Professional Documents
Culture Documents
The Beginning
What Is Namaste Care?
The Namaste Care Team
The Namaste Care Setting
The Namaste Care Day
Implementing Namaste Care
Assisted Living
Quality of Life at the End of Life
Dying and Death
ix
xi
xii
xix
1
23
39
59
77
121
143
161
205
Appendixes
A Namaste Care Nursing Supplies
238
242
B Namaste Care Activity Supplies
C Namaste Care Resources
243
D Namaste Care Activities of Daily Living Checklist
245
E Dementia Bill of Rights
247
F Pain Assessment in Advanced Dementia (PAINAD) Scale 248
References
252
Index 257
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Foreword
Publication of the first edition of The End-of-Life Namaste Care
Program for People with Dementia encouraged many health care
providers to reassess how to care for individuals with advanced
dementia. Although Namaste Care was originally intended for
implementation in long-term care facilities, the program has since
been adapted in other settings where individuals with advanced
dementia live, specifically assisted living communities and hospices.
This second edition is a result of the expansion of Namaste Care
and the popularity of the first edition.
Since the publication of the first edition, Namaste Care programs have been successfully implemented throughout the United
States as well as in Australia, England, Scotland, and Greece. One
large assisted living organization in the U.S., Arden Courts, chose
to incorporate Namaste Care into all of its facilities. A hospice organization, Seasons Hospice, is using the Namaste Care approach
in all of its facilities as well, under its own customized name (Touch
for All Seasons). The success of Namaste Care was also reflected
in the selection of Joyce Simard, M.S.W., as one of Provider magazines 20 to Watch in 2013 for her compassion and commitment
to providing quality of life at the end of life for individuals with
advanced dementia.
Namaste Care is an enlightened program that strives to maintain the highest quality of life possible for individuals with severe
and terminal dementia. This care involves the creation of a special
room that provides a quiet, peaceful environment for residents in
the last stage of the disease. Meaningful activities are individualized for each resident and a continuous presence of staff members
provides both physical and sensory stimulation. Namaste Care does
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xii
not require additional staff, just some rethinking of staff assignments, and can be implemented with minimal programming cost.
This high-touch care can be taught to all staff as well as to family
members. The family members in particular appreciate the attention given to their loved ones.
I am sure that publication of this second edition of The End-ofLife Namaste Care Program for People with Dementia will encourage
many more long-term care facilities, assisted living communities,
and hospices to pay greater attention to individuals with advanced
dementia as well as other terminal diseases and conditions. The
book will hopefully serve as an important road map in this effort
because it describes in detail how the program can be implemented,
how the Namaste Care team is established, how an appropriate
Namaste Care environment is created, and what the days activities
could look like. In addition, the book discusses decision making
at the end of life and what is meant by comfort care. An understanding of death and dying and the need for care after death are
also provided. Finally, the appendices include useful resources for
establishing a Namaste Care program.
Namaste Care provides residents and their families with quality care that addresses not only physical but also emotional and
spiritual needs. It reminds us that individuals with advanced dementia should not be isolated in their rooms, but instead need to live
their last days in a pleasant environment receiving loving care from
all staff and families.
Ladislav Volicer, M.D., Ph.D., F.A.A.N., F.G.S.A.
Courtesy Full Professor, University of Southern Florida, School of Aging
Studies, Tampa, Florida
Retired Clinical Director, Geriatric Research Education and Clinical
Center (GRECC), Veterans Administration Hospital (Bedford,
Massachusetts)
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Preface
xiii
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xiv
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PREFACE
xv
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xvi
People with advanced dementia living in any care setting deserve the right to be acknowledged, enjoy meaningful activities, be
in the presence of others, and receive the loving touch approach
that is the foundation of Namaste Care. Richard Taylor eloquently
reminds us in his insightful book Alzheimers From The Inside Out: I
want and need to give and receive love. Even when I cant remember your name, will you please love me? Namaste Care is all about
giving and receiving love.
I developed the Namaste Care program to bring an improved
quality of life to nursing facility residents in the last stages of
Alzheimers. Namaste (pronounced nah-ma-sta-) is a Hindu term
meaning to honor the spirit within, a perfect name, I thought,
for a program designed to acknowledge the person first, not the
disease, and to honor the person in all aspects of his or her life.
The Namaste Care program also removes the isolation surrounding many residents in health care settings and invites them to be in
the presence of others in a place that is peaceful and filled with soft
music, with the feeling of love surrounding them.
This book was written in the hope that you, the reader, will be
inspired to enhance the care that is provided to residents, patients,
family members, or clients with advanced dementia in whatever
setting they call home. It also reflects a personal journey of mine of
over 35 years in health care. My goal for writing this book was to
provide easy-to-read, step-by-step advice on how to start a Namaste
Care program in your organization or how to use Namaste Care
approaches in a home setting. Vignettes of actual experiences are
woven into each of the chapters as examples of how Namaste Care
works. If you work in health care, you have no doubt experienced
the humorous side of our work that makes a sometimes-difficult job
less stressful. I hope that you will smile as you read about some of
my less-than-stellar ideas and resident encounters.
When this book was first published, I never dreamed that Namaste Care would be used internationally. Programs now can be
found in Australia, England, Scotland, and Greece. And those are
just the ones I actually know exist.
I have changed some vocabulary in this second edition to reflect the ongoing shift in the United States from a medical model
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PREFACE
xvii
And so, for as long as I am able, I too will not let myself get overwhelmed. I will offer to teach Namaste Care to one person or one
group what I wish I could teach everyone. I will teach Namaste
Care to people in one country what I wish I could teach people all
over the world. And gradually I hope and I pray that the standards
for quality of life for people with advanced dementia will improve.
Maybe you will be encouraged to do the same.
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TM
ISBN-13: 978-1-938870-02-6
ISBN-10: 1-938870-02-6
90000
www.healthpropress.com
9 781938 870026
Simard
>
SECOND
EDITION