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The Human Connection Model for memory care

September 8, 2016
by Pamela Silberman-Mills, MA, CTRS
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“Contemporary advocates for nursing home reform (Fagan, Williams, & Burger, 1997) contend that quality of life for nursing home residents will improve only when their lives are more like life in the world outside.” (Ronch & Goldfield, 2003)

This paper summarizes the Human Connection Model, as organized by Pamela Silberman-Mills, with the influence of proven person-centered philosophies including: The Montessori Method for Positive Dementia Care (Brenner, 2012); Dementia Capable Care: A Best Abilities Approach (CPI, 2008); and The Best Friend’s Approach for Alzheimer’s Care (Troxel and Bell, 2004). Additionally, “The Six Essential Senses” have been adapted from Daniel Pink’s book A Whole New Mind (Pink, 2005), for use within a dementia experience model with Daniel Pink’s written permission. The purpose of this paper is to summarize the scope of the Human Connection Model and its best practices.

The Human Connection Model asks every aging services practitioner to intentionally and creatively take part in the older adult’s current experience. Together they draw out each person’s lifetime values and expertise, co-designing the caregiving. Appreciative of the fact that each person is an expert within his or her own life, the Human Connection model highlights the key elements of: Individual Choice, Community Ownership, Sustaining Kinship, Employing Expertise and Integrative Wellbeing.

Why focus on connection?

Multiple researchers agree (Theurer et al., 2016)(Tomaka et al., 2006)(Sorkin, 2002)(Medvine, 2015)(Zhong et al., 2016) that the need for emphasizing human connection is essential for our physical and emotional health, boosting strength and healing during disease processes. Dementia is a disease of accumulating losses. In essence, through its stages, we lose our ability to connect with and express our personhood. Over time the self we and our loved ones once intimately knew appears to slip into the shadows—still perceived, but able to be articulated indirectly with limited recognition. The disease causes many to sacrifice their memories, social relationships, comforts of home and financial assets. Further in the disease process, the person relies on others to eat, bathe, dress, administer medicine and maintain relationships.

Consumers of the U.S. healthcare system have voiced concern over the difficulties of being “just another number” in the mass provision of healthcare services (BoozAllen Hamilton, 2014). The central priorities of the “medical model” (also known as an “Institutional model”) of dementia care were to “keep residents clean, dry, safe and quiet” (Warchol, 2008). With limited emphasis on an individual’s value and emotional wellbeing, this model confined passive care receivers who were not just lost in the system, but lost in themselves.

Some of the basic needs of childhood are love and emotional connection. When we receive these, we learn to feel worthy and lovable. At any age, social isolation leads to loneliness, depression and poor health. Therefore, by creating a connected community, focusing its daily pulse on supporting a person’s intimate needs for being known as their best self, we alleviate one brutal symptom and soften the disease.

How is “connection” defined within the Human Connection Model?

Humans are connected beings. We seek and thrive upon relationship from conception to cessation. Our relationships transpire privately and publicly, within our family, friendships, work and cultural environments. We reflect these connections through our choices, opinions, preferences and associations. We articulate them by the words we speak, the silence we keep or the behavior we express. This differentiation is the practice of who we are. The Human Connection Model recognizes these components of connection within each person’s vital identity and creates a community pulse around it.

Symbolism of the conch shell

The Human Connection Model adopts a conch shell as its symbol, as this type of shell represents multiple aspects of personhood and the journey of dementia. The conch shell contains both coarse and smooth components, albeit one. On the surface, the observer may assume he or she knows all that exists in a person’s self. Yet, not one of us has seen the entire journey. Some may only get a glimpse if we use our time together to deeply listen. As a caregiver commits to traveling with the person experiencing dementia, he or she may discover an endless pathway of untold grottoes that may at first appear convoluted, but also could reveal smoother sides. The Human Connection Model centers itself on providing a safe space for this profound exploration. Over time, there may be areas that remain hidden; yet, each revelation is still a valuable component of the whole.

The Six Heart Strings of affective care

Just as a guitar has six strings that individually and collectively enhance the song, the Human Connection model has Six Heart Strings that lead the way towards providing more affective care within a community that includes persons with dementia. Each one of these ‘strings’ is a necessary component for the community to be in tune with all persons. Adapted from “The Six Essential Senses” named within Daniel Pink’s book A Whole New Mind (Pink, 2005), a brief summary of these Six Heart Strings and how they relate to creating an experience of wellbeing for caregivers and care receivers is as follows: