While many facilities are embracing culture change and person-centered care for their residents, there is still low staff morale and high turnover. Too often when I visit my clients in long-term care environments, both the elders and the staff appear to feel dispirited, discouraged, and depressed. Additionally, many family caregivers struggle with how to connect and communicate with their elder relatives, especially when they have dementia. While the aim is to achieve “person centered care” we must address the spirit-side of caring as well.

What is the Spirit-Side of Caring?

The spirit-side of caring recognizes that each person has a spirit, or the essence of a person that connects directly to the heart. The spirit-side of caring, places equal emphasis on the importance of nurturing and supporting the spirits of elders and those who love and care for them. The spirit-side of caring also recognizes that the spirit of the environment impacts how people feel. If the environment feels depressing, negative, and uncaring, the people who live and work in that environment most likely will also feel depressed and dispirited.

Tending to the spirit-side can help professional caregivers develop caring attitudes and help them recognize that the work they do truly matters! They see the elder as more than his or her disease, but as a person who has a spirit, soul, and heart. When the spirit-side of caring is embraced, staff can experience their work with a sense of renewed pride and commitment.

When families learn to tend to the spirit-side of caring, they can find more meaningful connection with their loved one. They realize what matters most is “being with” their loved one. They learn to connect in positive ways. Family caregivers recognize that they must also pay attention to their own spirit. And they become more conscious that their negative spirit can have a negative effect on their loved one.

How Care Mangers Can Tap into the Spirit-Side of Caring?

Mid-way through my career as a Geriatric Consultant and Counselor, my mother was diagnosed with Alzheimer’s disease (AD) and lived with it for over 15 years. Spending time with my mother at the nursing home, I paid particular attention to my mother’s spirit and how the staff interacted and connected to her. I noticed that when the staff connected to my mother’s spirit, she was much more engaged and happier. She also showed less agitation and other behavioral outbursts. However, what really caught my attention was something my mother said one day while I was visiting her, “Nancy, what’s wrong with all these people around here, they all feel half dead!”

Even with her dementia, my mother was able to pick up on the “spirit” of the people and the environment around her. It was at that point, that I became passionate about finding ways to help elders, their family, and professional caregivers engage in the spirit-side of caring.

Tapping into the spirit-side of caring requires that care managers assess their elder clients through a different lens. They need to evaluate the spirit of the elder in addition to the physical, social, and emotional aspects of the elder. They also need to pay attention to how the environment impacts the spirit of their elder client. Are the professional caregivers connecting to the spirit-side of the elder? The following are some important points to help tap into the spirit-side of caring.

  • Pay attention to the elder’s spirit- Care managers must pay attention to the spirit of their elder. Does the elder seem spirited or dispirited? A dispirited elder is often sad, depressed, can become easily agitated or angry. The elder often disengages from the environment and the people around him or her. The elder literally can appear lifeless.
  • Be aware of the spirit-side of the professional caregivers- It is important observe whether the professional caregiver appears disinterested, uncomfortable, impatient, or dispassionate. These are usually indications that the caregiver’s spirit is distressed. Additionally, it’s essential to pay attention to whether the professional caregiver is connecting to the spirit of the elder.
  • Be aware of the spirit-side of the family caregiver- Family caregivers frequently struggle with how to communicate and connect to their elder family member, especially if the elder has dementia. Families tend to focus on the physical aspects of care. I playfully “fire” them from the role of nurse or care manager and give them permission to “just be” with their elder family member instead of always “doing.” I have found that family caregivers often feel relieved and are more open to finding ways to enjoy one another when the focus is off doing something rather than being present.

 How Geriatric Care Managers Can Encourage the Spirit-Side of Caring?

There are various ways that care managers can support the spirit-side of caring with their clients. Music, dance, nature, children, pets, and spiritual practices are all ways to tap into the spirit. Let me provide a few case examples of how to support the spirit-side of caring.


