Note: The following was published in our monthly column “Living and Loving: Elder Care in the 21st Century” in Gate House News’ Concord Journal. We will continue this theme of dementia in this blog with periodic articles on the subject.
Deborah Bier, PhD, is Director of CCHC's Concord office
The popular cultural view of Alzheimers Disease and other dementias is that they are all about pain, tragedy and heartbreak. But this is only part of the story — stop there, and we are robbed of real sweetness.
The wisdom that care partners (family, friends and professionals) can glean from people with memory problems can be profound. If viewed through an all-too-often missing lens, and by utilizing known best practices, time with such folks can also be enlightening, love-filled and satisfying.
Here are five life-affirming lessons I’ve received from “Habilitation Therapy,” the best standard of care for those with dementia, their families and professional caregivers. I believe that what helps dementia patients feel happy, calm, secure and fulfilled actually represents vital life lessons reduced to their essence, revealing wisdom of the ages.
1. Be here, now. People with memory problems can be anxious if they focus constantly on a future filled with confusing unknowns, or on a past they no longer inhabit. They become agitated, upset or withdrawn – which sounds a lot like what anyone else living in the past or the future experiences. But folks with dementia experience such overwhelm very frequently.
This can cause “difficult behavior,” which can be addressed by coming into the present. If together we examine the colors of the books in the bookcase, the rhythm of the clothes dryer turning, a leaf, a rock, an old worn shoe, the past and future drop away. Everyone feels better as we share the moment together.
2. Be the change you want to see. If we care partners worry all day about the million tasks to perform before we fall into an exhausted sleep, we create greater suffering for ourselves… and for others who experience our unrest.
Emotion is especially contagious for people with dementia. Often lacking context for an interaction, they pick up emotional cues from others and act them out. If someone with dementia is “acting badly,” we can constructively look first to our own behavior – body language, tone of voice, speed, emotional state – to see what is being mirrored back.
3. Slow down. Do you get anxious and easily distracted when life is whirling too fast, and you’re trying to do nine things at once? I sure do; not surprisingly, so do folks with memory problems – only much more so. Slowing down helps everyone all stay focused, calm, centered and in the moment.
One 90-year-old with memory loss told me: “I can’t understand what I read in the newspaper if I’m trying to do or think about anything else.” Where there’s anxiety, together, focus on just one thing at a time. Breathe deeply together. Share a cup of tea. Tell silly jokes. Focus your mind, body and heart on the specifics of each care task as it’s performed. Experience the difference it makes for us as care partners as well as to the person with dementia.
4. Listen deeply, respond thoughtfully. The statement, “I’m waiting for my mother to pick me up and bring me home,” could be met with the facts: the person with memory problems is 80 years old, and mom died decades ago. But that’s focusing on the surface of the words, not on the feelings living below. Address just the words and we serve the person with dementia a reality they cannot grasp or remember. “Difficult behavior” is bound to follow.
Listening deeply and responding to the feelings brings us to a more desired outcome, where we instead hear: “I want to feel safe and at home.” “While you’re waiting for her, you can tell me about all about your mother…” addresses underlying feelings. Sharing stories brings us closer, and redirects the person with dementia respectfully and with acceptance, fulfills their emotional needs, and preserves their human dignity – a worthy outcome for all exchanges.
5. Keep it simple. “Please set the table” may be too complicated for many with dementia. “Please put out the place mats,” and when that’s done, “Please put out the plates,” then napkins, silverware, and glasses – each as a separate task – can get the job done, and create a sense of purpose fulfilled.
For all of us, simplifying speaks to identifying and living our priorities, being grateful for what we have, improving quality of life, and leading a more purposeful existence. This can be a lesson we are blessed with whenever we care for someone with dementia.
While caring for someone with dementia isn’t simple or easy, we can build in opportunities to slow down and savor the time we spend together. While we care partners need to adjust the environment to regularly create slow and soothing conditions for those with dementia, we also will reap much-needed benefits of from being more simple.
Deborah Bier, PhD, is director of Caring Companion Home Care’s Metrowest Boston office, headquartered in Concord, MA (www.CaringCompanion.Net). She holds a doctorate degree in counseling, and is certified to both educate dementia caregivers and coach families of dementia patients. She can be reached at Deborah.Bier@CaringCompanion.Net. To find more Alzheimers and dementia information, subscribe the blog on their website.
