprised me that Helen would say something like this. First of all, Helen suffered from having moderate cognitive loss, so how could she possibly remember what time I got in that morning?! But more importantly, did she actually care enough about me to express her worries? I gave her a big hug and thanked her for noticing. She then proceeded to tell me she needed to go and check on her dog, in her car, in the parking lot. As we sat and talked, I validated her feelings and later asked a team member to escort her to check on her dog. I left that evening, touched, but mostly confused. I thought about our conversation for several days, in fact, which led me to reflect on our relationship in general.

I first met Helen when she moved into our memory care neighborhood. Helen was a homemaker with a kind spirit, talkative and headstrong. Spending time with Helen included conversations about her love for animals, helping to sweep the patio or setting the tables for lunch. Helen found her purpose through the pursuit of life skills and taking care of others; the very same ideals a mother or homemaker would possess. As time progressed, keeping Helen engaged in activities and life skills became more of a challenge. Our team was diligent and supportive of those needs. The one thing we did struggle with was the fact that Helen would constantly ask to go and check on her dog, in the car, in the parking lot. Helen’s persistence was often redirected with other conversation or engagement in pet care or life skills. This approach failed to work after a while and Helen started to become more anxious over time and sometimes even angry, yelling at team members to let her go and check on her dog. This would happen periodically throughout the day, but would usually worsen in the later afternoon hours. At first, I thought it was typical sundowning, but as it turns out, it was not.

As a team, we tried various interventions, but nothing seemed to keep her engaged for more than a half hour or so. It wasn’t very long before Helen started asking to go and check on the dog again. Sometimes she would sit in a chair, near the exit door, waiting for it to open. Those of us who have worked in memory care know this is a bad idea, letting someone who is potentially exit seeking, sit next to an exit door. So, we designated someone to sit with her, every time, everyday.  It was a great intervention, however, not a long-term solution to Helen’s exit seeking tendencies or figuring out why she was so adamant on checking on her dog, in the car, in the parking lot.

Finding a Resolution

Over time, I could see this was taking an emotional toll on Helen, as well as, the team. Helen didn’t seem happy anymore, in fact, she was unhappy. Helen didn’t smile like she used to or seem to want to partake in the life skills that once gave her purpose. Her daily purpose now was “going to check on her dog.” Why was it so important she check on her dog? Was she having delusional thoughts about this dog being in some type of trouble? Was this a memory she was reliving? Then, it dawned on me……that epiphany! “Let’s let her check on her dog, in the car, in the parking lot!” Easier said than done, right? All I could think of was her previous history of wandering out of her home, which was the very reason she came to live with us in the first place. What will we do if she doesn’t want to come back in?

I sat down with our team and mentioned the idea. Everyone looked at me like I was absolutely crazy and of course said, “What will we do if she doesn’t want to come back in?” I responded by telling them, “then we’ll all take turns walking with her.” We came up with a brilliant plan (her family was aware of everything we were doing throughout this time) to have our programming lead take her (the one team member I felt she trusted the most).  I would follow, just to observe and be there for support if something happened. So, the very next time Helen asked to go and check on her dog, in the car, in the parking lot, we helped her do just that.  It was amazing to watch our programming lead tell her “ok, let’s go and check on your dog.” Helen’s face lit up as she took her hand and walked to the parking lot. When we got there, Helen immediately walked through the parking lot, carefully checking each car. She looked discouraged as she told us her car wasn’t in the parking lot. We empathized with her and validated her concerns while she proceeded to walk around a few more times before she asked to go back inside. We walked her in just in time for dinner and sat her with her friends. Funny thing is, she never asked about the dog the whole time we were outside….

It was amazing to watch our programming lead tell her “ok, let’s go and check on your dog.” Helen’s face lit up as she took her hand and walked to the parking lot.

The Result

The next day, our team reported that she did not ask to go and check on her dog the rest of the night. We were on to something, something wonderful, in fact! I was excited we finally found a resolution for Helen. From then on, whenever Helen asked to go and check on her dog, we took her for a walk around the parking lot.  She always seemed less anxious after those walks and she never once tried to leave. Maybe she needed some fresh air or just needed to go for a walk? I believe her family did mention she enjoyed taking walks (another epiphany!) prior to moving in.  Those walks eventually turned into scheduled walks two or three times a day. Then finally, walking the dog three times a day at scheduled times. Helen rarely asked to check on her dog, was smiling more, laughing again and even partaking in the life of the neighborhood as before. She slowly became that motherly figure we all missed having around. Her family was extremely happy to see Helen enjoying life once again, having purposeful days and was most appreciative of having people around her who cared enough to want to figure out what Helen was actually needing or missing in her life.

Helen rarely asked to check on her dog, was smiling more, laughing again and even partaking in the life of the neighborhood as before.

As I sit and think about this in retrospect, I ask myself, “what drove us to do what we did for Helen?” The one thing that comes to mind immediately was the fact that I (we) absolutely loved Helen, very much, as we did all of our residents. You see, when you spend significant time with people (and I don’t mean texting, Facebook, Snapchat or Instagram), especially in the type of environment we work in, relationships commonly develop over time. As these relationships flourish, you genuinely start to care for your residents and I mean that literally. It pained me to see anyone in distress, discomfort or physical pain. My normal reaction, of course, was to help make it better. All people, even those who live with dementia, are capable of developing relationships with others. It was evident Helen cared for me just as much as I did for her, the moment she said, “why are you still here?” One of the greatest moments life offered me that day.


Written by Rae Ortiz

Senior Director of Resident Services

Rae has over 26 years of long term care experience serving the senior population in both Assisted Living and Skilled Nursing Communities.