Dementia Care - Is there a Better Method Than Redirection and Distraction? With Rachael Wonderlin

Can you work with the reality someone with dementia is experiencing?  Our Guest Rachael Wonderlin joins us to explain how the method she teaches can save distress and how we need to reframe dementia care to understand time from their eyes.

Charlie also delivers a very informative segment on how to avoid scammers.

In this Episode:

• 02:30 - Recipe: Tim Walz's Turkey Trot Tater Tot Casserole
• 03:16 - What You Need to Know to Protect Yourself From Scammers
• 21:55 - Interview with Rachael Wonderlin on Embracing their Reality™ in Dementia Care
• 37:01 - Outro

Transcript

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Dementia-Care-Is-There-a-Better-Method-Than-Redirection-and-Distraction? With-Rachel-Wonderlin

This podcast does not provide medical nor legal advice. Please listen to the complete disclosure at the end of the recording. Hello and welcome to Everyone Dies, the podcast where we talk about serious illness, dying, death, and bereavement.

I'm Marianne Matzo, a nurse practitioner, and I use my experience from working as a nurse for 46 years to help answer your questions about what happens at the end of life. And I'm Charlie Navarette, an actor in New York City, and here to offer an every person viewpoint to our podcast. We are both here because we believe that the more you know, the better prepared you will be to make difficult decisions when a crisis hits.

Welcome to this week's show. Please relax and get yourself a glass of cider and an apple donut. And thank you for spending the next hour with Charlie and me as we present an interview with Rachel Wunderland, a dementia care senior living consultant and brand developer and author.

Like the BBC, we see our show as offering entertainment, enlightenment, and education, and divide that into three halves to address each of these goals. Our main topic is in the second half, so feel free to forward to that chat-free zone. In the first half, Charlie has our recipe of the week and a report on scams.

And the second and third half, we have our interview with Rachel. So Charlie, you getting ready for the presidential election? Yes, I will be there, live, in person to cast my vote. You? Excellent, excellent, yes.

Oklahoma, does it offer mail-in, you know, mailing in ballots and everything, or do you have to go in person? Nope, they actually, this year they have early voting, or they had early voting, and they do absentee ballots. I don't know, you know, there's some controversy, apparently, about whether or not they get received and counted, but yes, we have all of those modern conveniences. Good, yeah, same here.

I don't know why, I could just mail it in, but I don't know, there's just something about actually going to the polling place. And getting your sticker. Yes, so, in our first half, are you excited about the presidential election yet? We have shared many recipes from first ladies, but this week, we have a recipe from the Democratic vice president contender.

I could have been a contender. Anyway, Tim Walz's turkey trot tater tot casserole would be a winner at your next funeral lunch, and guaranteed to raise your cholesterol 10 percentage points because it calls for a quarter pound of butter, bacon, and three cups of cheese. I wonder if Kamala wants those 10 percentage points.

Bon appetit. You know, recently, I saw a film called Thelma, featuring 94-year-old actress June Swib in her first starring role. She's been acting since 1948.

When asked about ageism in show business, she said, well, it's like anything else. I always feel rules are meant to be broken. In the film, Ms. Swib plays Thelma, a feisty 93-year-old grandmother who gets conned by a phone scammer pretending to be her grandson.

Told by both her family and the police that the $10,000 is gone, she borrows a friend's motorized scooter to get her money back. Her friend is played by Richard Rountree, the original Shaft from the 1970 film, who died before Thelma was released. He goes with her.

Through grit and determination, she gets her money back. The movie was inspired by what actually happened to the director's grandmother. In real life, however, there's usually less than a happy ending.

Fun fact, give or take, Americans reported losing $10 billion to scams and fraud in 2023. If it'll make you feel better, it was only 3.5 billion in 2020 at the start of COVID. All right, I'm going to give you a lot of information.

Go through it by yourself, then get a family member or a friend to go through this with you again. Educating yourself about frauds and scams is not easy. You do not have to do this all alone.

Let's begin with an imposter fraud. For example, someone calls or sends you an email saying they work for a company, including famous companies. They might use real names of employees or their photos to make you think the call or the email is legitimate.

They may contact you through social media, messaging apps, even links to illegitimate websites to offer you a great opportunity, which is a trick to separate you from your money. Some things to keep in mind, you can always hang up or ask for their name and phone number. Often this sends the conversation.

Next, be very leery of any emails, calls, or text messages that claim to be coming from your financial institution, government agencies, or other legitimate companies you do business with. Next, Amazon is the most common business impersonated by scammers. If you are told you have to act immediately or are pressured, remember, if it sounds too good to be true, it probably is too good to be true.

