BATTLE GROUND — I’ll have the mac ‘n’ cheese, please. And along with my meal, I’d like to have a heaping helping of dignity.
No customers ordered in quite that way Wednesday afternoon at Russell Brent’s Mill Creek Pub. They didn’t have to, because dignity was the dish served with every interaction between the waitstaff and the diners with dementia.
They came to Mill Creek Pub, along with spouses and caretakers, for the trial run of its new Supper Club, a 90-minute gathering of people with Alzheimer’s disease or any other condition associated with dementia.
A few weeks earlier, the staff received basic training in how to serve people whose short-term memory and physical abilities may be anywhere from faltering to gone, and whose emotions may veer from perfectly content to unaccountably upset. If the latter happens, Julie Williams of Home Instead Senior Care told them, try changing the subject. Try complimenting their sweater, or asking about their favorite foods or even talking about the weather. Or just try apologizing for whatever it is, even if you’re not actually responsible for anything amiss.
You cannot win an argument with someone living inside delusion, Williams said.
“You’re not living in your world anymore. You have to live in theirs,” she said. “We teach redirection all the time. It’s possible to forget the argument.”
If You Go
• What: The next scheduled meeting of the Mill Creek Supper Club.
• When: 3 to 5 p.m. Jan. 6. But owner Russell Brent said he wants Mill Creek Pub to be the “safe place” for people with dementia anytime it's open. Just call ahead to let the staff know you’re coming, he said, and they’ll be ready for you.
• Where: Mill Creek Pub, 1710 S.W. Ninth Ave. in Battle Ground.
Fortunately, no conflicts or problems emerged during what Diana Kretzschmar, an adviser to this effort who works with Prestige Care of Camas, called the beta test of Mill Creek’s Supper Club. A small crowd of invited guests turned up at 3:30 p.m. Wednesday and occupied one corner of the restaurant. All event diners seemed appreciative of the respect they were served with their food.
They ordered off of what Brent seemed slightly embarrassed to note were simple picture menus. Maybe that’s not necessary, he mused. But maybe it is. During the training, Williams pointed out that some people with dementia might forget what’s on one side of a page when they turn that page.
“There are all different kinds of dementias,” Kretzschmar said, but short-term memory problems are the common thread. People who get confused easily, or who realize that they’re making mental mistakes or losing abilities also get embarrassed or humiliated easily, Williams said, which is why some might have a rough go of it and others have stopped going out at all.
That’s a sadly shrinking world for spouses and caretakers, as well as the person with dementia, said Moira Quilling, who was at Mill Creek with her husband, Jerry, a charming, funny, even articulate guy who seems perfectly fine at first glance, until you notice how he’s enduring that classic Parkinson’s disease tremble and grasping for certain words.
He’s aware of what’s up. He described his Parkinson’s and his back pain, adding: “I also have dementia. It’s a brain problem. I have trouble remembering things.
“I’ve been very lucky. Moira has kept track of me. But it’s also kind of sad, because she is 12 years younger than me. She will continue to do things” while Jerry fades away, he said.
Joining the Quillings at their table were new friends: a man with a warm, winning smile and his wife. He is Larry Senescu, and he’s almost completely nonverbal, his wife, Mary, said. His condition is something called expressive-receptive aphasia, which means he can’t understand or generate speech. He uses a communication board at home, his wife said.
“We’ve been on this journey for six years. My world became smaller,” she said. “You’re not doing things. You’re not keeping up with your friends. They’re all traveling, doing things, meeting other people, and you can’t.”
This is one of the great things about the Mill Creek Supper Club: It’s not just a meal, it’s the spark of a little community. Moira Quilling noted that most of the people who turned up for this inaugural meal were still mobile and physically able, if not mentally. Starting to set up a support network — new friends, helpful businesses and nonprofit agencies — for the future is crucial, she said.
“Because it doesn’t improve. It declines,” she said.
She repeated some grim statistics about caregiver impact: Spouses who become round-the-clock caretakers tend to wear themselves out and suffer compromised immune systems. Too many die earlier than their spouses, she said.
About Alzheimer’s and dementia
Here’s a review of the Alzheimer’s and dementia training provided for the Mill Creek Pub waitstaff by Home Instead Senior Care:
• Alzheimer’s is a disease that can affect thinking, memory and behavior. It is a neurological condition and is not contagious.
• One in nine Americans has Alzheimer’s or a related dementia. The number of people worldwide with dementia is expected to rise from approximately 50 million now to as many as 135 million in 2050.
• Potential symptoms can vary between people and change within the same person. There are “good days and bad days.” Common signs include: short-term memory problems; appearing apathetic, distant or depressed; trouble making decisions and completely tasks; confusion about time and place; sudden mood changes; repeating words and phrases; sexually inappropriate behavior; losing things; hallucinations and paranoia; and in later stages, difficulty speaking and swallowing.
• When working with a customer with dementia: approach slowly from the front, introduce yourself and smile; speak slowly, calmly, comfortingly — and at eye level if possible; try using gestures and nonverbal communication; simplify the menu; offer simple either/or choices; allow enough time for response and don’t interrupt; don’t take anything personally; and don’t argue or embarrass the customer.
• If a customer becomes upset or inappropriate: redirect or distract the customer with a kind question or compliment; try moving the customer to a different table (changing the scenery can change the mindset); apologize, even if there’s no reason to; and if a customer is alone and appears lost — and cannot give you the name of a family member, friend or caretaker — call 911.
• Home Instead is looking for more local businesses interested in being certified as Alzheimer’s friendly. There are customized trainings available for restaurants, banks, drug stores, groceries and public safety agencies. Contact Julie Williams at 360-253-6028 or visit www.homeinstead.com/436.
She’s a big proponent of reaching out to local agencies such as the Area Agency on Aging and Disabilities, she said, because of the help they offer. She couldn’t imagine how helpful it would prove to be, she said.
“It is so important to get help,” she said. “Your life depends on it.”
Brent made a welcoming speech to the small crowd. He said a supper club for people with dementia is good business sense, as well as the right thing to do.
“When you see the wave coming, be the first on it,” he said of the “silver tsunami” of aging Americans, and predictions that dementia will become vastly more widespread all around the globe.
Shanti Potts, a volunteer with the Elder Justice Center and another adviser to this effort, smiled as she encouraged the crowd to be “brutal” in its critical feedback, so future meetings of the Supper Club can go even smoother. Kretzschmar added atmosphere by playing standards of yesteryear, from big band to the Beatles, on the house piano; she added the British World War II favorite “(There’ll Be Bluebirds Over) The Whitecliffs of Dover” for an ex-Royal Air Force pilot who fought in the Battle of Britain — and who is now nonverbal.
“It’s the music of their generation,” Kretzschmar said. “They may not be able to remember what they did a minute ago, but they still have the remembrances of things past.”
“Going out like this is beneficial to the care receiver, but it’s crucial to the caregiver,” Moira Quilling said. “Instead of serving up the same stupid stuff I always make at home, I’m getting served for a change. It’s so nice.”