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# 2023-06-17 - A Loving Approach To Dementia Care by Laura Wayman
I checked out this book from the local library. I am interested in
dementia care, in particular, how to do it in a loving way. This
book strikes me as a valuable resource. It includes many personal
stories about caregivers dealing with dementia-related challenges.
This is NOT light reading! I found myself reading much more slowly
than usual because of the emotional weight of the material. Below
are notes i took while reading.
# Chapter 1, Introduction
Providing care is an important and noble endeavor, but to be able to
provide the best possible care, you must also take care of yourself.
To complement this book, I highly recommend that all caregivers
connect with additional resources. Reach out to your community and
ask for help...
# Chapter 2
The common tragedy of caregiver illness or death illustrates why
stress management is so important for caregivers.
If you do not take care of yourself, you will not be able to care for
your loved one or client.
My years of observations and interactions have taught me that
communication with the dementia-challenged person involves much more
than words coming out of your mouth. Most of the communication comes
from tone of voice, facial expression, and body language. Adults
with dementia communicate on the basis of emotions.
# Chapter 3
It is human to deny what we find unpleasant or frightening. But when
denial prevents us from seeing facts and facing their implications,
it will not help us or our loved ones.
Here's what becoming a dementia-aware caregiver looks like.
Dementia-aware caregivers:
* access support from the medical community.
* remain open to continuing education about their loved one's
conditions.
* consider the bigger picture.
* continuously reach out to stay supported along the way.
Here are some additional, quality-assured dementia-awareness raising
community resources who are promoting ways of more successfully
living with dementia in communities around the world.
* Dementia Partnerships, Sharing Knowledge and Learning Across the
Well Pathway for Dementia
* Alzheimer's Europe, Switzerland 2013: National policies covering
the care and support of people with dementia and their carers
(HTM) https://dementiapartnerships.com/resource/dementia-awareness-resource-pack/
(HTM) https://www.alzheimer-europe.org/Policy-in-Practice2/Country-comparisons/2013-National-policies-covering-the-care-and-support-of-people-with-dementia-and-their-carers/Switzerland
(HTM) https://www.healthcheck.nhs.uk/increasing-dementia-awareness-training-resource/#I
# Chapter 4
In some cases, people with dementia will experience precisely the
same kind of dementia-denial their caregivers exhibit, namely that
understandable emotional desire to convince themselves that
everything is fine. However, anosognosia is an entirely different
problem. While anosognosia is still difficult to define, researchers
know it results from physical, anatomical changes or damage to the
part of the brain that affects perception of one's own illness. As a
neurological impairment, it is common following brain injuries or
diseases. For instance, people with a disease or illness causing
dementia may display anosognosia and insist they do not have a
problem. Naturally, the family member or professional caregiver who
has to deal with this can become exasperated.
To make the situation even more challenging, anosognosia may be
complete or selective, in the latter case only revealing itself in
certain situations that trigger the person's dementia-denial, such as
when he or she becomes frustrated trying to perform simple daily tasks.
... the most effective caregiving strategy is one of acceptance and
empathy toward the symptoms and subsequent behaviors, rather than
endlessly trying (and failing) to make the person with dementia
understand.
Here are five things to keep in mind when caring for someone with
dementia symptoms and anosognosia:
1. Use positive action statements in your communication. Be gentle,
encouraging, and empathetic about necessary tasks. Avoid asking
too many questions or giving too many options. Keep it simple!
* Break down activities into a series of steps. Using visual
cues, such as showing them with your hand where to place the
dinner plate, can be very helpful. Instead of "Are you hungry,
would you like to eat some lunch?" Change the question into a
simple and easily processed positive action statement such as:
"Come with me, let's have some lunch together."
* I like to call this playing "Dementia Jeopardy!" In other
words, give the person with dementia the answer without
expecting them to understand or have to respond to the question.
Someone with a healthy working brain enjoys considering
questions and options and coming up with appropriate responses;
they can do this on "autopilot." In people with dementia, when
there is loss of brain functionality in the area that processes
questions, options, and decision-making, this will inevitably
cause frustration and anxiety for the person when that
processing ability is no longer there.