Do not click on links that arrive through social media or text unless you are confident they're real. Before committing to anything, verify the caller or the person online and verify the information is legit. Listen, when in doubt, pause, ask questions, and locate the officially listed number of your financial institution, government agency, or other legitimate institution from their websites, not links that are provided by the potential scammer.

Visit your bank and tell an employee you want to discuss a potential scam, which brings us to scams. The most common reported scams, and I say reported because some scams are very much underreported. Victims are too ashamed to report them or figure that authorities can't help.

Now, some of these include online shopping scams, scams involving prizes, sweepstakes, lotteries, job opportunities, and romance. Seniors especially fall victim to scams. Even in their neighborhoods, the local handyman, car repair shop, even the home health aide who's supposed to be looking after you or an elderly family member could take advantage.

How? By changing invoices for services you did not request, increasing fees, and writing checks out to cash by someone other than you. Remember that the vulnerable are targeted. Keep in mind that scams over the phone or through the internet can be difficult to track and prosecute.

To protect yourself, be skeptical. If you are on your computer, look out for bad grammar and spelling and strange looking links shortened with B-I-T dot L-Y or something similar. Any requests for payment via cryptocurrency, online payment apps, prepaid credit cards, or gift cards are suspicious since these are telltale signs of a scam.

Never send money or personal information to someone whose identity you are not able to verify. Call a phone number found on a company's website or brochure. And actually, as an aside, this is crazy.

While I was writing this up for this episode, I received an email supposedly from my credit card company asking me to verify information I already knew was not true. I was just about caught up in a scam of my own. So be careful.

Scammers often try to rush you into making decisions or providing information. They create a sense of urgency to make you act impulsively and not think things through. They may say an offer is good for a limited time, a product is about to run out, or that you must make a payment immediately to prevent negative consequences.

Bullshit. Their goal is to put the squeeze on, so you don't have time to think carefully about what they're asking of you. Here are a few pointers from the National Council on Aging.

Con artists often target older adults who live alone. These scammers know adults are socially isolated, are less likely to consult a family member who may suspect something is not right. A University of Michigan study found that feeling lonely or suffering a loss made older adults more vulnerable to financial fraud.

No surprise there. Listen, when you are sad and struggling, it may be tempting to talk to a friendly sounding person on the telephone. Stop it.

Take care of yourself. Second, most of us were taught as children to respect authority. Scammers know this and use it to their advantage.

Scammers pose as an authority figure to pressure the person into doing what they want. For example, you receive a call from someone claiming to be from the Internal Revenue Service, the IRS, or the Social Security Administration, SSA. They aggressively insist you owe big taxes, fines, or other fees, and threaten criminal charges if you do not comply.

They ask for personal information, especially Social Security or Medicare numbers to steal your identity. They might say that your credit cards, bank accounts, Social Security checks, and other assets are frozen, and that you have to send money in order to unfreeze them. Remember, if someone from Social Security calls and asks for your Social Security number, I'm sorry, but the real Social Security Administration has your number and wouldn't ask you for it.

A text message that seems to be from your electric company states your bill is overdue. The sender warns you your service will be terminated if you do not pay up quickly. Or maybe you get an email alerting you that there's a problem with your bank account.

The email asks you to verify your account information to fix the problem. Okay, take a breath, and then release. Stop, think, and stay financially safe.

First thing, again, verify whether the company or agency trying to contact you is legitimate. You cannot rely on caller ID for this because phone numbers, email addresses, and even websites can be spoofed to mimic familiar organizations. Reach out to the organization directly using phone numbers or email addresses listed on their official organization website.

Tell them about communication you received and ask them to confirm that it's real. Remember, government agencies will generally never call, email, text, or contact you on social media to ask for personal information or money. Next, most people want to help someone who is in trouble.

Not me, I live in New York. But this is especially true when that someone is a person you care about, such as a grandchild or a romantic interest. With a grandparent scam, for example, someone calls you pretending to be your grandchild and claiming they're in dire straits.

They need money to get out of jail or pay urgent medical bills, or they're pleading with you to help. Actually, this is the plot of the film, Thelma, that I mentioned at the beginning, exploiting Thelma's love and concern for her grandson. Again, protect yourself.

In any scenario where you're being asked for money or personal information, take a moment and take a breath. If you've been contacted out of the blue, verify the number is coming from the person the caller is claiming to be. Feel free to hang up and call back from your saved phone number or email of the contact to confirm the situation is not bogus.

