By Maureen Noble, BA Social Work, Director of Case Management at Concierge Care Advisors
Dementia can cause unpredictable behavior and personality changes. The person can appear to move back in time, speaking and acting as if they were a completely different age. Caregivers who specialize in providing care to this population are gifted and often unrecognized for these skills. Recognizing the stage of life to which the person has retreated and JOINING them is a true skill. Agitation, distress and behavior issues can be reduced if the family and caregiver recognize the stage of life and provide care and guidance within that person’s current reality without judgement.
This approach can be adopted by any caregiver, whether directly providing care or peripherally providing services. One of the best examples I ever encountered was in an Auburn nursing home. Ivy had dementia and kept her two dogs (stuffed) on either side of her in her wheelchair. These two pets provided her with much comfort during the day. Unfortunately, the stuffed dogs weren’t as skilled at picking up fallen food from meals as real dogs would have been, so they became quite disheveled and dirty. CNAs tried to take the dogs to wash them, but this idea greatly distressed Ivy, so she refused to allow it. The laundry supervisor spoke with Ivy about taking the dogs to “the groomer” to get spiffed up. The change in approach and words used were like magic and Ivy agreed. Every time the dogs needed to be washed, they went to the groomer.
Another great example came from a locked dementia unit. A couple of the men in the unit had been powerful businessmen. This was their identity even without the dementia. With the dementia, they were back in their jobs and often ordered the nurses about for tasks and even demanding coffee. In the 90’s, these behaviors could have been seen as disrespectful and difficult for many women. The nurses set a great example for the team by understanding where the men were and playing their roles. The men were allowed an area of the nurse’s station set up as desks. They had papers to deal with. This settled them down many times. Given their short attention span and need to frequently move about, the intervention of getting back to work could be employed repeatedly during the day.
Along the same lines, many women were used to being busy with housework or childcare. Sitting around with nothing to do was anathema to them. Their hands needed to be busy. Providing a basket of unfolded towels for them to fold could be very helpful. Some women would take a cloth and dust the handrails along the wall as they moved about the unit. Some took care of baby dolls.
Caregivers’ and family members’ ability to understand that dementia denies a person’s ability to live in our reality is important for successful day to day interactions. Those able to provide this loving care are true heroes.