2. Spend time with no pressure, no agenda, no judgment, and no
expectations. Allow the person to be whoever he or she is right
now. Downsize any responsibilities that are unnecessary.
3. Avoid fact- and reason-based discussions with the person who has
dementia symptoms and anosognosia about her or his medical
condition or changing care needs. The more you, the caregiver,
become dementia-aware, the more you will see that your loved one's
comments, behaviors, and changes are an expected part of the
disease process and out of her or his control, helping you better
plan and accept what is yet to come. When voicing concerns, stay
calm, confident, patient, and present in the moment. Articulate
your thoughts in a simple and positive light. Practice
communication that excludes discussion about what abilities he or
she has lost, all the while increasing the focus and attention on
what abilities still remain.
4. Allow people with dementia the dignity of experiencing whatever
emotions they are feeling at the time, with an understanding that
these feelings are real to them, even if they are difficult for
you to understand.
5. Be sure to take care of yourself.
# Chapter 5
The word dementia comes from the Latin dis, meaning "away from," and
mens, meaning "mind." It describes a state of being away from your
mind or existing in this world while being away from the previous
life. Like sleepwalking. Dementia is not a specific disease. It's
an overall term that describes a group of symptoms associated with a
decline in thinking skills severe enough to reduce a person's ability
to perform everyday activities. The way I like to describe it is
that the person presenting dementia symptoms has a "broken thinker"
and to become "dementia-aware" is to learn to "think" for them.
Delirium is characterized by a sudden onset of confusion. Symptoms
of delirium occur rapidly--not over a long period of time, as happens
with dementia.
There are some circumstances that can cause people to develop
dementia-like symptoms. Depression, dehydration, malnutrition,
hospitalization from a severe injury or fall--all can cause a person
to behave abnormally. ... The most common cause of dementia is
Alzheimer disease, between 60 and 80% of people with dementia have
Alzheimer disease. There are, however, many other causes of
dementia, including stroke, Lewy body disease, Parkinson's disease,
and head trauma. Many people have a dual-diagnosis...
Nearly everyone with dementia has progressive short-term memory loss.
Dementia frequently brings about impaired judgment and a loss of
inhibitions, causing individuals to exhibit behaviors that may appear
odd and may be out of character for them. In addition, people with
dementia may have difficulty making decisions. The person's ability
to be organized and to do multiple tasks simultaneously may become
limited. Many people with dementia choose not to participate in
their usual activities if there is too much outside stimuli.
Being a dementia-aware caregiver involves accepting the unfortunate
fact that when the effects of permanent, progressive loss of normal
brain function are readily observable, there is no way to stop,
alter, or fix the escalating dementia symptoms. Instead, the
caregiver needs to implement a realistic care approach, with the
understanding that you can only do your best to manage the changes.
It is critical for a dementia-aware caregiver to stay fluid and
flexible, as the strategies for managing the symptoms will shift in
the blink of an eye...
Your day must be filled with patience, empathy, and efforts to
maintain your loved one's dignity. At the same time, you must manage
all the day-to-day activities necessary to feed, clothe, bathe, and
nurture the person in your care.
A person with Capgras syndrome, also known as Capgras delusion,
believes that people close to her [or him] have been replaced by
duplicates. The person with Capgras may doubt her [or his] own
identity and question whether [he or] she, in whole or in part, has
been replaced by an imposter. This syndrome is more prevalent in
women than in men.
The delusions center around one of the senses--most often sight--and
remain localized to that one sense. For example, a man afflicted
with Capgras may recognize his wife's voice on the phone yet believe
that she is an imposter when he sees her in person.
[How does short-term memory loss feel?] Consider this comparison:
almost all of us have gone to the mall, parked, shopped, and returned
only to realize we cannot remember where we left the car. You know
how uncomfortable it feels when you can't find your car? You may
even start to wonder if it has been stolen. Well, that unpleasant
blank feeling and memory deficit is what the dementia-challenged
adult feels every day, every hour, every minute. Can you imagine
how frightening and disorienting this must be?
