E Brochure 2019

Dedicated to families and community by enhancing the lives of those challenged by Alzheimer’s, Memory loss and other forms of Dementia, we provide quality of care unsurpassed in the industry to help those on their journey with Dementia. 360.582.9309 651 Garry Oak Dr. • Sequim, WA 98382 www.dungenesscourte.com

HELLO & THANK YOU We are pleased that you have contacted us to learn more about the Olympic Peninsula’s Premier Memory Care Community. Our unique and functional design plan is specifically for people who are challenged with any and all forms of Dementia, including Alzheimer’s disease. At Dungeness Courte we provide a social environment in a non-clinical setting arranged much like a typical private home. Our specialized and compassionate staff is skilled and receives continual training in the most modern and effective methods of providing “Gentle Care” and our residents not only feel more at home but are encouraged to... ...securely stroll our center courtyard and enjoy our beautifully landscaped backyard with its welcoming walkways and relaxing places to sit and enjoy nature’s beauty. Relax with family members in one of our friendly family rooms while joining in on an interesting activity, whether it is puttering in the vegetable or flower garden, engaging in a group exercise class, enjoying a relaxing afternoon at a “Movie Matinee” or joining in for an afternoon with “Musical Magic” from local entertainers. The best way to understand the uniqueness of our community is to visit us, share some refreshments and chat about the particular needs of the person on whose behalf you are looking. It is so important to be well informed, and to be aware of all options when making a residential choice for a loved one. We are here to help you and assist in any way we can. If you have any questions please feel free to call us at anytime. After all, an important part of our care is providing support for families and friends in our community.



MISSION STATEMENT Anticipate. Meet the needs of our residents and families with the highest level of expertise, compassion and quality care. Facilitate. Professional and personal growth of our care providers. Serve. A resource and partner in our community.

SECURITY WITH DIGNITY Freedom of movement and choice are the cornerstones of our innovative programming. Everything at Dungeness Courte is carefully crafted for therapeutic value with optimum security. Inside, spacious common areas and cozy sitting areas give residents and their families plenty of places to visit, rest or just be a part of things. Outside, our completely secured courtyard has numerous garden spots and patio areas to provide that positive connection with nature we all cherish.



ADMISSIONS PROCESS AND ASSESSMENTS We currently assess individuals to ascertain appropriate levels of care, and then we design a unique program. Our assessment team is dedicated to ensuring a comprehensive care plan is developed which emphasizes a person’s functional strengths. Under this statement maybe we can include the bullets already listed and add a few more…making this page more complete: • Licensed nurses on-site 24/7 • Fitness/restorative program designed to help maintain mobility and independence • Variety of activities encouraging socialization while stimulating the mind and spirit • Secured home environment with freedom to wander inside and outside our uniquely designed building.

BENEFITS OF 24 HOUR LICENSED NURSING SERVICES Dungeness Courte Memory Care provides 24 hour licensed nursing services which includes a Registered Nurse and/or a Licensed Practical Nurse on-site 24 hours a day. At Dungeness Courte our families have peace of mind because... • All medications and treatments are administered by our licensed nurses. • Our licensed nurses have the expertise to assess behavioral concerns, medical needs, individualized care plans, fall prevention plans along with other medical concerns. • An evaluation by our licensed nurse may eliminate an emergency room visit. • Our licensed nurses monitor and review medication dosages, reactions and sensitivities and communicate directly with physician. • Our licensed nurses communicate with residents’ medical professionals (doctors, ARNP’s, mental health providers, Physical and Occupational Therapists and Home Health Nurses, but not limited to the above professionals. • Our licensed nurses are available to asses pain issues at any time of the day or night and provide pain management services. • All medication orders/refills are conducted by our licensed nurses. • Many LTC Insurance plans require 24 hour nursing services on-site.

