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Dementia Care in the COVID-19 Era: Brad Justin, CNA

Caregiver Brad Justin, CNA can sum up much of what is different about working within an assisted living community in the current era with just two words: heavier lifting. In using the analogy, he gives a nod to trauma expert Gabor Mate.

As he talks about his journey, he gives a nod to professionals across many fields. There are procedural changes in place that are specific to the elder care industry, and there are risks to keep in mind. But much of Justin’s approach to managing new stresses comes from disciplines outside eldercare.

In Justin’s world, professional development and personal development are closely entwined. So are self-care and care of others. Justin’s current role is one step in a career focused on healthcare and human services. Under the present circumstances, this role requires a high level of mindfulness and planning.

Caregiving in a Time When Caring Brings Pain

Justin provides private caregiving services to a client at a well-respected – and arguably fortunate -- Seattle assisted living community. The virus itself isn’t stalking their halls. They’re not living the horror stories that have been flashed across news screens in recent months. They’ve got their health in the most basic sense, but residents have cognitive issues as well as physical ones, and isolation is both a health issue and a challenge.

People here are breathing – just as they are in the many similar facilities around the nation. However, they may not always be breathing deeply enough. Mindful breath is a part of Justin’s own plan for making it through the pandemic. "My spiritual practice has turned in the direction of looking inward, sitting and breathing" he says.

Justin is aware of multiple personal challenges, from how he focuses his attention and processes information to how he experiences empathy. Like many in the healing professions, he has the kind of empathy that can make it hard to keep moving forward when those around him are in pain.

He is a health consumer as well as provider, relying on nutrition and counseling and the support of an online tribe. The path, he believes, is about love and about including one’s own self in that equation. It's not about constant information.

"Writing is one of my tools to help me clarify and create,” he says, “I write little poems, affirmations. That's been part of my self-care. It's touch and go now, but I think later it will get easier".

Meeting Complex Needs

Justin is credentialed as a CNA. He spends part of his time providing basic physical care, but his focus in recent years has been on meeting complex human needs. His path has included self-employed caregiving out in the community and a program assistant position in a children's grief program.

His current focus is dementia and how it can cause agitation and behavioral changes that make placement and care a challenge. He has spent several full days each week meeting the needs of one client who is experiencing particularly difficult issues. Most of his duties are as caregiver. He typically spends a few hours a week engaged in care management activities such as conferencing with other professionals.

Like other healthcare workers, he has upped his use of technology. Justin uses multiple conferencing platforms to help his client interact with people in his life -- from his client’s wife to the professional who is helping him with his search for ‘right fit’ housing. Recently he helped his client re-connect with a special group: fraternity members from his youth.

Justin is considering other ways to use technology. Among them is creative expression. He is looking into tools for engagement – engagement being crucial to managing life with dementia.

It's not ideal. There are a plethora of technologies that enrich the lives of people with physical and mental challenges. There have been since long before COVID-19. Still, they don’t replace human contact.

When Justin says we need to use technologies effectively, he is referring to something more than mastery of the technical aspects. Eye contact has its place. Undivided attention is something he believes we all want. “If (high-tech, low-contact) is the way we’re going,” he says, “We have to consider how to preserve what’s vital. There are beautiful things about being human. We can’t let them become an endangered element.”

An Eye to the Future

Justin is grateful for the experiences he’s had in healthcare, all the way back to the first year, when he was employed in home health, providing basic physical care within the context of traditional employment. His age – 37 at the point of entry – and his broad life experiences allowed him to begin personalizing his career track at an early stage.

Where does he see himself down the line, with more education? Functional nutrition: helping people become their own best selves by modifying what they put into their bodies. He is excited by the idea that people can actually modify their genetic expression through nutrition. It’s been part of his path in developing himself as a human and caregiver. One day he may pass it on.

Justin’s practices are helping him make it through the difficult present tense. The future, he believes, will bring opportunity.

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