# Chapter 6
You will never win an argument with someone who has dementia. In
fact, you may already sense that the person you are caring for will
be much more cooperative if you acknowledge and give affirmative
responses to her or his feelings and subsequent behaviors--in her or
his reality, not in yours. This reality, from which the person who
has dementia may drift in and out, is very different from your
reality and from what your loved one's reality was before the
dementia became an issue.
The most challenging behaviors for caregivers sometimes are
precipitated by their attempts to bring the person who has dementia
into their reality.
... the more at peace you are, the more easily you will guide your
loved one or client into a place of serenity. The caregiver who
remains calm can gently lend the person who has dementia to
experience feelings of peace.
Even the most challenging and bizarre dementia behaviors are born
from past events. These behaviors are triggered by things that are
happening now that in some way evoke a sight, smell, sound, or
emotion from long ago. When you understand the root causes of these
behaviors, you can put on your creative thinking cap and develop
unique approaches that will help you redirect your loved one or
client into more cooperative behaviors.
Even if you do not know what's causing a specific behavior, you can
still use redirection to obtain a more tranquil reaction, as long as
you approach each challenge from a place of peacefulness.
Remaining calm while caring for the person who has dementia can be
very difficult. The stress that caregivers face is considered
chronic stress because it is long-term, constant, and unrelenting.
This stress can be powerful enough to damage the caregiver's health
and cause serious illness. Properly managing stress is vital to
successful caregiving.
This chapter's message is simple: one way to manage stress is to
remember that you cannot correct the dementia wonderland. All
attempts to being people with dementia into "reality" will only
create more stress for both parties. Instead of setting yourself up
for intense frustration, give your loved one or client affirmative
responses and positive action statements. Doing so will help you
remain in a place of calm confidence, which will in turn help the
person who has dementia.
# Chapter 7
As the disease strips away their language centers, people with
dementia lose their ability to communicate verbally. The brain
attempts to compensate for these losses by using all of the remaining
senses to perceive, interpret, and acknowledge what is happening in
each person's immediate surroundings. The use of other senses
heightens the impact of nonverbal communication.
In summary, the person who has dementia will feel what you are
feeling and reflect those emotions back.
The best way to help the person who has dementia remain calm is fore
you to remain calm. Do your best to leave harassed or anxious
feelings outside of the relationship. Above all, take time away to
find respite and keep yourself in a less stressed place. Even if you
are not in a place of happiness, you can still smile and make eye
contact. Setting the right tone at the beginning of every
interaction will result in a higher level of cooperation from the
person who has dementia.
The person with dementia is hypersensitive to what you are feeling.
Since the person with dementia will mirror your feelings and moods,
you have the power to set the tone. Assuming an upbeat manner will
create many more positive moments for you both as you go about your
day. If you can do it, you will be rewarded with an enhanced
caregiving relationship.
# Chapter 8
As the short-term memory fades, a person with dementia sometimes
becomes caught up in painful, unresolved memories and is trapped by
the negative feelings those memories trigger. This "rut" may be the
root behind unpleasant behaviors.
Many people who have dementia appreciate it when someone does
something as simple as listening with a caring ear. They may express
painful feelings that they are still trying to work through. When
you adjust your listening skills to accommodate both the pleasant and
the painful memories--listening without judgment or argument--you
will become much more effective at communicating and speaking the
"special dialect of dementia." This kind of listening can also
create an opening for the person with dementia to resolve or tie up
loose ends by working through the negative events, venting "emotional
steam" that may have been suppressed for years. It sometimes happens
that the person will go back in time to escape the painful present
reality, only to get stuck in equally painful long-ago memories.
When you are communicating with someone with dementia, be patient and
develop a trusting relationship. Always provide a dignified and
respectful atmosphere, even if the person is not always able to
provide the same for you.
Although those with dementia have much in common in terms of the
disease of dementia, each individual beings a one-of-a-kind storyline,
so it is up to the caregiver to listen, adjust, and change, remaining
flexible and fluid in addressing the ever-evolving needs as the
dementia progresses.
