I was able to transfer some of what I learned from my profession to experiences with my grandmother in the last years of her life. The premise is very simple; in dealing with someone with memory loss or early stage dementia the key is anxiety reduction.
How troubling it was for me to encounter a resident of our Alzheimer’s unit beside herself with worry because “her mother was waiting for her to come home from school and she didn’t know how to get home”. The worst thing I could do would be to try to reason with her about the inanity of a ninety-year old woman worrying about her mother waiting for her to come home from school. That is a fairly obvious point but how best to diffuse her anxiety?
Actually, the best way to get her to relax is to enter her reality and find a way to reassure her. Something like, “I just talked to your mom and told her that we would make sure that you were home for dinner”. Usually a few minutes later the issue was forgotten.
It’s amazing the variability of a person’s lucidity when they have dementia. My own grandmother would spend hours fidgeting in an open dresser drawer in her bedroom; and yet when cajoled into playing her favorite card game, a complicated, progressive rummy game that involved sorting as many as 17 cards in her hand , she would actually win her fair share of hands.
My mother struggled with how to handle her mother once memory loss was a problem. My grandmother loved to help clean up in the kitchen. After a meal she would load the dishwasher. My mother is very particular about what goes where in the dishwasher so she would constantly be saying, “no ma, that goes on the top shelf”. I convinced her to let grandma load the dishwasher by herself and then go back later and put things where they belonged.
People with dementia still love to be helpful. Performing tasks is something that helps their self esteem and keeps them from feeling anxious. At work, two residents with memory loss loved to sort our cancelled checks. They would get frustrated when they were done and there was nothing more to do. Finally our employees decided to secretly “unsort” the checks and let them begin again. The residents felt proud of their contribution and were glad to be needed and kept busy.
Life can be easier for those with memory loss and their loving care givers when we enter their reality to ease feelings of anxiety.
Bill Lowe, CMSS President (firstname.lastname@example.org)