Case Study: Improving quality of life in an assisted care facility

Case Study: Improving quality of life in an assisted care facility

This is the story of how GeriJoy helped a patient at Evergreen Residence, a leading provider of Assisted Living and Alzheimer’s Care  in California’s Central Valley. 

By Neil Tantingco

Owner, EverGreen Residence. 

In July of this year, our team received a pleading call from a granddaughter, desperate to relocate her grandmother, who had the telling signs of advanced Alzheimer’s, from another community.

The grandmother had a history of swinging punches, verbal abuse, and often preferred to be alone in her room.  The owner of her community at the time often resorted to administering Risperidone.

Historically, Evergreen Residence often declined accepting clients who have violent or verbally combative tendencies, but our team collectively accepted the challenge since we had success with another resident with similar qualities and who is now doing better.  The Evergreen team of caregivers assembled a strategy to transition this new resident by blending our caregiving methodology, heavy family engagement… and GeriJoy!

GeriJoy’s memory care program

As part of GeriJoy’s memory care program, we cautiously introduced the grandmother to the GeriJoy Companion, who we initially called “Buddy.” The grandmother was instantly drawn to Buddy and she started describing her old beloved dog “Trixie,” who she obviously missed.  Without any prompting, this grandmother with Alzheimer’s, who rarely uttered even two word phrases, began describing Trixie’s appearance, habits and other qualities to Buddy.  When Buddy suggested renaming himself to be her new pet “Trixie,” she refused since her beloved Trixie “could never be replaced.”  Again without any prompting from any of the caregivers, the grandmother insisted on renaming Buddy to “Cutie.”  This first encounter lasted about 15 minutes, which because of the grandmother’s uncommunicative, aggressive, and combative behavior, was beyond our initial expectations.

During the following days and weeks, we continued to sit the grandmother in front of the GeriJoy Companion as part of our transition process.  Every time the grandmother petted Cutie’s head, Cutie sat up and carried on blocks of 20-30 minute, two-way, interactive conversations.  Through the GeriJoy Family Portal, we added photos of different places, residents, and caregivers at Evergreen, and of the resident’s family, so that Cutie could engage the grandmother and encourage her to connect with the community while reinforcing family connections and memories. The granddaughter was overjoyed when the grandmother started recalling her granddaughter’s name every time Cutie showed old pictures from the past.

GeriJoy’s memory care programming has been a potent caregiving tool, particularly in sundowning moments.  When the grandmother started showing signs of sundowning, our caregivers often relied on Cutie while applying redirection techniques to help calm moments of agitation.  Even when the grandmother was alone in her room, sitting in her recliner, our caregivers could overhear conversations that she had with Cutie. Additionally, the care logs that Cutie maintained and that we could check through the Family Portal are very helpful from a care management perspective, allowing us to verify and document that we are successfully engaging the grandmother and stimulating her cognitively and emotionally.

The dramatic improvements 

In the second month, by doctor’s approval, Evergreen Residence ceased to administer the potent Risperidone after we reported consistent calm behavior while under our care.  Now on our fourth month, we still have not experienced a single physical or verbal altercation towards the staff or other residents.  This grandmother is now co-mingling and socializing with other residents, and rarely misses any of the activities. Compared to her advanced dementia symptoms when she was first introduced to us, we consider her to be at a much improved moderate stage now.

Evergreen Residence is actually this grandmother’s third Assisted Living in about 18 months.  Other caregivers from prior facilities who cared for her are still amazed by her turnaround whenever they drop by Evergreen Residence to witness first-hand this case of dramatic improvement from symptomatically advanced dementia, unmanageable, violent behavior, and uncommunicative withdrawal to what we consider moderate dementia, pleasant mood, and high socialization and quality of life.

We feel that Evergreen Residence’s proven methodology for Alzheimer’s care combined with GeriJoy’s innovative memory care programs enable us to offer our residents an unparalleled level of quality and effectiveness when it comes to care, while also engaging and amazing family members. It’s a joy to have GeriJoy’s “Cutie” as part of our caregiving circle, and we look forward to documenting more inspiring case studies as we expand our utilization of GeriJoy’s programming.

Neil Tantingco




Psychiatric commentary

Provided by Dr. Ahmed Khan, MD, MPH
Adult, Adolescent and Child Psychiatrist
Stanford Hospital & Clinics

Unpredictable, violent behavior, among other symptoms, is a particularly dangerous and common consequence of dementia. It often leads to administration of psychoactive medications such as Risperidone/Risperdal, which can be helpful as a final resort, but also carries the FDA black box warning of increased risk of death in dementia patients. As physicians our goal is to do no harm and we try our best to avoid getting to the scenario of using antipsychotics in dementia patients.

The GeriJoy Companion is a caregiving tool that can engage dementia patients and provide the calming effect that is often sought through medications, but without the side effects and dangerous black box warnings!

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