Sometimes the stories that the person with dementia shares will be
unclear, repetitive, or even dull. However, the more time you take
to show genuine interest--intently focusing on what the person can
share with you about her or his past--the better able you will be to
build a deep connection. This connection will, in turn, help you
develop care solutions that effectively meet the social and emotional
needs of your client or loved one.
Human beings, including human beings with dementia, need to be able
to express their feelings to someone who cares; this is especially
true of strong (and perhaps unpleasant) feelings from one's past.
The strong feelings that are directly connected to past memories do
not magically evaporate as we age. On the contrary, they often come
back late in life to haunt us... By listening for and catching an
emotion that may have been bottled up inside someone for years, we
allow the person to express those feelings and easy their minds and
hearts.
# Chapter 9
If you were confused about your surroundings, could not remember who
the people near you were, felt disoriented and overwhelmed and could
only access memories and feelings from your distant past, where would
you go to feel the more secure and content? Of course, back in time,
to memories that brought you happiness, delight, and feelings of
self-worth and purpose.
In contrast, if you had frightening or unhappy feelings driven by
painful memories, you would naturally want to avoid those unpleasant
stops on your journey. ... Understanding the person's behavior helps
reveal whether he or she is experiencing pleasant or unpleasant
memories. If someone is experiencing negative feelings, we want to
affirm the person and yet bring comfort and peace to the situation.
Conversely, when the person is in a good place, we want to help
reinforce the positive memories and feelings.
Remember: you will never win an argument with a person who has
dementia. But whenever you affirm the emotions that the person is
experiencing, you will instead enjoy a magical connection! Affirming
emotions will provide many wonderful opportunities for you both to
feel appreciated. Making people with dementia feel valued helps
create an emotional safe place for them to land amidst their
confusion.
[Reflective action: a technique where you mirror the other person's
actions.]
Our usual way of communicating becomes less effective as the dementia
progresses. Communicating effectively with a person who has dementia
requires skill, confidence, and adaptability. Approach each
situation with patience. Repeat phrases that produce an affirmative
response. Slow down, watch, and listen--and repeat, repeat, repeat.
Use creativity to express both your feelings and your message.
Practice these new skills to convey your message when you handle each
different situation.
When you want to communicate with your loved one or client, be sure
to get the person's attention and make eye contact. Make certain the
person feels that he or she is your only focus. Look her or him
directly in the eye and be totally present. Speak slowly and
clearly, giving only one message at a time. Limit outside
distractions such as a TV or radio.
Use actions as well as words--the old saw "show and tell" skills that
you learned as a child in school.
Even when their communication abilities are failing, you can still
show people that you understand their unique attempts to get across
what they with to share. Watch facial and bodily responses. The
person's reaction to what you say can give you an idea of how much he
or she understands. Respond to her or his moods and emotions,
especially when the words do not make sense or are inappropriate.
And finally, never lose sight of the importance of nonverbal cues.
We all communicate by emotions, expressions, and touch. Holding a
hand, or smiling when talking, can convey much more than words.
The main focus on providing care for the elderly, especially those
who have dementia, is not about my agenda or even my feelings. The
focus is on the needs of the elderly person in front of me. If I am
going to be able to respond to the immediate needs of a person who
has dementia, I must be willing to enter her or his world
attentively, respectfully, and without argument. Most importantly, I
must treat each person with genuine loving care.
# Chapter 10
Creative intervention: finding a clever way to meet the specific
needs of a person who has dementia.
In developing your own creative interventions, you will find they
work best if you have the opportunity to research and collect
information from the individual's past. Each person with dementia
has a unique and long history of joys, sorrows, pleasure, and pain.
Tapping into the significance of historic events that make the
individual feel loved, secure, valued, or safe will usually bring
those feelings to the present time and allow you to share in the
origins of the feelings attached to the memory. The better you come
to understand the person for whom you are caring, the better able you
will be to provide her or his care.