THINGS TO REMEMBER TO BRING • SOCIAL SECURITY CARD OR NUMBER • MEDICARE CARD • SUPPLEMENTAL INSURANCE CARD • DURABLE POWER OF ATTORNEY • LIVING WILL OR HEALTH CARE DIRECTIVE • CLOTHING: Bring the items they love to wear the most. Please don’t bring more than 5-7 outfits. No fabrics that will need to be dry- cleaned or that will shrink or fade in the regular wash. Personalize all belongings with the resident’s name. Seasonal clothing is recommended: warm hat, coat and gloves in winter, sun glasses and sun hat in the summer. • PERSONAL TOILETRIES & EQUIPMENT: Dentures, hearing aids (with batteries), glasses, sunglasses, walkers and wheelchairs, (no canes). Hairbrush, comb and razors (electric only). • FURNISHINGS: Favorite chair (optional), pictures for wall (no glass), photographs ( copies only, no originals), and other memorabilia that creates a home like space. Radio or TV if desired. Dungeness Courte Memory Care provides the following for your convenience: Twin bed, built in armoire, bedside table & lamp, linens, towels, bedspreads and curtains are furnished for all of our residents (shared rooms also have an additional divider with 3 extra drawers). We provide toothbrush, toothpaste, hair care products, deodorants, aftershave, lotions, and sunscreen. Paper products such as Kleenex, toilet tissue, paper towels and incontinent supplies are also provided for our residents. ALL SNACKS AND FOOD MUST BE CHECKED IN BY STAFF & STORED IN KITCHEN &/OR NURSING STATION, FOOD IS NOT ALLOWED IN RESIDENTS BEDROOMS.

We currently assess individuals to ascertain appropriate levels of care, and then we design a unique, individualized program to manage and meet their needs. Our assessment team is dedicated to ensuring a comprehensive care plan is developed which emphasizes a person’s functional strengths. LEVELS OF CARE LEVEL I A typical Level I resident directs easily, is continent of bowel and bladder, has no significant other medical conditions, and is independent of most activities of daily living (ADL’s). LEVEL II A typical Level II resident requires more cueing with ADL’s, may occasionally be incontinent, and may have other medical conditions. LEVEL III A typical Level III resident requires much cueing or redirection, needs some help with most ADL’s, is regularly incontinent, and may have other medical conditions. LEVEL IV A typical Level IV resident requires full assist with ADL’s, continuous cueing, incontinence management and may have other significant medical conditions. LEVEL V A typical Level V resident requires full assist with MOST ADL’s, full incontinence management, and may have other significant medical conditions and/or behaviors. LEVEL VI A typical Level VI resident requires full assist with ALL ADL’s, full incontinence management, and may have other significant medical conditions and/or behaviors requiring two person transfer (Hoyer), non-weight bearing support, full nutritional assistance (feeding/pureed diets), and possible hospice care assistance.



ADMISSION FEES AND RATES LEVELS OF CARE LEVEL I $2690.00 (0-5 points) DEPOSITS LEVEL II $3350.00 (6-15 points) $200.00 Refundable LEVEL III $4010.00 (16-30 points) $1800.00 Admission Fee-Non-Refundable LEVEL IV $4670.00 (31-42 points) LEVEL V $5330.00 (43-60 points) SHARED ROOM WITH BATHROOM LEVEL VI $5993.00 (61 + points) Base Rent $3800.00 Base Rate along with corrusponding PRIVATE ROOM WITH BATHROOM level of care points will determine Base Rent $4400.00 monthly rental Charge. SERVICES INCLUDED IN BASE RENT • Variety of Activities encouraging socialization while stimulating the mind and spirit 7 days a week (including bus outings/field trips) – musical entertainment weekly • Three meals daily, including fresh fruit snacks and beverages throughout the day • Housekeeping services performed weekly, unless needed more often • Laundry service (daily), including labeling of clothes and inventory • Transportation provided to local scheduled appointments – within a 10 mile radius of community • Fully Furnished rooms (twin bed, armoire, and bedside table with lamp, headboard, barrel chair and curtains, individually controlled heating, emergency call system, large picture windows) • All TOILETRIES including incontinent supplies (shampoo, soap, toothpaste/ toothbrush, lotions, after shave, shaving cream, hair brushes/combs, Kleenex, toilet paper, linens, towels, comforter & pillows). • ALL utilities (excluding telephone & television cable in room) common areas provided with cable • In house nail and foot care SERVICES OFFERED AT ADDITIONAL CHARGE (PLEASE INQUIRE) • Mental Health Professional onsite once a month (if prescribed, Medicare insurance will be billed) • Professional manicure/pedicure twice a month (extra charge) • Beautician – weekly (extra charge for haircuts, perms, color) • Dental Hygienist – visits every six weeks (extra charge – covered under most dental insurance)



