Dementia Care vs Nursing Homes

About Juliet Holt Klinger

Senior Director of Dementia Care

Juliet is a passionate advocate for people living with dementia and their families. She is deeply committed to improving the cultural acceptance of those with cognitive differences. As our gerontologist and Senior Director of Dementia Care, Juliet develops person-centered care and programming for Brookdale’s dementia care communities. But if you ask her, Juliet says she continues to learn every day from the true experts, those living with dementia and their care partners. Juliet believes we need to move beyond the concept of caregiving, which implies a one-sided relationship, and embrace the idea of care partnering. Care partnering is about relationships built on cooperation—a two-way street promoting person-centered care and mutual feelings of purpose, where the person living with dementia also plays a strong role in shaping their care and daily routine. We are here to partner, learn and grow with our residents and families to make aging a better experience. After volunteering in nursing homes in high school, Juliet knew she wanted to work with older adults. While working on her bachelor’s degree in social work at the University of Iowa, she completed an Aging Studies Certificate program, before there were formal gerontology programs available. At Iowa, Juliet also had the chance to study with pioneers in the field of dementia care, an opportunity that shaped her passion for caring for those living with dementia. Trained as a gerontologist, with a master’s degree from the University of Northern Colorado, Juliet joined Brookdale in 2004. She is a seasoned senior living executive with more than 30 years of experience designing and executing innovative Alzheimer's and dementia care programs and living environments in both assisted living and skilled settings.

older woman and caregiver in senior living

Recently, I met a daughter who was visiting one of Brookdale’s Clare Bridge dementia care communities and was astonished to find residents tending to a flourishing garden with a dog by their side. It never occurred to her that a dementia care setting would have outdoor spaces or let pets move in.

From our conversation, I could tell she had imagined our community resembling a stereotypical “nursing home” rather than the lively and lovely environment she discovered on her visit. It reminded me that many people don’t know the difference between an assisted living dementia care community and a skilled nursing facility. They are different – and have different purposes – and that’s important to know when considering options for a loved one’s care.

I would like to point out that the dreary nursing home of yesterday is a far cry from the reality of most skilled nursing facilities of today. Brookdale operates a number of skilled nursing communities and I am constantly impressed not only by the services they provide, but also the dynamic resident programming and focus on bringing joy and meaning to daily life. However, most people with dementia do not require skilled nursing care for long-term living. With dementia, physical or medical needs may not be the triggers for round the clock care.

What is needed, and what people living with dementia will benefit from most, is a setting specifically designed to nourish their mind, body and spirit as they live with dementia. They need a place where they can rediscover their talents and skills and be consistently engaged in purposeful, meaningful endeavors throughout the day. This engagement is critical to maintaining self-esteem and staving off depression. Specialized dementia care programs can boost resident’s physical wellness through exercise, nutrition and time spent outdoors. Central to our Clare Bridge dementia care program is the concept of person centered partnerships where the person living with dementia is understood and well-known by their care partners.

The reality is that this kind of environment can be very difficult for family caregivers to create and sustain at home. Creating meaningful, successful days and managing the complex symptoms of dementia can be something that takes years to understand how to do. Dementia care is a very specialized combination of not only clinical and psychosocial care and approaches, but also programmatic and environmental adaptations as well; all which promote well-being for those living with dementia. This concept, which is more than 30 years in the making, is to provide the best life possible for those living with dementia.

At any given moment, Brookdale’s dementia care residents are not just gardening – they are dancing, painting, practicing tai chi, discussing current events, going out to a restaurant, and sharing their wisdom and love with other generations – for example, through our partnership with Kinder Care. In our view, with the right support, there is just about no limit to what our residents can achieve. It’s exciting, and a privilege, to work with them to push the boundaries of what is possible.