A romance scam happened to Alice Lin. As reported by KCAL News, the 80-year-old widow received an unexpected message from a man on the app WeChat. A good friendship blossomed and her new friend persuaded her to download a cryptocurrency trading app.

In the end, Lin lost more than $700,000 after emptying her retirement and savings account to invest in what appeared to be a promising financial opportunity. Scammers go on social media and dating sites to lure in unsuspecting older adults. They engage with seniors and promise love or friendship, but always end up needing to borrow money for a variety of reasons.

They are often unavailable to meet in person or repeatedly make plans but fail to show up. Remember, online scams can happen to anyone, even those who consider themselves too smart to get duped. Protect yourself.

Any scenario where you're being asked for money or personal information, again, take a moment. If you've been contacted out of the blue, you want to first verify the call is coming from the person the caller is claiming to be. Hang up, call back from your saved phone number of the contact or email from a saved address to avoid typos.

As if that weren't enough, additional scams that target older adults include internet email scams, computer tech support scams, scammers pretend to be calling with concerns about computer viruses and other threats, blackmail scams. A blackmail scammer tries to scare their victims into sending them money or by threatening to distribute private content from your computer or phone. These scammers are often complete strangers, but sometimes they are someone you met online and thought you could trust.

To wrap up, and I ain't talking Christmas gifts, talk to family, friends, or financial companies before making any financial decisions, especially when they're approached with unsolicited offers or requests for personal information. Find the elder abuse hotline in your area. Look up the phone number.

I've also seen it referred to as the Adult Protective Services Helpline. Add additional security measures for financial and online accounts. Many financial institutions offer services specifically designated to protect older adults from fraud, such as alerts for suspicious transactions.

Do not answer calls from phone numbers you do not recognize. Let the call go to voicemail. Remember that scammers often use high-pressure tactics over the phone to extract personal information or financial details.

If you or a loved one have been scammed, report it to a reputable agency. Your story can help them build a case against scammers and take action. See the show notes for reporting options.

Finally, and I can't say this enough, protect yourself. Do not be afraid to slow down and ask questions. Take a deep breath and give yourself enough time to think through the situation logically.

Avoid making snap decisions. Harness your skepticism. Use the force, Luke.

Hang up or disconnect with a chat session and call a trusted phone number or a trusted family member or friend before sending any funds. Look for the red flags. I'm exhausted.

You know, at the university where I teach, they're cybersecurity. We have these mandatory things we have to do, like, it seems like every two months, and they're all about scams and not letting, you know, clicking on links that then put the university website, you know, system into danger. And so many times I'll get an email and I'll look at it, you know, and all of the red flags, like you're talking about and that they teach us.

And then I say, well, I'll say to David, well, is this real or is this fake? And I think the answer to that always should be if you think it's fake or if you're asking yourself that, it probably is. Yeah, and even, you know, you're not sure, again, get their phone number or just hang up or don't even pick up the phone for a number you don't recognize and let it go to email. Take your time.

You know, Marianne and I spend a lot of time on the web. And if we're not sure, then someone who says spends less time, you know, protect yourself, protect yourself. And if you make a mistake, you know, and you click on a link or you do, you know, something that you think, geez, I shouldn't have done that, call your credit card company, tell them what you did.

Yeah, yes, yes, yes. And, you know, get it, they'll send you free of charge a new credit card. You know, you don't have to live with it and wait and see what's gonna happen.

Just say, ah, I shouldn't have done that. And call them and they'll send you a new card and you can protect yourself that way too. Yeah, don't waste time beating yourself up.

Like Marianne said, just do it right away. That's it. No problem.

Please go to our webpage where you can review all this information and pass it on to your friends. And this week's recipe for Tim Walz's Turkey Trot Tater Tot Casserole. Oh, I can say it fast.

It's kind of like Beetlejuice, but I don't wanna say it three times. Yes, please do. Plus, additional resources for this program.

Everyone Dies is offered at no cost, but is not free to produce. Please contribute what you can. Your tax deductible gift will go directly to supporting our nonprofit journalism so that we can remain accessible to everyone.

You can also donate at www.everyonedies.org. That's every, the number one, dies.org or at our site on Patreon, www.patreon.com and search for Everyone Dies. Marianne. Today I have the pleasure of sharing with you an interview with Rachel Wunderland.

Rachel has a master's in gerontology and has been working with and advising with dementia care community regarding communication and programming strategies with her company, Dementia by Day. Rachel's books and resources can be found in our show notes, so please check them out. Rachel, welcome to Everyone Dies.