EVERYDAY LIFE The daily experience at Dungeness Courte improves the quality of life for people with dementia by supporting rather than challenging them and offering life-enhancing, yet familiar activities, like exercise, baking, gardening, religious events, music and reminiscing. Our residents benefit from our therapeutic practices. Our specially trained staff provides individual attention to meet the unique needs, preferences and abilities of each resident.

COMMUNITY RESOURCES Families and visitors are encouraged to browse through and borrow books and videos from our Alzheimer’s resource library. As part of our mission, Dungeness Courte sponsors community events to help people dealing with dementia. Dungeness Courte offers two unique programs to assist you. Day Program Our Day Program offers relief from 1-10 hours per day. Once a part of the program, individuals are welcome to participate daily or on a drop-in basis. Respite Program Our Respite Program offers relief from 1-30 days. One time, on-going planned respite, or vacation relief is available. Take a break for the day or plan some time for yourself on a regular basis.





MANAGED BY EXPERTS Dungeness Courte is professionally managed by Northwest Care Management, the Puget Sound’s most respected experts on Alzheimer’s care. The professionals from Northwest Care Management have been working with local communities throughout the region for more than a decade. Northwest Care Management understands the importance of people being able to remain in a community they value and trust, being close to family and friends, while receiving the best services and care available. Dungeness Courte is designed to enhance the experience for the residents and their loved ones.

“LIVE IN THE MOMENT AND CHERISH TODAY” Dungeness Courte Memory Care Community has served the Olympic Peninsula since August 1999 and is proud and honored when families choose “Our home” to be their loved ones “new home”. The families open their hearts and share their past with us so in return we help families “Live in the moment and cherish today,” making “new memories” and look with hope towards tomorrow, with opportunities to balance emotional, physical and spiritual well being!

Emotionally…… Making that connection for our resident and their family of what is home to them from day to day – it is a feeling of warmth and relief that comes with that emotional “happy safe place” we all have and cherish. The simple life and a piece of “quiet calmness” of home; balancing life begins with the family’s acceptance and courage to embrace the change of their loved ones new challenges and theirs. Physically…… Dungeness Courte assists in maintaining physical abilities along with emotional stability. Day to day activities can be challenging, we simplify this by giving them dignity and independence, but knowing how and when to help with a gentle hand and a soft touch with a hug and a smile can make all the difference in the world to them and they feel accepted for who they now are. Physical challenges can be overwhelming for anyone, having that helping hand everyday lessens the confusion and builds a trust that is needed for a happy day and life. Spiritually…… We are all connected in one way or another, being able to recognize this and have that continuation of life through reaching out and holding, feeling and finding that much needed and welcomed tranquility we all dream of and achieve through our spirituality can save even the most challenged individual during the day.

DAY RESPITE AND OVERNIGHT RESPITE Our adult day stay and overnight respite care participants are provided with a safe, nurturing family environment which includes care, nursing services, meals, pre-planned structured activities program and respite to the adult caregiver. (Non-covered charges for daycare participants include showers, which can be provided for an additional cost of $20.00 per shower; must be scheduled in advance). • Adult Day-Stay is offered 7 days a week up to 10 hours each day (minimum 3 hours) • Day Stay Program is offered from 8:00 am until 6:00 pm (additional hours upon request) • Participation cost of our program $18.00 an hour • One time set up fee of $100.00 • Overnight respite stay participation cost can be determined once an assessment has been completed the cost ranges between $200.00 to $350.00 a night Please call for additional information and to set up your lunch assessment to begin your loved one’s day stay/respite care program 360.582.9309.