Sadie is a 95-year-old woman who has dementia. She was a schoolteacher and also never married. Her niece shared with me that Sadie was loved by all her students and their parents. And she loved being a teacher. However, now Sadie lives in a condo, has 24/7 caregivers, and her niece reports that the woman whose spirit always shined was now sad and lonely. Her caregivers state that it’s difficult to engage her. I suggested that perhaps the best way to lift Sadie’s spirit was to bring the spirit of being a teacher back into her life. Here are some of the ways I worked with her, her caregivers, and her niece.

  • I suggested her niece make a scrapbook of some of her school memories for her. This book was something the caregivers and her niece could use to reminisce with her. Her niece found pictures of her past schools and tracked down some letters students and parents had written to her over the years.
  • I put together a school reminiscent kit– a box of pencils, erasers, paper, notebooks, chalk and a little chalk board, and ruler. These items were great talking points about various school memories.
  • I researched and found old school songs and made a CD for Sadie to listen to. Even the caregivers loved listening to the songs with her.
  • I contacted a kindergarten class schoolteacher in the neighborhood that was willing to let Sadie and her caregiver visit their class once a week during music time. Sadie absolutely loved that experience. And an added bonus was the children would send her cards and pictures every so often.
  • I suggested her niece find stories that Sadie most likely read to her kindergarten children. Her niece enjoyed reading them to Sadie who thoroughly enjoyed them. Within a month, Sadie seemed more alert, happier, and less depressed. And interestingly, her caregivers perked up too. They seemed more content and interested in finding ways to engage Sadie. I let the caregivers know how much I appreciated their willingness to find ways to engage Sadie’s spirit. And I continually reinforced the wonderful ways the caregivers were supporting Sadie’s spirit and let them know that their work really mattered.


Max is a retired physician. He has three children and two sisters. He is divorced. Max developed early onset dementia at the age of 62. About ten years later, Max was moved into a nursing home. Max has been quite agitated, at times refusing to let the staff bathe him. Staff members were struggling with how to engage him and to deal with his resistance. In Max’s situation, I believed that he needed to feel that he was still needed as a “doctor.” He took great pride in his work and had a very successful practice. And he still remembered a lot about medicine. I met with his care team and his daughters and suggested the following:

  • His family brings his stethoscope and his appointment book
  • His family makes sure he had some clothes that would remind him of work
  • His family make a scrapbook of him working as a doctor and patient letters that were sent to him that family, visitors and staff could enjoy looking thru with him. When family visit, they too ask him how he is doing as “the director” of the medical unit
  • Everyone call him “Doctor” and then his last name
  • Staff were to tell him each morning that he needed to get dressed for work and talk with him about all his appointments that day
  • Staff made a “fake chart” that he could carry with him while he was in his wheelchair
  • I suggested staff ask him medical questions. And he often was “right on” with his answers!
  • LPNs periodically ask him medical questions about conditions or medications
  • When I visited, I too talked with him about medicine, read him articles I could find out how medicine has changed. I also had him write me a fake “letter of recommendation” to the nursing school at Emory, where he did his internship, which I wrote as he talked.

While Max was still agitated at times, he did settle down more. It was clear that he loved being called doctor and feeling that he was still needed.


There are many ways to that GCMs can help their clients tap into the spirit-side of caring. It requires a willingness to connect to the heart of the person, think out of the box and be creative. Furthermore, GCMs need to consider how they can be role models for the staff and families. It often means working with them all one on one. Tending to the spirit-side of caring is truly a service of the heart.

Advocare Care Management is an advocate for seniors. We offer numerous resources to help your loved one age with grace including customized assessments, advice, and resources. Aging can be challenging, and we are here to make the process easy. We offer care planning throughout South Florida including Miami-Dade, Broward, and Palm Beach counties. We are available 24 hours a day. You work with knowledgeable professionals that are here to help. Contact us today and see how we can make the process of caring for your loved ones easy.

Reprinted with permission from Advocare Care Management is the place to go for all of the assistance and support you need.