Thank you for joining us. Thanks for having me. Great.

So I appreciate reading about your work and some of the concepts in terms of communication that you've developed and copy wrote is one of them is called embrace their reality. And so in terms of dementia, what do you mean by that? So embracing their reality means to get into the world of the person living with dementia, no matter where it is, no matter what their truth is and to do what is true for them, which I think the validation theory and redirection miss out on. They don't really make it clear that what you actually wanna do is do what's true for the person living with dementia.

So validation theory, you're talking about Naomi Files? Yes. So for our listeners who don't know what that is, what, not that that's what you're promoting, but what is it that Naomi talks about? So Naomi talks about this concept that you do not want to lie to somebody with dementia because they're going to know the truth is what she says. And that you do wanna go to their world, but it doesn't really make it clear, frankly, how to do that.

So with embracing their reality, I make it a lot more clear, I think, about how to actually go to their world. And in fact, we just put out a short film demonstrating how to do this on embracingtheirreality.com. So people can actually go to embracingtheirreality.com and watch our short film, which is a really great way to learn like what it is in practice, like what that actually looks like. So if I were to have dementia and I were to say, I need to go, I need to leave, I have to go pick up my babies, how would you respond in terms of embracing my reality at that time? I say, great.

We have lunch coming up and I called ahead, the sitter is there. So we're gonna go ahead and just make sure you get something to eat first. So with that, you do wanna use a little bit of redirection, but really embracing their reality comes in, especially when someone says, where is my so-and-so, where's my mom? And you could say, where do you think she is? And do you find that the people with dementia get frustrated or what kind of answers do you get from them when you say, where do you think she is? Well, that's the reason I use it is at work because the person will say, oh, I think she's at work.

I think she's at home. I think she passed away. And whatever they say is the right answer.

And that way you know where their reality is. You're not having to come up with anything. So I've had elders who, I worked on dementia units in nursing homes with my nursing students.

And I've seen elders who are very, some are very frantic about where is my mom? Where is my children? I had one guy who was, I mean, very frantic about he had to go feed his chickens. And he was on a locked unit and he would claw at people because he had to get out and he had to go feed his chickens. So how do you respond to that? What do you do in that situation? Well, in that situation, I would say, okay, let's go get the chickens.

Like first, I think we need to make a list of supplies that we need to get for the chickens. So let's go ahead and make that list of supplies that we need to get up. We need to go get some feed.

Maybe we need to build some cages and we can actually go get the stuff and build those cages. And does that, is that redirection generally calm the person down in your experience? Yeah. Yeah.

Because we have a lot of people who listen and who are caregivers for people with dementia and how to sort of, people are, I'm sure in your experience, very concerned about truth-telling. They don't wanna lie. But what I talk to people about is you have to be kind of creative and be in the moment.

Like with this guy, we didn't have the feed or building a pen or doing anything. But I would say to him, can I feed them for you? I'm going out right now. Can I feed them for you? And he would say, well, you promise? You promise you'll do that? Yes, absolutely.

I will go do that. And he'd be, okay. For him, for this particular person, it was, he wanted to make sure that those chickens were fed.

And of course, every time you went in or out the door, he was there and you were, it was like a Groundhog Day kind of thing. It was the same conversation over and over again. And, but you had to take that time to talk with him because he was so frantic about those chickens.

Yeah, that makes sense. So one of the podcasts that we did a while ago was on whether or not, or how to tell somebody with dementia that a family member has died. Do you have any thoughts about, from your model and your experience, what are good practices or what are effective practices in terms of talking with people with dementia about death? Yeah, 100% do not is the short answer.

Telling someone, especially if the person is, you know, in the middle stage or so of their dementia, telling them that they died is just really, honestly, really cruel because they're not gonna be able to grieve appropriately. And when you can't, you know, to grieve, you really need to understand the passage of time. But if you are living with dementia, you kind of inherently don't understand the passage of time.

So that's not going to work out very well. So we wanna embrace their reality. If that person is alive, we want to continue to let them to be alive.

And to your earlier point, I always say, let's do what's true for them. It's not lying. We're just taking the word lying, throwing it away, replacing it with this concept of doing what's true for that person.

No matter where it is. So when that person says, my son's not coming to visit me anymore. Where's my son? And the reality is that the son has recently, let's say, died of a heart attack.

Do you at any point say to that elder, you know, Joey's died? Do you take that elder to Joey's funeral? No. No. No.

No. Don't talk to me about that. No, don't do any of those things because what is that gonna do? I mean, that's just not me.

That's not gonna, you're not gonna have a better day. She's not gonna have a better day. That would be horrible.

And she can't understand the passage of time. So when she forgets that he died, you know, later, like, what are we trying to accomplish here? Right? That's what I would ask is like, what are you trying to accomplish? And I think a lot of times people tell someone that a loved one died because it makes them feel better. They think like, oh, I did.

I told them. And so I did the right thing. And it's like, wait, you didn't really do the right thing.

You just sort of made your own self feel better. Do you think it helps the family member to feel better, to tell the truth or? Not for long, because they're gonna upset their loved ones. So they're gonna find out real quick that it wasn't the right thing to do.

So I've had back, God, I wanna say probably 30 years ago when I can, well, actually maybe even 40 years ago, I can remember when they would put people with dementia in the state mental hospital. I worked at a state mental hospital in Massachusetts. And we had people with dementia in the state mental hospital because they really didn't see dementia as an illness.

And they didn't have Alzheimer's units in nursing homes. And it was like, we don't know what to do with these people. So if you can believe it, they put them in state mental hospitals.

And I can remember one guy, and like I said, this was 40 years ago, so that they would, so that we were in that tell the truth mode. And so every time he would say, where's my wife? Staff would say to him, she died. And this man would fall over in grief and sob and cry.

And we had a staff meeting at a point, we said, why are we putting him through this with the truth? Because his reaction is as though it's the first time he's heard this. Every time was the first time. And his grief was so profound, it seemed cruel.

And so nowadays, four years later, we say, well, of course it is. But back then, we didn't know any better. And so as a treatment plan for him, we said, we're not gonna tell him that every time.

We're going to say, you know, like you say, you're saying, well, where do you think she is? We would say, she's at the grocery store. That's pretty common for the validation method. The problem with that is that if he does not believe that she's at the grocery store, you're gonna have a really awkward moment, which is why asking, you know, where do you think she is is a nice way to kind of start it off because it gives you.

So that, you know, just for listeners, cause you know, we have older listeners also who think, well, I can remember a time where, you know, that's why I say, here's what we did. And so we say, yeah, that's what we did because that's what we knew to do at that point in time. We also put them in state mental hospitals and we don't do that anymore either.

And so to have a new way or a different way or an evolved way of talking with older adults about where the significant person, what's going on is important for us to hear. So you do training, do you do training with families or do you train with staff primarily? How do you go about educating people about this? So my company works primarily with senior living companies. We do a lot of staff education and we do family education through our online dementia portal, Dementia by Day School.

Families can actually sign up to take a course there. And we do, I do a number of speaking events. So a lot of his clients will bring up their buildings and we'll do a family event or wherever it is that I'm going to do the event.

So if people are in that area, they can look you up there and read a couple of books out and the website has resources there. So I would encourage people to take a look and learn about this concept and the strategy of helping older adults with dementia embrace their reality. Do you have any final thoughts? No, just, you know, if you look me up you'll also find the 16 things I'd want if I got dementia, hopefully my name's on it whenever you find it.

But if you Google it, it should be one of the first things you see is my name listed. But yeah, the 16 things poem, we have our short film out on embracingthereality.com. And there's plenty of ways to find me and to watch videos and to learn more. Great, and I encourage our listeners to do that.

Thank you for talking with us today, Rachel. Yeah, of course. Thanks for having me.

Thank you for the interview, Rachel. And that's it for this week's episode. Stay tuned for the continuing saga of Everyone Dies and thank you for listening.

This is Charlie Navarette and from poet Robert Herrick in the year 1591, gather ye rose buds while ye may. Old time is still a-flying and this same flower that smiles today, tomorrow will be dying. And I'm Marianne Matzo.

We'll see you next week. Remember, every day is a gift. This podcast does not provide medical advice.

All discussion on this podcast, such as treatments, dosages, outcomes, charts, patient profiles, advice, messages, and any other discussion are for informational purposes only and are not a substitute for professional medical advice or treatment. Always seek the advice of your primary care practitioner or other qualified health providers with any questions that you may have regarding your health. Never disregard professional medical advice or delay in seeking it because of something you have heard from this podcast.

If you think you may have a medical emergency, call your doctor or 911 immediately. Everyone Dies does not recommend or endorse any specific tests, practitioners, products, procedures, opinions, or other information that may be mentioned in this podcast. Reliance on any information provided in this podcast by persons appearing on this podcast at the invitation of Everyone Dies or by other members is solely at your own risk.