DAYCARE INFORMATION & PRICING • Daycare offered 7 days a week - up to 10 hours per day. • Cost $18.00 per hour. One time set up fee of $100.00. • Hours include 8:00 am until 6:00 pm - if earlier or additional hours are in need this can be arranged through administration and nursing staff. • Overnight Respite Program - offered 1 - 30 days. • Cost can range from $200.00 to $350.00 per twenty four hour period - assessment will determine level of care needs and fee. • Dungeness Courte will assess and obtain physician orders before scheduling respite stay. • Our daycare and respite care residents are provided with a safe, nurturing family environment which includes all activities, nursing services, meals and care; (non-covered additional charges for daycare residents include showers at a rate of $20.00 per shower; must be scheduled in advance). • Please call for additional information and to set up your lunch assessment to begin your loved ones daycare/respite care program (360-582-9309).





CORNERSTONE STATEMENT At one point in every day, one of our customers will come into contact with one of us, the Dungeness Courte Memory Care employees; and at that moment in time, we will be the sole ambassadors and representatives of our community. Our entire reputation as an assisted living community will be in our hands and we will make a memorable impression. This impression will either be good or it will be bad and we will have spoken to our customers more loudly than all of our community involvement, our advertising and all our public relations put together. DUNGENESS COURTE MEMORY CARE SERVICE CREDO 1. We strive to be the very best. We do the best job we are capable of all the time in every part of our community; we are proud of what we do. 2. We react quickly to resolve our customers’ problems immediately. 3. We smile and maintain positive eye contact with our customers. 4. We are friendly, helpful and courteous. We treat our customers as we would like to be treated ourselves. 5. We are ambassadors of our community. We always speak positively and refrain from making negative comments. 6. Our uniforms are immaculate. We follow the dress code; wear safe footwear and nametags at all times. 7. We are positive. We always find a way to get the job done. We always try to make it happen. We never give up in satisfying our customers. 8. We use proper phone etiquette. We always try to answer within three rings and with a smile in our voice. If necessary, we always ask if we may place customers on hold and we eliminate call transfer whenever possible. 9. We are knowledgeable about the services Dungeness Courte Memory Care offers. If I do not know about a specific service, I will ask my supervisor to give the customer an answer. 10. We never say “no”. We say, “I will be happy to check and see.” We suggest options if we are aware of them. We contact our supervisor if we feel that we cannot satisfy our customers’ needs.

10 Warning Signs of Alzheimer’s Disease 1. Memory loss that disrupts daily life 2. Challenges in planning or solving problems 3. Difficulty completing familiar tasks 4. Confusion with time or place 5. Trouble understanding visual images and spatial relationships

6. New problems with words in speaking or writing 7. Misplacing things and losing the ability to retrace steps 8. Decreased or poor judgment 9. Withdrawal from work or social activities 10. Changes in mood and personality

ALZHEIMER’S DISEASE AND OTHER TYPES OF DEMENTIA Alzheimer’s disease. More than 5 million Americans have Alzheimer’s disease, which is the most common form of dementia accounting for 60 to 80 percent of all cases. That includes 11 percent of those age 65 and older and one-third of those 85 and older. The disease also impacts more than 15 million family members, friends and caregivers. Dementia. Dementia is a general term for the loss of memory and other intellectual abilities serious enough to interfere with daily life. Other Types of Dementia. Vascular dementia is a decline in thinking skills caused by conditions that block or reduce blood flow to the brain, depriving brain cells of vital oxygen and nutrients. These changes in thinking skills sometimes occur suddenly following strokes that block major brain blood vessels. It is widely considered the second most common cause of dementia after Alzheimer’s disease. Mixed dementia is a condition in which abnormalities characteristic of more than one type of dementia occur simultaneously. Symptoms may vary, depending on the types of brain changes involved and the brain regions affected, and may be similar to or even indistinguishable from those of Alzheimer’s or another dementia. Parkinson’s disease dementia is an impairment in thinking and reasoning that eventually affects many people with Parkinson’s disease. As brain changes gradually spread, they often begin to affect mental functions, including memory and the ability to pay attention, make sound judgments and plan the steps needed to complete a task. Dementia with Lewy bodies is a type of progressive dementia that leads to a decline in thinking, reasoning and independent function due to abnormal microscopic deposits that damage brain cells.