In the early stages, as your loved one or client how you can help her
or him stay independent and maintain a sense of control. It is best
to encourage independence as much as possible, since doing so will
reduce the burden on you and on the person for whom you are caring.
As the dementia begins to hinder the person's memory and abilities,
he or she will find it beneficial to contribute to self-care, even if
it is in a small way.
To a point, independence boils down to the old saw: Use it or lose it.
A common tip from experienced caregivers is to learn to be patient.
Granted, this is not always easy, but it will pay off in rich
rewards. Do not rush people who have dementia. Give them plenty of
time. Although it is often faster and easier to do things for other
people rather than wait as they perform tasks for themselves,
allowing them to complete basic tasks gives them a sense of value and
helps them to feel proud of even the simplest accomplishments.
Above all, be sure to continue your favorite activities together.
Listen to music. Take a walk. Talk about your favorite shoes.
"Gossip" about the usual suspects. Focus on the person's talents and
abilities. Look for common interests and use them to establish
community connections.
No matter how the disease affects the individual, it is important to
treat her or him with dignity and respect. Although certain
abilities will be lost, the person's emotions and feelings will
remain, as will the need for companionship and belonging. To add to
the person's quality of life and help her or him maintain a unique
ID, provide activities and interactions that bring a sense of joy and
celebration.
Never lose sight of the person who was there before dementia.
# Chapter 11
Unfortunately, as individuals struggle to cope with dementia,
paranoia [is common.] The people with dementia may have
misperceptions or hallucinations about family members, old friends,
and strangers. In most cases, this is just a phase that eventually
subsides, but there is no way to predict how long these symptoms will
last. The severity of the symptoms can depend on the type of dementia.
The resulting behaviors are especially related to a loss of control.
As people with dementia come to rely on others for assistance, they
may feel as if the caregivers are taking over their lives or even
robbing them. And as the dementia progresses, they often lose the
ability to recognize that they themselves might be to blame for
missing items. It would seem to them that the misplaced items must
have been stolen, and they will often accuse the people closest to
them of stealing the items.
Instead of reacting to these behaviors, coping with and managing them
is key to making the person feel safe and supported.
As noted in earlier chapters, it is best not to argue with a confused
person. Disagreeing may only escalate and fan the fires of anger,
anxiety, paranoia, and fear. If you cannot win the battle, change
the war. No matter how outlandish the claim or accusation, listen
and proceed as though you believe everything the person with dementia
is saying. Plan to take action that will give the person a sense of
relief. The most frustrating response she [or he] can get from you
is an argument to try to convince her [or him] that the situation is
not real.
This is a big change in how we have always communicated with adults,
so it takes practice! I even have to remind myself to ask less and
do more, as this is a core component of dementia-aware communication.
For example, when you first greet someone you often ask, "How are
you?" You expect a common response such as "Fine, how are you?" I
have observed how this ordinary and simple question can make the
person with dementia uncomfortable, stopping them in their tracks as
they struggle to process an answer. When I began to notice this was
causing some difficulties, I changed this customary greeting to a
positive statement such as, "You look great today!" or "It is so nice
to meet you!" The change in their response was remarkable, so much
more relaxed and less confused.
Many of the things that people with dementia do are attempts to
empower themselves by hanging on to the remaining elements of control
and choice they still possess. As we go through life, we suffer
diminishing control over many things. These losses put dents in our
emotional armor, especially if they are caused by dementia.
Given all of the other losses that person's with dementia may be
experiencing, the last thing they want to feel is that they have lost
their grip on reality. When people with dementia insist that people
around them affirm their perception of the world, they are actually
asking for help in framing their own worlds. By providing
validation, you will help to make everything else seem less confusing
to them, even if the relief is only temporary. Your affirmation
provides a brief respite, allowing the person with dementia to rest
her or his mind in the midst of what must feel like constant chaos.
Remember that each situation and scenario is very real and true to
your loved one or client in her or his wonderland. It must be very
frightening to experience events that seem so real and not receive
validation from others. As you listen to and focus on every
complaint, accusation, or angry outburst, try to allow yourself to be
open to what is being said. Be a detective and discover the who,
what, when, where, and how of each situation. Handling your loved
one or client's issues is yet another way to bridge the gap between
the two of you...
