Ever since graduating from Bluffton University with a degree in recreation management, Kristen Niekamp has been wanting to work with elders. 

A few years after college, she accepted the position of activities coordinator at Maple Crest Senior Living Village, and then worked as a companion at Mennonite Memorial Home before becoming an activities assistant. 

When MHCO opened Willow Ridge in 2012, she took the opportunity to be involved in the Green House Home model.  She has finally come to roost in Pandora as memory care coordinator at Hilty Home. 

Her past experience and education are a good fit for Hilty’s memory care units.  She is a certified activities director and also certified in CARES dementia training (Connect, Assess behavior, Respond appropriately, Evaluate what works and Share with others).

“I work predominately in Riverview,” said Niekamp.  “Higher functioning elders with dementia who are coming right from their homes have the opportunity to stay in our New Horizons unit.  Riverview serves elders with more progressed dementia.”

At this writing there are 13 elders on Riverview and Niekamp tries to keep the same daily routine to avoid confusion and agitation.  In the morning she’ll start the group out with some exercises, then a short activity. 

“Some people with dementia need quiet time alone because they get so tired from trying so hard,” she added.  “We forget that it’s a struggle to walk, to eat, and perform other daily activities that come so easily for us.” 

The elders experience more stress as the day wears on. There are some she calls “sundowners,” as they get more agitated, restless, or fearful toward evening.  “It has to do with the sun transitioning from daylight to darkness. Elders may have the feeling that it is time to leave work, head home to make dinner, and perform that evening routine,” said Niekamp. 

Every day is different
Although Niekamp tries to keep the Riverview residents on a patterned schedule, she admitted that every day is different when living with dementia.  The Riverview elders love to talk about their parents and grandparents, listen to music and enjoy Bible study and worship services.

Religion has been a big part of life for most of them.  A field trip could be as simple as a drive in the country and stopping for ice cream.  The plan for each day, however, is to give each elder something to look forward to and a chance to experience moments of joy.

“I love the intergenerational program with Hilty Preschool and Child Care,” she said.  “We interact with the day care program three days a week.”

Although Niekamp feels that socialization may not help those with dementia get better, she does feel that it may help delay the disease.  “Dementia is difficult to diagnose because there are so many kinds,” she added.  “Not all dementia is Alzheimer’s.  Some is related to certain diseases, like Parkinson’s, for example.” 

Niekamp is also seeing younger residents in Riverview, which alarms her. 

“Whether they’re in the early stages, or living in the Riverview wing, our elders need kindness,” she emphasized.  “I try to connect with and encourage them on a daily basis.”

Making Life Better at Hilty
• Remember that we are in their homes.  Don’t argue!
• Always identify yourself by name.  Don’t make the elder guess who you are.
• Call the elder by his or her name.
• Use short, simple cues.  People with dementia are not capable of dealing with complicated directions.
• Use the two-choice method.  Don’t say, “What would you like for dinner?”  Instead, ask them, “Would you like chicken or salad?”
• Use encouragement and positive reinforcement.
• Avoid sudden changes in their environment. Respect their preferences to make it as homelike as possible.