Dementia care tailored for men

When her husband Al first moved into a dementia "house" at a Lethbridge long-term care facility, Gayle Pilling says he was often anxious and fidgety, especially in group activities. He would restlessly drum his fingers on the table and talk to himself, which annoyed some of the others and heightened their anxiety, creating a ripple effect. 

“But when he moved into the all-male unit last year, he seemed to calm down right away,” recalls Gayle. Family members of the men who live at St. Michael’s Health Centre in the specialized all-male house—a 12-bed unit that filled up quickly when it opened in October 2014—agree the male-oriented activities and masculine energy are working well for them.

Lisa Zubach, Resident Care Manager on the unit at St. Michael's, says the new unit not only brings down anxiety levels, but also reduces problematic behaviour among some residents, leading to a safer environment for residents and staff alike.

“The men we have in our unit are gentlemen who, because of their disease process, have some aggression or have become a little bit unpredictable,” Lisa says. “We wouldn’t want to put our other residents, men and women, at risk by putting them in with gentlemen who have some challenges with aggression. Certainly our other dementia residents can become aggressive, but it’s often displayed differently than it is with the men.”

Colin Zieber, Executive Director of Seniors Health for Alberta Health Services in the South Zone, says people with dementia often perceive themselves to be at an earlier time in their lives, so they may feel more comfortable if their surroundings somehow reflect those earlier stages of their lives.

“For many of them, when they were in school, living in a dorm or in the army, they would generally have been in a group of guys," says Colin. "This unit is an innovative approach to meeting these guys at their point of reference."

Lisa says that often the men don’t engage in activities the women enjoy, such as teas or crafts, and can even become anxious around these sorts of activities.

“So we have some specific activities in that house that are more male-oriented, like playing cards and doing big puzzles. There’s a foosball table and the decor is more masculine,” she explains. “There are also some gentlemen in that unit who were bachelors their whole lives, and I can see their anxieties rise when they’re in a group activity with the ladies. They start to pace and they get more verbal, yet you can see the calm come back to them when they return to the secure environment of their own house."

Gayle says a regular pub night organized by staff is extremely popular with the all-male unit as well.

“They serve de-alcoholized beer and juice, chicken wings and other pub-type food,” she says. “The men love that a lot. These things keep the men a lot calmer. There’s no hollering. It’s been very helpful to Al."

Colin says the concept of specialized dementia units has been in development for some time.

“We knew as part of our capacity planning in late 2012 or early 2013 that we needed to develop some new dementia spaces,” he notes. “We had discussions with Covenant Health, and Lisa and her team worked on the nuts and bolts of how this would work. Of the 48 beds at St. Michael’s we looked at, there were maybe one or two homes that would provide some unique programming, including an all-male unit. It’s just another way of providing patient-centred care and trying to be as innovative as possible. It’s also about listening to families and to our staff."

“A lot of it is around engagement,” Lisa says. “We’re giving them things to do. Recreation Therapy and Occupational Therapy are always working on new initiatives and programs. As a relatively new program, it’s still growing, and we’re learning things on this journey that we’re on together."

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