Catholic Charities Report

Pictured above: Carol Gobin, LPN, the current director of the Memory Care Unit.

Focusing on Affectionate Remembering

By Gary Bouchard

Residents and staff at Mt. Carmel’s Memory Care Unit live in the moment

Too often in the care and treatment of people afflicted with medical conditions, emphasis is on what has been lost. In the case of those afflicted with dementia, their loss of memory is abundantly clear. That makes it all the more remarkable that the staff on the Memory Care Unit at Mt. Carmel Rehabilitation and Nursing Center in Manchester, a facility of Catholic Charities New Hampshire (CCNH) focuses, not on memory loss, but on affectionate remembering.

Roxanne Ashby, RN, QCP, CDS, the former director of the unit, who is now the assistant director of Nursing Services at Mount Carmel, says that the residents on the Memory Care Unit, “really represent humanity in its purest form. None of the filters that we all learn to develop as an adult are there. They make no apologies. This is how they are feeling and they just tell you. So we get to experience unfiltered joy, unfiltered sadness, love, grief, anger — the whole spectrum.”

She explains that this unfiltered expression of emotion fits with the diseases that cause dementia.

“A person’s hippocampus, the part of our brain responsible, in part, for storing short-term memory, is affected first. The amygdala, which aids in expressive emotions, sits right next to the hippocampus but is affected much later,” she says. “So throughout the continuum of the disease process, the residents are able to process and express emotion — which makes this the most rewarding part of the job.”

Carol Gobin, LPN, the current director of the Memory Care Unit, has been working in the unit for 35 years. “She is amazing,” says Ashby, “and the heart of the unit.”

For her part, Gobin emphasizes the great joy she takes in her work — joy that has enabled her to withstand in recent years not only the severe challenges of COVID-19 protocols within the unit, but two personal bouts of cancer that seem not to have diminished her enthusiasm one bit.

“It’s a fun job,” she says. “That’s for sure! The residents keep you laughing! They blurt out witty comments or ‘dad jokes’ that surprise us every day. They are living completely in the moment.”

Gobin says her staff collaborates with families to learn about the residents’ favorite programs, music, hobbies and so on.

“They give us background, insights into who the patients were before they began to lose their memory. We learn about who they were and we incorporate that into their present. We also get glimpses of the old them that comes out,” she says.

Both Gobin and Ashby describe the challenges that linger in the wake of the recent pandemic.

“Normalcy has changed in the face of COVID,” says Ashby. “We have to be very vigilant about all symptoms, regulating protections for the residents and staff.”

Gobin explains that the patients, “don’t understand if they are contagious why they can’t be with the others. So we make it a game. We might say we are going to have them do a special project, or tell them, ‘This is my favorite TV show and I can’t watch it, so can you watch it for me and tell me what happens?’”

Gobin and Ashby note that with the easing of protocols, it’s “heartwarming to see families be able to gather with the residents again.”

Another challenge is staffing. This, Ashby says, has required, “a lot of supplementation from outside agencies, so we are always doing new training and staff education.”

Still, Gobin emphasizes, “there’s probably over 100 years of longevity among the staff, so we have a lot to remember together.”

The memories they share are of the many residents who have passed on who they miss.

“It can be rough,” Gobin says. “We save the pictures of the residents and we reminisce about them as a group.”

Nobody carries more of those memories than Gobin, who has served on the unit long enough to remember when the nuns were still in residence and helped out on the floor.

“The staff tease me because I have seen the furniture on the unit change three times,” she says. “I tell people, ‘They’re saving a room for me here!’”