Tuesday, December 1, 2020

Voices of Dementia Healthcare Professionals: Catherine Molnar Livingstone

This month, we were extremely fortunate to have the opportunity to speak with Catherine Molnar Livingstone - a fellow Havergal College alumnus. Catherine works in the psycho-social area of dementia care and has unique experiences working as a Recreation Therapist in the Northwest Territories, in addition to launching her start-up, Opal Season, aimed at dementia advocacy and caregiver support. Catherine is here with us today to share her diverse experiences and insights on dementia. 


1.  Tell us about yourself – who you are, what you do, and what your day to day work looks like.

In 2019, I founded a social enterprise start-up called The Opal Season Company. Based in Winnipeg, I work with families and organizations to make dementia-friendly experiences accessible and enjoyable. I focus on psycho-social interventions, palliative spiritual care, and helping care partners support their loved ones with appropriate activities.

To date, I have worked with families, faith groups, researchers and private companies from Yellowknife to New York City, from Australia to Ireland. Until COVID hit, I was traveling back and forth to the UK, meeting with market innovators and undertaking product research. I look forward to getting back on an airplane when everything becomes safe again!

My social enterprise mandate is to support rural and Indigenous Canadians, as these groups typically receive inequitable care in this field. Earlier this year, for example, I worked with an Indigenous group in Alberta to create a dementia education resource for their senior population. We ‘translated’ clinical language into a First Nations-led metaphor of traditional animals (like moose and bears) to explain therapy-based goals and activities.

Currently, I’m working virtually and doing product development. In the spring, I created a prototype that was field-tested by over 120 recreation professionals in 9 countries, so now I’m developing that further. I’m also collaborating on a series of dementia-supportive videos that are an alternative to traditional TV programs; I’m most excited about partnering with an American Congregation of Dominican Sisters on a Christmas video featuring their meditative music, which is well suited for end-of-life care. 

I’m also a Consultant with the American organization ‘Positive Approach to Care’, which is spearheaded by dementia expert and Occupational Therapist Teepa Snow. I place the PAC values of engagement and understanding at the core of my practice with families and community partners.


2. What sparked your interest in healthcare and specifically geriatrics? What made you choose to pursue a career working with seniors with dementia? 

For over 20 years, I actually worked with cultural institutions, museums and community groups across Canada. I have a Master's Degree from the UK, and pursued PhD work in History before focusing exclusively on curatorial programming, museum education and fundraising. 

After a move to the Northwest Territories with my Air Force husband, I pivoted into Recreational Therapy with the Territorial Dementia Facility there – and discovered a new passion: supporting people living with dementia.

As I mentioned, I don’t come from a clinical background, so I’m bringing an entirely different skill set to the team. I found I was good at using my knowledge base to support families with engagement ideas to keep their loved ones feeling valued, productive and cognitively stimulated. This means doing quite a bit of research into people’s lives, and providing them with activities that validate those unique experiences and play to their current physical and cognitive skill strengths.


3. What is it like working with individuals with dementia? What are the most rewarding and challenging moments you have encountered?

I find working with people living with brain change to be incredibly meaningful. The work can be filled with a range of emotions, from fun and laughter, to profound sadness. It’s also an opportunity to open my heart and learn, as I was able to do with the Indigenous Elders I supported in the Northwest Territories. 

It was an honour to serve these seniors, and it took a great deal of willingness to listen and learn from them and their families about how I could best support them with culturally safe practices. Of course, we are hearing more about the residual effects of Residential Schools now – but seeing the present-day ramifications of the damage done, and hearing about it from the Dene and Inuvialuit Elders themselves, was incredibly eye-opening. 

It was very much a daily act of Reconciliation, and something I am very grateful to have been involved in. Part of the reason I founded a social enterprise company is to help ensure seniors in places like Inuvik and Tuktoyaktuk receive the same quality of care as southern Canadians.


4. How has the COVID-19 pandemic affected your work and the elderly you work with? 

Sadly, this pandemic has shone a light on the current challenges in the Canadian care system. It’s incredibly difficult in that facilities need to keep their residents and staff safe, but the moratorium on visitors often mean people are left isolated, confused and frustrated. Early anecdotal evidence seems to suggest this is resulting in a cognitive decline for many people with a diagnosis of dementia.

Recreation staff are now often responsible for providing the entirety of a person’s psychosocial care, without the benefit of small group socializing. They are having to get creative by improvising programs limited to one-to-one interactions within people’s rooms; I'm brainstorming with staff in Canada, the US, and Australia right now on materials that can help with that. 


5. Given the impact of dementia on both the individual and their family/caregivers, what advice would you give to those who have a loved one with dementia? 

Always “assume competence”. It is easy for us currently living without dementia to assume that once they leave the doctor’s office with a diagnosis, our loved one is instantly a “changed” version of themselves, and that they require us to step in and take control of the small stuff.  For instance, we may assume that they no longer are able to do the dishes or take care of yard work.

It’s an instinct that comes from a place of love, but it risks robbing our partner of autonomy and dignity. It can be difficult, but care partners need to be nimble, creative, and ready to improvise to provide their loved one with the best support for the skill strengths they do have. 

Think about “adapting” activities, rather than removing them altogether. But this does take some training and education; supporting people with brain change is a specialized field.

One example I like to use is a pilot program for a dementia-inclusive Book Club I developed last year. I connected with researchers in New Zealand, and used a specially-adapted Charles Dickens novel. Our group included people in early and even mid-stages of dementia, and with a bit of tweaking, we were able to have lively, enriching discussions about classic 19th century literature. It was age-appropriate and above all, assumed competence.  

There are great resources out there, but it does take legwork to find them. The Alzheimer Society should always be people’s first call after they leave the doctor’s office; they can connect you with many services you will need. Finally, if you haven’t heard of the work of Teepa Snow, I would strongly suggest you search her out. (Her lectures are widely available on YouTube and Facebook.) Her way of explaining people’s progression through the disease is by far the most helpful framework I’ve been able to share with families to date.



We would like to sincerely thank Catherine for taking the time to share with us her reflections on working in dementia care. Catherine can be reached at catherine@opalseason.com, through her website www.opalseason.com, or find her on Facebook @theopalseason. In particular, the Companion Cards shown in the image above are available for free on the Opal Season website. She always warmly welcomes hearing from members of the Havergal community.