Last fall, I shared Megan’s story with you.  Megan, who began as a CNA, is currently an LPN, and is pursuing her RN credential, is only one of many employees who have received assistance from Immanuel’s Employee Education fund.  I’ve recently begun serving on the committee that helps decide how to distribute these funds.  That means that each semester, I will look at applications from employees who have asked for funds from Immanuel to help them reach their educational goals.  While I haven’t yet seen any applications, through conversations with colleagues I’ve learned that these are some of the reasons people apply for assistance from our fund:

  • They never had a chance to finish college as traditional-aged students and are going back now that they have the time and some financial assistance
  • They want to gain an additional credential in their work area (i.e. an LPN studying to be an RN)
  • They are traditional-aged students who work part-time at Immanuel and/or work full time during school breaks
  • They want to learn a skill or explore a subject they’re interested in but never had a chance to pursue before (i.e. art)

All of these reasons for going back to school suggest that the applicant has hope.  The student returning as a working adult to a degree program he or she started some years before, or to a new degree program that’s a bitter fit with their life now, hopes that their learning will enrich their life.  That enrichment might be financial or simply personal, but almost everyone embarking on a degree does so out of hope.  The student returning for an additional job credential does so because they believe that it will better equip them to serve current and future residents.  Even the non-degree-seeking student who takes an art class simply because they’re interested does so because they believe it will make a positive difference in their life.

Each of these reasons for applying for education funding implies hope for a future that is both different and better than the present.  I’d also like to point out that taking action implying hope for a better future doesn’t imply that a person’s current situation is bad.  Employees who seek additional education do so because they want something different, and they are willing to give what it takes to achieve their goals.  An LPN studying to be an RN is probably doing so because she enjoys nursing and wants to do it at a higher level.  She hopes that by obtaining another credential, she will be to provide a different level of service to both the residents she serves and the organization.  She also likely hopes that she will increase her earning potential to create more opportunities for herself and her family.

Hope is a powerful motivator.  It keeps us going even when things are difficult.  When you give to the employee education fund, you give the gift of hope to employees who want to make both their own lives and this organization stronger.  Your gifts contribute to the culture of hope we’re creating here at Immanuel.  Thank you for being part of it.

This time of year, the Thanksgiving holiday encourages us all to consider what we’re thankful for.  For this week’s post, I asked my colleagues here at Immanuel Lutheran Communities to share what they’re grateful for.  Here are some of the responses:


“I am grateful for a lot of things, especially my family.”

-Nicole Normandy, HR Assistant


“I am thankful for family.”

-Christie Brown, RN, Director of Nursing, Immanuel Skilled Care Center


“I am grateful for the friends God has blessed me with, both coworkers and friends outside of work.  I am thankful for the Lord who is always with me.”

-Pam Andrews, Life Enrichment Coordinator, Immanuel Skilled Care Center


“I am thankful for my family and friends I have in my life.  I wouldn’t be where I am today without them.  I am also thankful for my job and the residents.  I love my job and my residents—they put a smile on my face when I get to work.”

-Shirley Pate, PCA/CNA Trainee


“I am thankful to still have my grandfather her with us.  I am thankful for the home health aids that go out and care for him when my parents and me cannot be there.  I am thankful for the amazing Unit Council team; I’m glad we could get some amazing leaders for the team I’m part of.”

-Lacie Jo Curtin, CNA


“I am grateful for the unending love and effort I see everyone who works here put toward our guests, and to each other, day after day after day.  It is inspiring and while it may not happen to every single person every single day, it happens often enough to make my heart happy.  In this season of beauty and thanksgiving, let’s count each of us working here in whatever amazing job we do, and count most of all, our guests as our blessings.”

-Kitt Adams, RN, Retreat West


“I am thankful for my boyfriend Reza, the opportunity to see him in Paris, and crépes!”

-Charlotte Vaillancourt, Executive Development Assistant


“I am grateful that I work in a community that celebrates Christmas.  I also love working on a team that’s small enough to feel like a family.”

-Dave Garnett, RN, MDS Coordinator


“I am thankful for the awesome teamwork we’re growing at Buffalo Hill Terrace.  Departments are working together.  Even with growing pains as new spaces open, everyone is coordinating very well.”

-Subrina Hanson, LPN, Assisted Living Nurse Coordinator


“I am thankful for my job.  I have the best job in the world.”

