Focus on the Emotional Pillar of Engagement

We recently began an occasional series looking at what we call our Four Pillars of Engagement methodology developed in collaboration with Harvard Medical School and Brigham & Women’s Hospital. A non-pharmacological approach that focuses on the whole person, the Four Pillars philosophy engages seniors with cognitive impairment through Physical Social, Cognitive and Emotional channels. We spoke last time about what Physical Engagement looks like; this week, we’ll focus on its Emotional component, and how that is put into practice at our Residence at Shelburne Bay in Shelburne VT.

“Ideally, emotional engagement drives every interaction at our community,” says Reflections Director Bianka LeGrande, who joined LCB back in March. “Our staff training focuses on education and preparedness, so that each activity and conversation can steer away from potential frustration and towards positive experience where residents feel they are vital and valued contributors to the community.” Associates at Shelburne Bay practice interactive caregiving, setting a positive tone, remaining open to cues and possible course corrections mid-activity, and never trying to force an outcome. When it’s time for a Reflections resident to get ready for bed, for example, a caregiver will begin by guiding that person towards washing up, allowing them to do as much on their own as they can, ready to “change the subject” if things get stressful. “Meeting each resident at an emotional level helps them cope and adjust to challenges in a healthy way,” Bianka explains.

Daily programming at Shelburne Bay is designed to be inclusive and engaging, and is intended to tap into individual interests and strengths. Activities aren’t segregated by gender or community segment. “We treat our community as one big family,” Bianka says, “and believe everyone benefits when all are invited to collaborate together on a project, whether they’re men or women, living in Assisted Living, Memory Care, or independently.” So on a baking day, you’re likely to see people from all corners of Shelburne Bay working together to decide who likes to measure out ingredients, who’s good at mixing, who’s in the group might rather sing a song to entertain the cooks. “The content of the activity is not nearly as important as residents’ sense of accomplishment and pride and the connection with the community that results.”

Another important goal of emotional engagement is memory stimulation, to enhance cognitive activity and reduce feelings of depression and anxiety that can accompany dementia. Shelburne Bay community members enjoy music hours together, singing familiar tunes; they garden and plant veggies, smelling different foods and sharing the memories they trigger; they have scavenger hunts and play reminiscing games built around familiar objects; they enjoy traveling suitcase discussions that tap into past traveling excursions and interests. These kinds of experiences and the memories they trigger reinforce connections to themselves and to one another, deepening their sense of self and sense of belonging.

Bianka emphasizes that what is most significant about emotional engagement programming is its sustained impact on each resident. “Even if they don’t remember every aspect of the activity itself,” she points out, “residents nonetheless carry the resulting positive feelings with them going forward. The caring we give them in these moments has a lasting impact on their wellbeing.”