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Dementia Care at Judson Senior Living

The Comfort Matters Model

Longtime Judson team member Jessica Kulczycki leads the community’s dementia education and recertification efforts as a Community Life and CARE Director.

When an adult struggling with dementia begins pacing the room, Judson’s Community Life and CARE Director Jessica Kulczycki knows there’s much more to wandering. It’s not “just because of dementia.” “Pacing can mean that they lack the start button to initiate an activity. They need help getting engaged,” she relates, explaining the basis of the Comfort Matters approach to improving the quality of care and life for people with the disease. “It’s really about playing detective,” Kulczycki says. The Comfort Matters response would then be to help the person get involved in an activity. If that doesn’t satisfy the action, maybe the person is hungry. “We want to make sure we are meeting their needs, so maybe we try a snack.” Kulczycki adds, “We can identify what that action means for the person, and then we create an intervention and care plan it. Then, we share the information with the team so everyone knows how to respond.”

Comfort Matters is an accredited dementia care program, and Judson is certified in the model. Kulczycki leads recertification efforts along with helping deliver weekly dementia education to all staff. The impact of Comfort Matters across Judson campuses is evident in how every team member is involved in dementia care. “It is important to train everyone, and we begin during the orientation process within the first 14 days of coming to work at Judson,” Kulczycki says. “Whether you are a nursing assistant or you work in security or maintenance, you have the skills to recognize someone is struggling and how to help, or you know who to find so we can get the person comfortable faster.”

A Whole-Person Approach
Kulczycki joined Judson in 1999 after working as an activity assistant with older adults. “I always enjoyed working with seniors, and it was especially interesting to find a community with an art therapist on staff — with an art therapy degree, I wanted to be a part of that team,” she says. So first, she served as an activity assistant and then as Director, organizing an array of games, social gatherings, outings, music performances, and educational experiences. Then, she was asked to manage assisted living memory care. “That evolved into not just taking care of our residents from an activities standpoint, but looking at their medical needs, as well — and that was exciting to me to be involved with the whole person.”

Kulczycki earned additional memory care certifications, and she had the pleasure of caring for a special Judson resident, the late Winne Lind. “Her journey could be rough at times, and the family thought we did a wonderful job taking care of her,” Kulczycki says. “When she passed, they looked across the nation for best practices in dementia care and found Comfort Matters.” The Lind family’s donation to Judson jumpstarted the Comfort Matters certification training. At this time, Kulczycki and her team began the accreditation process.

“The evidence-based program is rooted in observing and collecting data,” she explains. “It looks at the different medications that can be tough on seniors, and our goal is to not have them on those if we can find alternate solutions. We pay attention to weight loss, supplements, pain assessment, and hospitalization. We monitor why people are on certain medications and consider how we can engage them differently. We observe, assess, and dive deeper to find out where the behavior is coming from.”
In the Comfort Matters model, behaviors are called “actions.” Those actions are a response to a need. As with pacing, here is another example of how an action goes deeper than the behavior. Say a person is yelling out or repeating a sound or phrase. “They are lacking the communication required to share their emotions,” Kulczycki relates.

Perhaps a person is teary-eyed and frustrated. “Maybe that is because a loved one was visiting, and now that loved one has gone back home, so we might bring out photographs or call the person so they can connect and meet that emotional need,” Kulczycki says. So what’s different about a memory care neighborhood that adopts Comfort Matters? This is a question many families ask when we introduce the model. There’s the approach side of it — looking at the whole person and teasing out the root causes for actions to meet needs. And there’s the overall feel of the community. “The big thing is a sense of calm,” Kulczycki says. “When people are comfortable, they are not trying to wander; they are not yelling out; they are not distressed. Our memory care neighborhood can be quiet—peaceful.”

The Comfort Matters training and way of care have impacted Kulczycki’s approach to her health and well-being, she says. She follows a heart-healthy diet — “heart healthy is brain healthy” — and she urges friends and family to take the best care of themselves. “Right now, we don’t have a cure for dementia, and the No. 1 risk is aging. So, how can we age well?” Serving on the Judson team, in general, has emphasized these values. “Everyone is an individual. Everyone has struggles and complications. We all have those physical, emotional, and spiritual needs — and they’re all different, so it has helped me to honor the uniqueness of people.” Kulczycki adds, “I’m passionate about comfortable dementia care, and we will be facing this even more in the future. Getting this story out to share that there are other approaches and options is so important as we work toward a cure.”