Caregiving Versus Care Partnering

About Juliet Holt Klinger

Senior Director of Dementia Care

Juliet is a passionate advocate for people living with dementia and their families. She is deeply committed to improving the cultural acceptance of those with cognitive differences. As our gerontologist and Senior Director of Dementia Care, Juliet develops person-centered care and programming for Brookdale’s dementia care communities. But if you ask her, Juliet says she continues to learn every day from the true experts, those living with dementia and their care partners. Juliet believes we need to move beyond the concept of caregiving, which implies a one-sided relationship, and embrace the idea of care partnering. Care partnering is about relationships built on cooperation—a two-way street promoting person-centered care and mutual feelings of purpose, where the person living with dementia also plays a strong role in shaping their care and daily routine. We are here to partner, learn and grow with our residents and families to make aging a better experience. After volunteering in nursing homes in high school, Juliet knew she wanted to work with older adults. While working on her bachelor’s degree in social work at the University of Iowa, she completed an Aging Studies Certificate program, before there were formal gerontology programs available. At Iowa, Juliet also had the chance to study with pioneers in the field of dementia care, an opportunity that shaped her passion for caring for those living with dementia. Trained as a gerontologist, with a master’s degree from the University of Northern Colorado, Juliet joined Brookdale in 2004. She is a seasoned senior living executive with more than 30 years of experience designing and executing innovative Alzheimer's and dementia care programs and living environments in both assisted living and skilled settings.

When either my husband or I get sick, we take care of each other. When you’re laid up with a nasty cold, it’s nice having someone making your decisions and coddling you – it enables you to think of nothing else, rest and heal. After all, that’s what partners do; they take care of each other. But what if your ailment, the issue making you more dependent on your partner, is permanent and long term? Would you really want that decision making imbalance to continue for the rest of your life? Probably not.

When you’re taking care of a loved one living with Alzheimer’s or dementia, that role can (and must) be considered differently than other situations in order for it to be successful and healthy. This role has many names – caregiver, caretaker or carer, the British term that my spellcheck hates.

But to me, none of these words encompass the trust, love and partnership that actually go into this type of relationship. That’s why I am shifting to a new term: Care Partner. It just makes sense. The old terms imply a one-sided relationship, one where the caregiver is in charge and the person receiving the care is passive. Think of the term, “He is under my care” (my husband is cringing in the next room)—that doesn’t sound like a way of life that supports independence and self-esteem does it? And in fact it doesn’t.

Caregiver verses care partner seems like a subtle change, but the difference in these words can have a meaningful impact on the way you view your role during the unpredictable journey you are taking with someone with memory loss, and the way they view their role. Care “partner” evokes a relationship based on cooperation and common goals. One is not just giving and the other is not just receiving – it’s a two-way street fostering person-centered care and mutual feelings of purpose.

As we begin a journey of caring for (or better – with) a loved one we naturally and instinctively fall back on the one care exchange we all have experience with – parenting. Whether you are a parent or not, we were all once children dependent on parents, so we understand the dynamic. When someone is dependent on us, we take charge, we take control and we know better.

Care Partnering is different. It is two people experiencing the disease and negotiating its ramifications for their life together, equally. Yes – one person actually has the disease – but there is an understanding that both partners have new needs related to the presence of dementia. In this respect, both people are in fact living with the disease. Each person in the partnership has a role in the care and support provided.

In our Clare Bridge program we have a saying for our care associates, “do with and not for.” It is a motto for care partnering that truly captures the essence of what works.