Insightsthe blog of Porter Hills
How Does Dementia Impact Your Life? Part 2 (The Caregiver)
Working with seniors quickly became a passion for me 12 years ago when I began my career with Porter Hills. Back then, I was a Resident Assistant. One of the first residents that had an impact in my life was a little lady of about 97 years. She was one of the kindest souls and I spent any free time I had, sitting and talking with her. It was clear to anyone that spent any length of time with her that she had dementia; but I could see she was still aware. She still desired to have fun and remember family members long gone. She wanted someone to care about her and to be respected. It was this moment that made me realize that I had a calling to care for our elders as they age.
My co-workers and I continue to work to ensure that our elders age with grace and dignity, no matter what their ailment. Since caring for people with dementia can be challenging, I would like to share some information that may help guide you. In part two of our dementia blog, I will go over triggers for behavioral challenges and how to care for a person with dementia. As this blog series on dementia is completed, I would like to challenge you to think about how dementia has impacted your life and what you can do to make a difference.
In order to provide quality care, it is necessary to determine the source of the challenging behavior.
- Physical pain
- Is there an injury?
- Is the person hungry or thirsty?
- Do they have a cold?
- Are they sleeping enough?
- Is it too hot or cold?
- Is it too loud?
- Are they involved in an overwhelming task?
- Do they no longer recognize caregivers or family?
- Are they looking for someone or something?
- Is the relationship between patient and caregiver strained?
- Changes in a resident or patient’s behavior, level of incontinence or sleep cycle should be reported as this could be a sign of a health complication.
Caring for a person with dementia
Remember the person inside.
- In order to provide good care and relate to a person living with dementia, you need to know what their interests are. Music, food and other hobbies can provide good distractions and a sense of comfort. When arranging outings or activities, keep them short. If an activity takes too long, they may lose interest or become fatigued. The golden rule always helps here; treat others how you want to be treated. This can be especially frustrating for family members that remember the person “they knew” instead of the person they are now. Sometimes, people with dementia may revert back to an earlier time or place and forget loves ones. In times like this, you must reach out to friends, family or a professional for help. Neither the person with dementia or the caregiver is to blame and this can be difficult to reconcile. It is important to remember the disease is causing this. Just like diabetes causes high blood sugar, they have no control over what is happening.
- Sometimes it only takes a small task or a small choice to give a person back their dignity. Helping to fold laundry (even if it is not done the way you want) or choosing what is for dinner (even if it is lunch time) can create a special memory and a moment of peace.
Ask for help.
- When a caregiver is stressed, the person with dementia can pick up on it and will often react to a sense of anxiety. This will only make tasks more difficult.
Be aware of caregiver stress.
- Caregiver burnout is real. Sometimes it is necessary to take a break or ask for help to prevent errors or potentially harmful situations. In the home setting there are caregiver support groups. In a professional setting you should speak with your supervisor regarding your stresses.
Do not take behaviors personally.
- A person with dementia is not in control of their behaviors or thought processes. At times they are unable to think beyond the present moment and the emotion they are experiencing.
- A person with dementia may not be able to identify specifically that you are rushing them or becoming inpatient but they are able to sense anxiety and frustration. They may not be able to deal with the emotions they are perceiving and therefore they react to the emotion. It is important not to interrupt and to let them know you are listening.
Do not argue or correct.
- In order to facilitate cooperation or keep a person with dementia safe, the caregiver must be creative. Listen to them and try to figure out what is at the heart of their issue or what they are trying to communicate. If it is not of consequence then just let the matter rest. For example, if they get dressed and insist it’s time to go to work even though they’ve been retired for years, tell them it’s Saturday.
- If at all possible, maintain a quiet environment with as few distractions as possible. Keep the volumes on the TV or radio down when trying to communicate or move to an area where there are fewer people.
- When a person with dementia is anxious or having difficulty communicating, it is important that they feel that you are not in a hurry or frustrated with them. Reassuring them that you are listening and that they can take their time may help to put them at ease. Offering a “guess” may help but be careful not to try to speak over them. Affirm their feelings. Touch is also a powerful way to provide reassurance; giving hugs and hand holding. People, no matter where they are in their journey, want to belong and feel as though someone cares.
- People with dementia, especially in the early stages, are able to function better with routine. This may include having familiar objects and caregivers around. They may not always be able to recall names or faces but familiarity can be reassuring. When a person with dementia has to move to a new environment or go to the hospital due to illness, it can often lead to challenging behaviors.
Use other methods of communication.
- Gesturing, facial expressions, body posture and body language are all methods of communication. When a person has dementia they are often unable to communicate verbally but pick up well on alternative forms of communication. If you need to repeat something more than once, try to rephrase it.
Keep it simple.
- Try to be thoughtful about your word choice and speech. Use clear, concise speech and avoid jargon. Keep your speech even and audible but avoid high pitches. Also, be clear about your intention. For example, if you say “We are going to take a shower,” to someone with dementia, they may infer that you are going to get in the shower with them. This may frighten or confuse them.
Remember to laugh!
- We have all heard the phrase, “better to laugh than cry”, in one form or another. When caring for a person with dementia you must keep your sense of humor, for their sake and yours! If you take every moment seriously, you may miss out on the special moments that make all your care worthwhile. A smile, a song, a shared memory; even if that memory has been shared 100 times. Those are the moments to cherish.
- http://www.alz.org/ – The Alzheimer’s Association
- http://www.who.int/ – The World Health Organization
- http://www.ninds.nih.gov/ – The National Institute of Neurological Disease and Stroke
- http://www.nimh.nih.gov/ – The national Institute of Mental Health
- http://www.in-themoment.com/ – A website resource that draws the Parallels of Alzheimer’s and Improvisation- tips for caregivers
- Creating Moments of Joy. Purdue. Jolene Brackey, 2007. A wonderful book to inspire caregivers!