A Wish to Honor the Spirit Within
by Debbie Hommel, ACC/MC/EDU, CTRS
     Active engagement is often the goal of many of the activities and interventions offered by the activity professional. Our program success is evaluated by how involved our elders become and the responses we observe through participation. There is one population where active engagement may not be a realistic objective. Elders in late stage Alzheimer’s disease or advanced dementia have difficulty actively engaging with any intervention. Common symptoms or functional levels of this population include a loss of verbal abilities, diminished cognitive skills as well as the inability to complete any task independently – making any active engagement difficult or near impossible. Individuals in late stage dementia or other end stage diagnoses may show increased lethargy and increased sleep patterns throughout the day. When involving this population in traditional programming, it provokes criticism that our residents are “not engaged”. The activity professional feels pressure to prod this resident into more active participation which may generate negative behaviors on the elder’s part. If specialized approaches are not introduced for these residents, they are often gathered on the perimeter of programming or left isolated in the common areas or their rooms.

     Joyce Simard, a social worker and dementia care specialist, has introduced a concept called Namaste Care for individuals in late stage dementia. Namaste is a Hindu greeting, offered when people meet or depart. Namaste means “the Spirit within me salutes the Spirit in you” which is the basis for the Namaste Care program for individuals with advanced dementia, as designed by Ms. Simard.   Namaste Care is a seven-day-a-week interdisciplinary program where residents receive meaningful activities through a “loving touch” approach. A dedicated Namaste Room is created which provides a peaceful environment throughout the day which allows the elder to spend their day in tranquility. The elders are brought to the room, greeted individually and spend their day in comfort. It is recommended they be positioned in soft lounge chairs, kept warm and comfortable with a warm, soft quilt and receive individualized attention throughout the day. A Namaste Care Program routine is loosely followed based on the elder’s individual needs at the time. The routine includes snacks, music (new age sounds, nature sounds, and familiar music), theme sensory approaches, aromatherapy, environmental videos, and hand/foot massages.

     Key success of the program is directly related the staff who are assigned to the Namaste Care room. Ms. Simard stresses the need to select individuals who are comfortable with hospice care and are able to focus on the process more so then the task. Emphasis is on knowing the individual elder and using that knowledge to provide an individualized approach throughout the day. Ms. Simard outlines the program as driven by the nursing department however it could be co-led by activities and social services as well. Having a nursing assistant and activity assistant working side by side in the room would provide complimentary approaches to those within the program.

     People over the age of 85 are the fastest growing age group in the country. With better health care and services, people will continue to live longer and longer with debilitating conditions. Rather than assign these individuals to a lonely, dis-connected life, there is opportunity to provide comforting connections and a better quality of life through the Namaste Care Program. This program has the potential to enhance the lives of people with advanced dementia or who are at the end stage of any illness by providing a peaceful, non-isolating environment. Specially designed approaches, offered throughout the day will enable them to end their lives with dignity and tranquility.

~Namaste Care Web Site
This site highlights the work of Joyce Simard, MSW. Be sure to check out the article section of the site.
~You tube videos – search “Namaste Care Program” to find a number of videos on the subject.
Some are educational, outlining program content and others are videos of Namaste rooms in action.
Check out the Distance Learning Program
NCCAP pre-approved for 8.5 hours
~End of Life Dementia Care using the Namaste Approach 
At the end of our lives we will not be judged by how many diplomas we have received,
how much money we have made or
how many great things we have done.
We will be judged by: “I was hungry and you gave me to eat.
I was naked and you clothed me. I was homeless and you took me in.”
~Mother Theresa