As you approach each situation with an open mind, also consider the
possibility that a person's behavior may not be totally rooted in
dementia. For example, the paranoia caused by dementia may be
exacerbated by sensory impairment.
As frequently as possible, look for easy ways to lighten your load.
Lock the bathroom door and soak in a bubble bath. Get together with
your friends and play cards. Take a walk or read a book. Watch the
latest ballgame or a comforting movie. Choose your favorite relaxing
activity. You need to have a place where you can remove stress and
emotionally vent.
In addition to practicing these quick-fixes, schedule time for
long-term stress management and maintenance. Longer-term stress
busters can include regularly attending caregiver support groups (the
local chapter of the Alzheimer's Association can provide lists of
support groups in your area), seeing a counselor who is experienced
in caregiver issues, or learning meditation or progressive relaxation
exercises. There are also wonderful training programs that are
specific to stress management and that are suited to both family
caregivers and healthcare professionals. [HeartMath, hypnotherapy
relaxation and mood-enhancing spoken and music CDs, Snoezelen Therapy
for clients...]
# Chapter 12
Research is showing that some relatively basic interventions that do
not involve pharmaceuticals can be used to easy behaviors. A
simplified approach to managing agitation can be summed up as "modify
the environment, modify the behavior, and medication as a last resort."
In our professional caregiving training sessions, we always tell the
care providers, "If you keep doing what you are doing, you will keep
getting what you are getting." And if what you are getting is not an
affirmative response, try a different approach.
All types of behavior are forms of communication. When a person with
dementia acts out, he or she is trying to tell you something.
Agitation is often the result of the inability to deal with stress,
pain, or fatigue. The key is to identify whether the behavior is
related to a specific event or whether it stems from a sudden or
unusual environmental stimulation that causes an emotional outburst
and then escalates into a combative flare-up.
Either of these kinds of memory stimulations--which are usually
innocent--can trigger unpleasant, seemingly bizarre, or even
dangerous actions on the part of the person with dementia.
Take note of patterns and subtle clues that tension is mounting. The
more proactive you are in redirecting the behavior before anxiety
escalates, the more successful the redirection will be. The tendency
toward aggressive behavior often increases at the end of the day as
stress and fatigue build.
I have enjoyed great success using music with which the person with
dementia is familiar. Playing calming music or the person's favorite
type of music can lead to a decrease in agitation. Use this tool
before meals, since it can increase food and fluid consumption. When
relaxing and calming music is sued during bathing, it can make the
person with dementia less resistant to personal care.
Light exercise each day can also help maintain function of limbs and
decrease problem behaviors. Going for a walk--preferably one or two
hours before dinner--several times each week may help reduce pent-up
agitation in a healthy, productive way, as well as stimulate the
appetite. And besides, exercise is good for you, the caregiver, too.
Activities that include social interaction are also helpful.
Additionally, never lose sight of the person who was there before the
dementia. Activities that reflect your loved one or client's
previous life or career are very effective.
Above all, a serene approach from the caregiver is the magical key to
successfully managing agitation. The person with dementia is
ultra-sensitive to your moods and feelings and will mirror back
whatever is felt from the person providing care. So check your
anxiety, agitation, and stress at the door before you spend time with
a person with dementia.
# Chapter 13
Many people who have dementia resist personal care tasks like
bathing. ... people who have dementia travel back in time into their
pasts, retrieving old memories and feelings. What memories might be
brought to mind by a shower? [Hint: not always pleasant.] Now
imagine what it would be like to experience a shower in an unfamiliar
place with strange people around you.
It's no wonder that caregivers frequently face resistance to the
common task of bathing. A sensitive approach may make all the
difference. When your loved one or client resists letting you help
her or him with a shower, avoid the word "shower" or asking
questions. Instead, try simple and positive action statements:
* It's time to clean up now.
* Let's go take our bath before the water gets too cold and dirty.