-Bo Diaz, Transportation Coordinator


As for me, I’m thankful that I get to spend Thanksgiving with my family.  From the time I started college until I moved to Kalispell in 2015, I spent Thanksgiving far away from my loved ones.  While I created many great memories with friends during those years, I missed our family dinners, and I’m so glad to be with them.  I’m also grateful for the team I work with here at Immanuel.  It’s lovely to have colleagues who are always willing to pitch in and help out.  We all want to make life joyful for the residents, and it shows, every day.


And the Immanuel Foundation and Immanuel Lutheran Communities are grateful for you, our donors, volunteers, and supporters, who join us in our efforts to provide safe homes in vibrant communities for Montana’s seniors.


Happy Thanksgiving to all of you from all of us!

This somewhat lengthy essay is a response to an article in a national publication.  Your friendly blogger is not a memory support professional; my training in the area is extremely limited. This is a piece about ideas.  Some of them are ideas that come from observation and from my limited training, but I’m not recommending any action to anyone, and neither is Immanuel Lutheran Communities or the Immanuel Foundation

The October 8, 2018 issue of The New Yorker features an article by Larissa MacFarquhar called “The Comforting Fictions of Dementia Care.”  In it, MacFarquhar relates what she learned on a visit to The Lantern, a specialized memory support community in Chagrin Falls, Ohio, just east of Cleveland.  The Chagrin Valley community features an interior that is decorated to look “much like the town outside.”  The common spaces feature “facades of what looked like clapboard houses, with wooden shutters and shingled pitched roofs and porches that extended into the room.  Two long hallways… looked like streets in the same town, with more clapboard facades and porches on either side.”  Each “front door” opens onto a resident suite, offering the illusion that residents living in a locked community actually go outside every time they leave their suites.

The idea of illusion troubles MacFarquhar throughout the piece.  As she traces the history of dementia care from the days of physical restraints and Haldol (an antipsychotic) to “Reality Orientation” treatments to current, kinder practices, she talks a lot about lying.  By using that word, with all the value judgments it implies, and by making strong statements like “Family members and care staff lie all the time, and can’t imagine getting through the day without doing so, but, at the same time, lying makes many of them uncomfortable,” she poses a dichotomy between truth and lying that doesn’t necessarily exist where people with dementia are concerned.

Most memory support communities don’t take the illusion of external reality to the extent that The Lantern does (The Lodge at Buffalo Hill certainly doesn’t).  However, many communities encourage staff and caregivers to “live in the reality” of the person with dementia.  That means accepting their version of the world.  If a family member talks about her deceased husband as if he’s still living, then, a lot of professionals would recommend talking about why he’s away rather than insisting that he’s dead.  For professionals who recommend this course of action, these kinds of untruths are both kind and pragmatic.  If your family member believes her husband to be alive, news of his death will alarm her—and likely, she’ll soon forget it again, requiring you to tell her over and over that her husband is no longer alive.  This is likely to be extremely exhausting and unpleasant for both of you, so it’s something you might reasonably choose to avoid by going along with the fiction that her husband is simply absent.

The question, then—and MacFarquhar’s main concern—is whether going along with this fiction is lying.  Admittedly, this is a tricky question.  As MacFarquhar chronicles, people with dementia don’t necessarily want their family members and caregivers to tell them comfortable fictions.  She includes a summary by British researcher Graham Stokes of a panel convened a few years ago to discuss ethical issues in dementia care.  Stokes included people with dementia on his panel, and “All of them said, Why do you lie to us when we are at our most vulnerable?  Would you wish your relationships with others to be based on deceit?”  This is a fair point, and one that surely gives pause to many who interact regularly with people with dementia.  Surely in determining best practices in memory support we have to take into consideration what those with dementia want.  But the question becomes, What do you do if the person you’re interacting with believes you to be telling the truth when you are lying, and vise-versa?  What is the difference between the truth—insofar as it’s possible to determine that objectively—and a truth for the person with dementia?

I don’t have the answers to these questions, and I don’t think anyone yet does.  The memory support staff I know—and they range from managers to recreation staff to CNAs—believe in making every day as positive an experience as possible.  They certainly don’t set out to deceive the residents they care for, but if a resident believes she’s on a train, they’ll play the role of conductor.  Their training and their kind hearts tell them that the best thing to do for the resident is to enter their reality.  By being a train conductor for a little while, a staff member likely helps a resident have a much better day than she would if the staff member said, “Nope, I’m a CNA and you’re not going anywhere except to the TV room.”