Huntington’s disease dementia is a progressive brain disorder caused by a defective gene. It causes changes in the central area of the brain, which affect movement, mood and thinking skills. Creutzfeldt-Jakob disease is the most common human form of a group of rare, fatal brain disorders known as prion diseases. Misfolded prion protein destroys brain cells, resulting in damage that leads to rapid decline in thinking and reasoning as well as involuntary muscle movements, confusion, difficulty walking and mood changes. Frontotemporal dementia (FTD) is a group of disorders caused by progressive cell degeneration in the brain’s frontal lobes (the areas behind the forehead) or its temporal lobes (the regions behind the ears). Normal pressure hydrocephalus is a brain disorder in which excess cerebrospinal fluid accumulates in the brain’s ventricles, causing thinking and reasoning problems, difficulty walking and loss of bladder control. Down syndrome dementia develops in people born with extra genetic material from chromosome 21, one of the 23 human chromosomes. As individuals with Down syndrome age, they have a greatly increased risk of developing a type of dementia that’s either the same as or very similar to Alzheimer’s disease. Korsakoff syndrome is a chronic memory disorder caused by severe deficiency of thiamine (vitamin B-1 ). It is most commonly caused by alcohol misuse, but certain other conditions a Isa can cause the syndrome. Posterior cortical atrophy (PCA) is the gradual and progressive degeneration of the outer layer of the brain (the cortex) located in the back of the head (posterior). It is not known whether PCA is a unique disease or a possible variant form of Alzheimer’s disease.



Your Survival Guide to Alzheimer’s and Dementia PACING Reasons: She/He is scared and unsure of where she/he is. What you can do to help her/him: Walk with her/him. Hold her/his hand. Hell her/him that she/he is safe and loved. Offer snacks that they can carry in her/his hand as they walk. Keep the walkway clear so she/he is safe from falling. Try to distract her/him from pacing. Ask her/him to look at a magazine or work a puzzle with you. USING THE BATHROOM What you can do to help her/him: Mark the bathroom clearly with a sign that says “bathroom” or a picture of a toilet. Watch for clues like fidgeting with clothing or pacing. Write down the time of day that toilet accidents happen to better predict future accidents. Walk with them to the bathroom every 2 to 3 hours. Don’t make a big deal out of it. Don’t wait for them to ask. Say “We need to go to the bathroom. Carry extra toileting supplies with you when you are away from home.

REFUSING CARE What you can do to help her/him: Keep a daily routine. Don’t ask “Do you want to...bath, brush your teeth or get dressed?” In a happy voice say, “We need to...” (the care activity) Have all the supplies ready before you start an activity. Explain to her/him, in simple terms, what you will be doing. Make sure their refusal is not because she/he is afraid or does not understand what you are asking her/him to do. If she/he begins to fight you, step away. Try again later. HOME SAFETY What you can do to help her/him: Try to make their world simple. Use plain-colored placemats, tablecloths, bath towels and sheets. Block off stairs so she/he cannot fall up or down them. Have all of your house locks keyed to the same keys. Place safety latches up high and down low on doors leading to the outside. Have her/him wear an ID bracelet if she/he wanders, and sign her/him up for the Alzheimer’s Association’s Safe Return Program. Used locked cabinets for soaps, cleaners, poisons and medicines. Take up all throw rugs.