* I am so hot; a cool bath would make me feel better. I'm going that
way, so some and give me a hand getting the bath ready.
* A warm bath sounds so good. It would warm you down to your bones.
* "Your daughter called and said she is on her way to take you to
_____ [the doctor's office, lunch, etc.]" Use whatever topic might
motivate this person to get ready.
* "It's Saturday. Time for bath night." Draw on the person's past
routine, if you know what it is. Use terms that are understandable
within the person's dialect of dementia.
* I picked your favorite lavender-scented soap. You smell so good
when you use it. Let's go use some right now.
If the approach is not working now, come back and try again at a time
when he or she is more likely to be cooperative. If Mrs. Smith is
not a morning person, approach her in the afternoon when she is in a
better mood.
* Make sure the setting is quiet and private, with adequate but not
overly glaring lights. A stark or bright light can feel cold and
institutional. Honor the need for modesty; hold up a towel or
undress and redress the person as you go. It is always appreciated
if you provide assistance while keeping the person's dignity in mind.
* Be prepared. Have everything you need at hand... If you get the
person ready and in a cooperative mood for bathing, you do not want
to miss the window of opportunity because you have to go fetch a
towel. Furthermore, it is not safe to leave the person alone,
especially if he or she is wet and soapy.
* Give instructions one at a time. Do not rush the task.
* Demonstrate the task at hand. Remember to always allow the person
to do whatever he or she can.
* Consider your own attitude and appearance.
* Play soft music, preferably the style that is the person's
favorite. Additionally, praise and compliments always help...
* Finally, some caregivers have found that promising care recipients
a bowl of ice cream can work wonders as an incentive.
You will probably encounter days when things go smoothly and other
days when they do not. The person with dementia has mood swings just
like everyone else.
You may also want to read Bathing Without a Battle by Ann Louise
Barrick and co-authors.
# Chapter 14
"Life Stations" should replicate things that we see in normal,
everyday life. Here are some great examples of life stations that
you can bring to your community:
* Office Station with a desk, older model desk phone, typewriter, etc.
* Baby Station with a crib, baby dolls, baby clothes, blankets, and
baby bottles.
* Kitchen Station with dishware, pots, pans, and a counter with
mixing bowls and spoons.
* Teacher's Station with a chalkboard, desk, notebook, picture books,
and coloring books.
* The Man Cave with sanding blocks, pieces of wood, PVC pipe that
fits together, and paint brushes.
* Dressing Room Station with a vanity or table and bench stacked with
costume jewelry, a hall tree with hats, jackets, feather boas, and
scarves.
* Laundry Station with various sets of colorful socks, towels, a
laundry basket, and an ironing board.
It is necessary to have all staff, leadership, and family members
trained in a dementia-aware care approach in order to use these life
stations effectively. The idea that simply setting these life
stations up and then expecting the residents to use them on their own
is not what happens. [In that case, these life stations often sit
unused and gather dust.]
Helping the resident take part in life station activities can play a
significant part in dealing with challenging behaviors.
A healthy brain is so good at accessing this information, thinking,
and solving problems that you don't even notice it working. Tasks
that you've practiced many times start to seem simple; but even
simple tasks use many different parts of our brain in amazingly
complex ways.
Often this [progressive loss of brain function from a cause of
dementia symptoms] culminates in people with dementia symptoms losing
interest in activities they used to enjoy and being less likely to
take part or even try them.
They will need even more help and support from other people. They
need those caring for them to step up and proactively "think for
them," including helping them to engage and participate in meaningful
social activities.
A person with dementia still needs good quality of life, but without
some assistance from families and caregivers, it is much more
difficult for them to achieve purpose and pleasure.
Ideally, activities should:
* compensate for lost abilities, whether physical, emotional, and/or
social.
* promote self-esteem and provide feelings of accomplishment and value.
* maintain residual skills and not involve new learning.
* provide an opportunity for enjoyment, pleasure, and social contact.
* be sensitive to the person's cultural background.
Dementia-challenged adults often have difficulty with visual
perception and coordination.
