Gentle and Peaceful Activity Reduces Agitation, Increases Quality of Life

By Carrie Esselman, Therapeutic Recreational Specialist, Valley VNA

Namaste is a Hindu word that expresses, “to honor the spirit within.” It’s the perfect name for a meaningful and peaceful practice of accompanying elderly people through the final stages of dementia, many of whom are nonverbal and easily agitated. Namaste Care™describes a program that brings honor to people who can no longer tell others who they are or who they were or care for themselves without assistance. Namaste Care™, adopted by the leadership and staff at Valley VNA in Neenah in January, requires both a special space and a special mindset where residents have the essential environment they need and crave in the last stages of their disease; namely, a peaceful, spa-like environment free of loud noises or overstimulation, warm and affectionate touch, a serene schedule free of rushing or clamoring to the next activity, and the most genuine, heartfelt presence of caregivers.


Namaste Care™™was established in 2003 in a single nursing home in Benington, Vermont, by Joyce Simard, MSW, now an internationally-known social worker in eldercare, who works to educate families and professional caregivers on how they can help people live, not just exist, with irreversible dementia like Alzheimer’s disease. “I do not think that keeping a person clean, fed, and groomed is living; this is merely existing,” Simard said. “People need to be engaged in meaningful activities, they need to feel wanted, loved, and need to feel as if they still can contribute.”


Simard recognized that traditional activities for people who reside in long term care settings are not typically designed for residents with Alzheimer’s disease or dementia. She wanted to design a program where all personal care activities, like bathing and dressing, were completed with intentional, soothing strokes, and time was spent in tranquility and company with others, not alone in a room or off to the side at a bingo game.

Joelin Mueller of the Valley VNA life enrichment department trained with Simard last year to facilitate Namaste Care™ in Neenah. It is offered to Valley VNA residents five days a week, two hours a day, in the community’s sunroom. A large lit fish tank, soothing aromatherapy, soft music complemented by birdsong and river sounds envelop eight people who stay throughout the entire time. It is quiet, but not silent. Each person is greeted and welcomed into the room and assessed throughout his or her stay for comfort and pain. There are warm blankets, the lighting is adjusted so the room is not too bright, and residents who are able are transferred to specially-provided recliners. After all of these arrangements are set, the quiet and relaxed interaction between Joelin and her Namaste Care™ participants begins.

“Our main goal is to be present to our advanced dementia residents,” Mueller said. “We slow down and meet each person’s needs in the moment. We ease their anxiety and agitation,” Mueller said. First she washes each person’s face, brushes their hair, and tells them how beautiful they are, how wonderful it is that they are there, and she gets to spend time with them. Hand massages, kisses, and hugs part of every Namaste Care™ time. After lunch, the same people return and engage in sensory and other appropriate activities.

Residents who participate in the program at Valley VNA have gained weight, take in more hydration, eat significantly more, and have better family visits, according to Mueller. “Staff, fellow residents, and families notice that our Namaste people are a lot less agitated than before. For staff, this means less stressful bathing and personal care, too.” Because of the impact of the program, leaders and staff hope to expand it to seven days a week, four hours a day. “This is the way our people live every day. It’s important to be consistent,” Mueller said.

Namaste Care does not require any special equipment, Simard does not have proprietary contractual agreements, and special certifications are not mandatory. “It’s ingenious, really, to see so much improvement, so much serenity, from returning to the basic human need to be loved and accompanied,” Mueller said. She gets choked up when she talks about her role in bringing Namaste Care™ to Valley VNA. Her favorite moment so far? When she asked a typically non-verbal participant how she was feeling and she opened her eyes and quietly said, “I’m home.”