In his essay “On Truth and Lies in a Nonmoral Sense,” German philosopher Friedrich Nietzsche posits, “What men avoid by excluding the liar is not so much being defrauded as it is being harmed by means of fraud.  Thus… what they hate is basically not deception itself, but rather the unpleasant, hated consequences of certain sorts of deception.”  As a scholar I’m compelled to note here that this essay is mostly about metaphor and language and how we as humans construct the world, but Nietzsche’s ideas are nonetheless useful here.  When a memory support staff member takes on the role of train conductor, she might in an objective sense be deceiving the resident in question.  But the resident is probably happier in this case “being defrauded” than she would be otherwise, and she’s not harmed by the “fraud” in any concrete sense.  There aren’t really any negative consequences here, except in the most abstract sense.  In fact, I’d go so far to say that it’s not really fraud, because fraud implies intent.

MacFarquhar concludes her article with a description of a Dutch community built to look like “a modern neighborhood in a Dutch city.”  It includes a restaurant, a pub, a café, a supermarket, a small mall, and even a music performance venue.  While the residents cannot leave, some parts of the community, like the restaurant, are open to the public.  MacFarquhar never says out right that this community lies, and she even seems to admire its homelike atmosphere and philosophy of public engagement.  However, her description immediately follows dire warnings about the consequences of lying.  Just before embarking on her description of the Dutch community, she quotes philosopher Sissela Bok: “The veneer of social trust is often thin… As lies spread… trust is damaged.  Yet trust is a social good to be protected just as much as the air we breathe or the water we drink… When it is destroyed, societies falter and collapse.”  In many senses, everything about the Dutch community is a lie.  Residents do not actually purchase things at the supermarket, and their homes are not in a normal neighborhood.  But could such deception really lead to the collapse of society?

I don’t think so, and as you can probably tell, I was, well, bugged by this article.  I value honesty in my interactions, but I can’t honestly say that if I were to develop dementia I would want everyone around me to tell the objective truth, regardless of the consequences for my well-being on any given day.  It should be up to every individual to make that decision, but as MacFarquhar rightly notes, it can be very hard to know with regard to dementia whether an individual’s desires remain the same.  What we do know is that while people with dementia might not experience what we would consider the objective truth, they have experiences that are real to them.  By watching and listening to them, we can get a little bit of access to their truths, and that’s probably more than they can get to ours.

All of my colleagues want to be ethical (as do I), and “tell the truth” seems like the most basic part of ethical practice as a professional and as a human being.  But maybe in memory support, ethics mean something else.  Maybe they mean respecting the truth of the person you’re working with, whatever it happens to be on the day.  Maybe it simply means, as I know my colleagues over in memory support do every day, creating a here-and-now for people with dementia that respects who they are at this particular moment.  I think this is what MacFarquhar is struggling with throughout the article, and again, I don’t have the answers.  But I don’t think it’s as simple as truth and lies.

Villas residents Fred and Shelby Thompson aren’t from northwest Montana, but they love it here.  In their photo, you can see a stained glass piece they made together that symbolizes their two homes: Montana, symbolized by Glacier National Park’s Lake McDonald, and Alabama, symbolized by a pink camellia.  They first came to Glacier nearly fifty years ago.  On that first trip in 1969, the couple decided they would eventually move to Glacier Park, and decision that came to fruition when they built their first West Glacier house in 1997.  Both still speak with gentle, light Southern accents, but it’s clear from their West Glacier home (where we met them this past August) that they’ve put down roots in Montana.

Fred and Shelby’s journey together started when they were in high school.  They were high school sweethearts who married soon after they graduated.  In those early days, Fred worked construction, first as a plumber and pipe fitter and then as a ceramic tile setter.  Shelby worked as a bookkeeper and the two of them made their first home in a travel trailer.  Later, Fred went to work in the family laundry and dry cleaning business.  In fact, the couple first came to Glacier so Fred could run the laundry at Glacier Park Lodge.  Shelby remembers that summer fondly—it was the only extended period in their marriage when she didn’t work.

