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 (wlowe@cmsschicago.org)
Chicago Senior Living
Assisted Living
in Chicago