Many years ago, I remember professionals advising caregivers to encourage those with dementia to “orient to reality.” When Louise would insist she had not eaten dinner, we would often go through the evening and explain the steps of when she had dinner, what she ate, who was with her, and all the other confusing details. What would it have hurt to have indulged her with a little extra mashed potatoes or blackberry pie?
That is where many of us are today: what would it hurt? What would it hurt to let Betty sit on the park bench for a little while waiting for her mother to pick her up? Or for George, a former CEO, to treat the aide as a store clerk helping him purchase a new suit? Or for Hank to have scrambled eggs at midnight?
Imagine if we engaged our loved ones differently. What if we join Louise in her reality, even for just a moment? We answer her frustration at missing dinner, with a compassionate concern, “Oh my gosh, I’m so sorry! Would you like some pot roast?” She feels validated and you get to be the good guy who is fixing a terrible situation. With that validation, positive feelings about the interaction will linger well after the memory of the event fades.
What if we join Betty on the park bench waiting for her mother? We talk about why she’s waiting, the route she expects to take, what she might see along the way, if she might stop for dinner… hmm, what sounds good for dinner? Would you like dessert? Boy, I’m starting to get hungry. Maybe we could come back out after we eat something, okay?
Rather than fighting that muddled brain that frustrates you and your loved one, let go. Yes, that is not necessarily as easy in practice but here are some practical ways to implement that:
- Don’t argue, find a way to agree. Agree to terms, seasons, meal choices, and how to do things. Agreement is validation. Validation increases positive feelings and chemicals in the brain and quiets the pangs of anxiety.
- Instead of stepping him through the logical steps, look for diversions. Yes, you could argue all day that he is who he sees in the mirror or you could have a more positive interaction if you agree that the doesn’t look a thing like that fellow but perhaps we can go for a walk til that guy goes away.
- Rather than ask if she remembers your name, announce who you are in every interaction – even if you’ve been her best friend since kindergarten. Remind her of the good times, tell lovely stories of your escapades but don’t ask her to remember them.
- Try to steer clear of limiting words such as can’t, don’t, and stop. Instead work within today’s mood, abilities, and challenges.
- Stay away from condescension. You’re most often assisting someone with way more life experience than you – and sometimes well educated, world traveled, too. Treat your charge with dignity, respect, and care.
- Keep it simple. Break down tasks. Simplify choices. Use as few words as possible to convey small bits of meaningful information at a time. Don’t overwhelm your loved one with lots of detailed chatter.
- Bring enthusiasm, excitement, and reassurance to each encounter.
Dining with, reading aloud to, singing for, and dancing with your loved are just a few ways to interact with those with declining memory. But do remember to interact. Dementia can be an isolating disease for both the senior and his caregivers. Communicating however you feel comfortable can be a source of solace.
There are now more than 5 million people in the US affected by some form of dementia. Thankfully, resources such as the Alzheimer’s Association, the Alzheimer’s Caregiver Institute, Teepa Snow and others offer education and training to help. Or, if you’re in the San Francisco Bay Area, come see how Kensington Place of Redwood City is engaging differently.