As time went on, both Fred and Shelby moved on to different jobs.  The couple never had children, and they always supported each other in their careers.  Eventually, Fred established himself as the Production Superintendent of a paper and cardboard company.  The plant where Fred worked specialized in boxes for chicken products—so now I think of Fred whenever I eat Chick-fil-A nuggets.  Meanwhile, Shelby made her career in the US Department of Agriculture, where she worked first for a program that made loans to local farmers and then specialized in rural water systems, including water towers in remote locations.  At the time, her achievements were unusual for a woman, and Fred was always by her side.

Along the way, they had a lot of adventures.  Both Fred and Shelby had pilot’s licenses—a choice Shelby made so she could ensure that the couple could always fly safely–and one of their favorite things to do together is travel.  Maybe that early travel trailer was a foreshadowing of things to come.

Over the course of their 64-year marriage, Fred and Shelby have visited all seven continents together.  They’ve seen the wildebeest migration in Kenya and Tanzania and the penguins in Antarctica and have been on 14 river cruises throughout the world.  Though they reached their goal of visiting all seven continents when they set foot on Antarctica in 2006, they continue to travel as much as they can, and wherever they go, they have as many adventures as possible.  In Antarctica, Shelby took the Polar Plunge.  Fred chose not to dive in to the freezing ocean, but he cheered her on from dry, if not warm, land.  They visited East Berlin in the 1970s, where they remember seeing actors portraying happy citizens on their tour, and recently got a bit overheated in Beijing’s Forbidden City—though they don’t regret the trip.

It’s important to Fred and Shelby that they explore and develop personal connections with the places they visit.  They make friends wherever they go, and sometimes they reconnect with people they met on trips.  They’ve also visited faraway locations for personal reasons.  They went to China because they have an adopted great niece from that country and wanted to know more about her birth culture.

The Thompsons have certainly seen a lot in their lives, and as they move on to the next chapter, they’re happy with where they’ve been and where they’re headed.  “We’re getting old and we know it, but we look back and we don’t have any regrets,” they told us when we interviewed them for their photo.

Tomorrow, Saturday, November 3, the public will have the opportunity to see The Villas at Buffalo Hill for the first time.  For over a year, this project has been rising slowly from the top of Buffalo Hill next to Buffalo Hill Terrace (of which it is a part).  While we haven’t measured, there’s a good chance that, thanks to its hilltop location, the top of the Villas is the highest point in Kalispell.  Many community members have been curious about what this building is like inside, and tomorrow, they’ll have a chance to see it.

The Villas feature 36 beautifully-finished apartment homes, most of which have been customized to the tastes and preferences of their first occupants.  These apartments represent a new variation on independent living at Immanuel.  Residents pay an entrance fee and, after move-in, a monthly fee that’s somewhat lower than the rental rate at Buffalo Hill Terrace.  In addition to one restaurant meal a day and access to all of the amenities Immanuel has to offer, the entrance fee provides residents with the safety net of an investment; at move-out, part of it will be refunded to the resident or their heirs (the percentage depends on which of several plans the resident chose).  In other words, the Villas provides residents with a home for now and security for later.  And because the Villas are located on Immanuel Lutheran Communities’ campus, residents whose health needs change won’t have to go far if they need assisted living, short-term rehabilitation, memory support, or skilled nursing.

Of course, the Villas aren’t the only thing opening this weekend.  We’ll also be revealing to the public the new auditorium/chapel and swimming pool.  These amenities are at least exciting as the Villas.  For a long time, we have been looking forward to having a gathering space larger than the Buffalo Room, and many residents are eagerly anticipating the possibility of taking a swim or soaking in a hot tub without ever leaving campus.  These new spaces will expand our fitness offerings and make it possible for more residents to attend popular activities like Dinner and a Movie (during which participants enjoy a special meal while watching a feature film).  They’ll also make it possible for us to host more external groups and make large events, like the Family and Friends Christmas Dinner, run even more smoothly.

While the buildings look beautiful and are ready to host visitors and be used by residents, there’s still a feature missing.  We want to install a stained-glass window in the chapel, and we need your help.  Our quilt raffle this summer got us started, and a generous anonymous donor pushed us further along the path, but we still need about $12,000 before we have enough funds to purchase the image of Jesus as the Good Shepard our artist has designed.  If you would like to help, please click on the link below and designate your gift to “stained glass.”  We want the chapel to be a sacred space where our residents worship as well as celebrate, play, and exercise.

To see what a difference your gift could make, come to the Open House at the Villas on Saturday, November 3 at 10am—or join us at 1pm on Sunday, November 4 for the Chapel Dedication Service.  We’d love to see you!