DRESSING What you can do to help her/him: Allow twice the amount of time you think it will take for them to get dressed. Don’t act rushed or in a hurry. Limit their clothes to two outfits. Let them pick which one they want to wear. Lay their clothes out in the order she/he needs to put them on. If she/he loves one outfit and refuses to wear anything else, buy several outfits that look just like it. Use pants with elastic waists and pullover tops to make dressing easier. WANDERING What you can do to help her/him: Make sure that she/he wears a medical ID bracelet. Keep a recent photograph of her/him to help the police if they become lost. Keep all of the doors locked. Consider installing a keyed deadbolt. Place safety latches up and down lown on doors Enroll her/him in the Alzheimer’s Associations Safe Return Program. Make sure she/he gets enough exercise and sleep. Let them do chores, such as folding clothes or helping with dinner. Place cloth of the same color doorknobs or paint door knobs and doors with same colors as walls.

COMMUNICATION What you can do to help her/him: Pay attention to what she/he is trying to tell you. Keep what you are telling them short and simple but not child-like. Use one-step instructions when asking them to do what you want. This will decrease their frustration level and make each activity a success for her/him. Don’t tell her/him more than she/he needs to know at one time. Be patient. Give her/him lot of time to answer your questions. Don’t argue with her/him. It is easier to agree with them and do what you had planned anyway. Don’t try to reason with them, you will just get angry and they will not know why. Change what you are talking about to something they like. Don’t correct or fuss at them for getting something wrong. Does it really matter? It may only make them feel bad. Don’t say “I just told you that.” Just repeat the answer you have already given to them. Don’t ask her/him to remember things that happened in the past. Talk about what you remember happening and how she/he was a part of it. Don’t say “You can’t.” Say “Do as much as you can, and I will help you.” Don’t demand things from her/him. Always show her/him what you want her/him to do. Her/his entire day depends on how you speak to them. Speak very calmly and know that your body language needs to reassure them.

IN THE CAR What you can do to help her/him: Keep the car keys out of sight. Always talk to her/him about where you are going. Tell her/him where you are going as you leave the house. If she/he wants to know why they can’t drive tell them the doctor or insurance company said she/he could not drive anymore. Open the car door for her/him. Help them put on their seat belt. Tell her/him each car’s seat belt is different if they have difficulty putting it on. Use the child safety lock feature on the car door so she/he is not able to unlock the door from the inside. Make the trips in the car to places she/he likes to go as well as places she/he has to go. In later stages of AD, having them sit in the back seat is safer and less scary for them. If they refuse to get out of the car when you get where you are going, don’t argue with them. Drive around the block and try it agian. If she/he refuses to get out of the car when at an Adult Day Car Center, call ahead and ask a staff member to meet you in the parking lot or at the door. If she/he refuses to get out of the car at home and someone else is there, ask them to meet you at the door and invite them to come in.





EATING What you can do to help her/him: Serve meals at the same time every day. Serve food with different colors and textures. Make the table a calm place to eat. Use plain-colored dishes with no pattern to set off the color of the food on the plate so she/he can see the food. Use a shallow bowl with a lip on it if she/he keeps pushing the food off the plate. Put only the knife, fork or spoon they need to eat with next to their plate. Allow plenty of time to eat. Don’t rush them. If they refuse to eat it may be because: They have too many choices on thier plate. Try offering one food item at a time. They may not know how to get started. Show them the act of eating. SURVIVAL TIPS What you can do to help her/him: Put staying healthy at the top of your list. Have a backup plan in case something unexpected happens to you. Take one day at a time. Keep your sense of humor. Pat yourself on the back for the good job you are doing. Get enough rest and eat right. Make time for the things you like to do. Talk about how you feel with others. Listen to your friends. Make a list of all the tings your loved one can still do.

360.582.9309 651 Garry Oak Dr. • Sequim, WA 98382 www.dungenesscourte.com