* Ensure that surfaces are uncluttered, with few distractions and as
little noise as possible.
* Maintain good lighting without glare.
* Establish easy in-and-out seating and correct work heights.
* Use plastic containers to help avoid breakages.
Don't choose activities that reinforce inadequacy or increase stress.
To achieve the most success when carrying out activities, consider
the time of day when the person is at their best.
Understanding the person as an individual with dementia symptoms will
help you to plan appropriate activities for them. This means knowing
the person's former lifestyle, work history, hobbies, recreational
and social interests, past travel experience, and significant life
events. There are nice ways in which the person with dementia can
contribute to the household or community and feel useful. Encourage
them to have something that is their responsibility, no matter how
small.
Items of nostalgia can be used to redirect your loved one or client
to a sense of familiarity and security, especially if they have
special meaning to the person you are caring for.
Try not to overstimulate the person with dementia symptoms. Be
selective with outings. Avoid crowds, constant movement, and noise,
which many people with dementia symptoms find overwhelming.
It can be helpful to write a customized activity care plan working
with all of those involved in their care, including family members,
clergy, professional care providers, neighbors, and friends. This
will help make sure that the activities are consistent and are suited
to the individual needs of the person with dementia symptoms.
For many people with dementia, a sense of movement and rhythm is
often retained. Listening to music, dancing, or having contact with
babies, children, or animals provides positive feelings. People with
dementia often have excellent memories of past events and looking
through old photos, memorabilia, and books can help the person to
recall and enjoy earlier times.
Some sensory experiences that the person with dementia might like
include:
* enjoying a hand, neck, or foot massage
* brushing their hair
* smelling fresh flowers
* using essential oils and fragrances
* stroking an animal or different textured fabrics
* visiting an herb farm or flower show
* looking through a box containing things that the person has found
interesting in the past, such as costume jewelry, postcards, or
greeting cards
Lose your preconceived notions of how the activity should be done or
what the outcome is supposed to be...
# Chapter 17
Sometimes it can feel like there's not a lot in your life to laugh
at. But laughter is a wonderful stress buster and has great effects
on your body. In fact, it increases blood flow, decreases stress
hormones, boosts metabolism, and helps put our problems in
perspective. Most importantly, it can help us keep our sanity in
overwhelming situations.
# Chapter 19
It is hard to remember how important it is to be thankful for
everything we have in our lives, especially when we are faced with
the daunting task of caring for a loved one or client who has dementia.
It may be difficult to find something to be grateful for, but it can
be even small things...
# Chapter 20
If you are a caregiver assisting someone with dementia, you are
losing your loved one one piece at a time. You will have to
continually grieve each loss as it is presented: your loved one's
loss of physical ability, loss of memory (including when he or she
forgets who you are), and loss of ability to carry out everyday
functions. At the same time, you will be grieving the loss of your
own freedom, your sleep patterns, and even your energy. The
normality of your everyday life is gone and will not return to the
way it was before you became a caregiver.
Grief is the conflicting feelings caused by the end or of change in a
familiar pattern of behavior.
Understanding and accepting the grief process guides you through
acknowledging the loss. You can then give yourself permission to
feel the emotions and will be aware that grief is a normal and
natural part of the human experience.
A book on the subject of grief that I recommend is The Grief Recovery
Handbook by John W. James and Russel Friedman.
For a more complete list of resources and additional dementia-aware
support: https://laurawayman.com/iamdementiaaware/
(HTM) https://laurawayman.com/wp-content/uploads/2020/04/CCMC-April-2020-WEB-final.pdf
(HTM) https://laurawayman.com/wp-content/uploads/2020/04/compassionate-communication.pptx
[The back of the book has a relatively short section titled The
Dementia-Aware Guide to Caregiving.]
author: Wayman, Laura, 1955-
(HTM) detail: https://laurawayman.com/product/a-loving-approach-to-dementia-care
LOC: RC521 .W39
tags: book,non-fiction
title: A Loving Approach To Dementia Care
# Tags
(DIR) book
(DIR) non-fiction