Incorporating Hygge in Dementia Care

I recently devoured Wiking’s “Little Book of Hygge” during my time at the airport whilst on my way to LCB Senior Living’s home office in MA. It was so good, that during the time I spent learning about the LCB culture, and especially the Brass Ring Dementia Program and Reflections philosophy, I started thinking about ways we can incorporate this Hygge into our care model and programming for folks with dementia.

There are several ways I see this crossing over from my first inclination that it’s another excuse for me to buy more Yankee Candles (sorry, husband) into something meaningful and useful within our communities and homes where we have residents with dementia. One of the ways Wiking breaks this down in his book, which I think ties well into incorporation with dementia is by what Hygge means for the five senses. Since we already know the power of sensory stimulation and engagement with dementia, this seems like a natural way for us to look at bringing in Hygge.

Taste
We absolutely understand how important food is to our residents. It is usually one of the most, if not the absolute most crucial factor for resident and family satisfaction, as well as choice when it comes to selecting a community. We also know that with dementia and aging, often comes the conditional side effect of a decrease sense of taste. Any of us who work in communities know that this is why our residents are so often complaining that food “has no taste” as they grab the salt shaker time and time again.

The good news for how this ties into Hygge is that typically, the sweet taste bud is the last one to go, which explains why so many residents have a sweet tooth. As Wiking writes, “The taste of hygge is almost always familiar, sweet, and comforting.” This doesn’t mean that he (or I) am advocating that nutrition be damned and we begin feeding our residents cheesecake and fudge for every meal (although if that becomes a thing at any community, please allow me to visit), but rather that we take note of those special treats that have significance for our residents, and incorporate them into the menu.

Hygge is highly tradition-focused, especially when it comes to sweet treats and food.

For me, every year around the holidays, since I was a born, my family would spend all day on Christmas Eve cleaning the house, wrapping gifts, and listening to Christmas music in preparation for our family gathering that evening. Around seven o’clock, once my siblings and I had all showered and put on our holiday sweaters and stockings, we would pile into our family’s mini-van and make our way to the Moravian Church for a service called the Love Feast. My mom had grown up doing the same, and the generation before her had as well. With very little in our bellies after spending the day in preparations, the Moravian sugar cake and coffee that was served during the hour long service tasted unbelievable to me. Now, I’ve taken on the role of Christmas Eve host, and since we’ve moved too far from the closest Moravian Church, I’ve begun making the sugar cakes myself. To my husband, someone who didn’t grow up with this tradition, these seem like mediocre coffee cake, but to me it’s the treat I look forward to all year because of the memories and hygge tied to it.

What we need to be doing with our residents is discovering what foods are their Moravian Sugar Cakes.

Sound
While Wiking notes that the crackle of a fire or a candle is likely the most hygge sound (and of course we’ve all noticed the attraction of faux-fireplaces in our memory care communities), really what is most hygge is the absence of sound.

So often when we think about dementia and sound we think of music. And certainly there are unmistakable gifts that our residents and loved ones with dementia experience associated with song, but I think something we don’t talk about as often is noise.

One of the best colleagues I’ve worked with once told me that whenever she has a moment, she likes to go and just sit and listen to her Memory Care neighborhood and imagine how the little noises might impact her residents. The hum of a dryer, the beeping of walkie-talkies, the door opening and closing, associates murmuring.

So often we don’t think of this as the true stimulant it is, because we are so good and dismissing it. For those of us who have experienced the Virtual Dementia training or something similar, we might be better equipped to sympathize with our residents, but that often doesn’t mean that we are as aware of the “noise pollution” as someone with dementia. What’s more is that for a resident with dementia, this is often not perceived as just “noisiness”, but as much more.

Once we are aware of the noise in our community, and once we’ve done what we can to control and limit it, providing quiet spaces and making sure that residents have access to those is critical. This might mean converting space in your neighborhood, or implementing a policy of not locking resident doors so that they can go to their apartment when they need to get away. That part will be up to you, but just keep in mind that each resident’s tolerance will be different, and you’ll likely need a few alternatives.

Smell
Smell is most closely related to taste. In fact, we know that a large part of our experience of taste comes from what we smell of the food. However, there are certainly smells that are hygge without being tasty.

For example, a colleague of mine just told me that she grew up in a house that was heated with a wood-burning stove and it wasn’t until she moved out and came back to visit that she was hit with the familiarity of that smell. It’s likely that if she develops dementia and winds up in one of our neighborhoods, that smell will take her back to her childhood.

What’s key here is safety. There are certain smells that might bring back bad memories. We want to identify those that our residents associate with positive things. Family can likely help with some of this, and our associates can certainly incorporate sensory programs with essential oils, baking, etc.

There are three smells that you should absolutely incorporate right away if you aren’t.

1. Lavender

   I bet you already knew this one. Lavender is proven to help with calming, centering, and even pain reduction.

2. Pine

   Pine is known to stimulate and maintain clear thinking.

3. Baking Bread

   I’ve never met ANYONE who walks into a room where there is bread baking and doesn’t comment. If your community doesn’t have a bread machine, it’s the best thing you’ll ever invest in. Plus, you can serve the bread at dinner after people have been smelling it bake all day.

Sight
Once you read Wiking’s book, you will reevaluate all of the light in your life. For example, Wiking describes how even when you enter the home of a broke Danish college student, you’ll find lamps or lighting worth several hundred dollars. The Danes know that the right light is the foundation of hygge.  But how does that cross over for folks with dementia?

We know the phenomenon of sun-downing is a symptom of many forms of dementia. For those who suffer from sun-downing, we see increased confusion, agitation, and even aggression at times in the hours before and during sunset.

One way to counteract this is by designing spaces (and residents’ days) around natural light. There are some lighting options that mimic the UV rays of sunlight as well. But whenever possible, spaces that allow the beauty of outside to be seen from inside are best, especially in colder months where it’s not as safe to spend extended periods of time outdoors.

Touch

Finally, touch is an element of hygge that Wiking identifies is key to a full experience. If you haven’t already seen a glimpse into the cultural phenomenon that is “oddly satisfying” on YouTube, check it out. Basically it’s video after video of these tactile experiences that we find just that… satisfying. If we take this concept into our memory care neighborhoods, we think of all the opportunities we have for residents to experience tactile stimulation.

Beyond the “busy boards” or non-toxic baking or sculpting, it’s important to think of tactile engagement for residents that allows them to be purposeful and appreciate beauty at the same time. Here are just a few ideas.

-Gardening

-Wiping Tables

-Folding warm clothes

– Petting an animal

-Applying lotion

-Wrapping gifts

-Washing a car

-Washing a dog

-Hand-writing a letter

-Cooking

-Playing an instrument

More hygge, less pressure.

Here’s a take-away that I think is really important, because I think often we, the dementia care professionals, feel overwhelmed that “oh man, here’s another thing we need to start implementing into our programming”.  But I’m here to encourage us to not look at this as a programming opportunity as much as a discovery and energy opportunity.

Once you read the book you’ll understand that the underlying reason and principle of hygge is doing that which brings us joy. If we can focus on that, and with those glasses, look at our environment with the idea of increasing joy, warmth, and coziness, then that is enough.

You can buy Meik Wiking’s book here. And if you read it and love it like I did, please pass it on to someone else!