Insights to Dementia

We’ve been working with a gentleman who recently began worrying in the afternoon that he needed to get to his job, and that he had a ton of things he needed to do that day.  Sound familiar?  This sort of behavior can be awfully difficult to redirect, since he is focused on the tasks he believes he needs to accomplish.  And, it is compounded with the notion that he spent all day playing games and needs to play catch-up.

If you’ve been working with dementia, I’m sure you’ve heard that often a person’s thinking reverts to an earlier period in their life.  Hopefully, it was a nice period that they feel comfortable in.  Sometimes, if a person’s early life was rather difficult, this symptom of dementia can be hard to live with.

In trying to help our gentleman we employ a few different strategies.  First, we try reassurance.  I tell him that he had the day off or that all his work is taken care of.  We also try to pre-empt his sudden realization he should be at work by playing cards or dice games beforehand.  Inevitably, he looks at his watch and sees the day is almost over and starts to worry.  So, we may try to redirect him with an activity or take him on a walk to the restroom to take his mind off of it.  Usually between these methods we could keep him stable.

Interventions: The Falling Cascade

Medical interventions can happen quite frequently when working with the elderly population.  Sometimes, they are very necessary.  Other times, they inadvertently lead to a really poor outcome for the person.

For instance, my wife and I were planning a natural childbirth, one with as small amount of medical interventions as necessary.  Why would one want to forgo the wonders that modern medicine can provide?  It was because of the cascade of interventions during labor.

Are “Behaviors” Really Behaviors?

Many times we can find ourselves writing off one of our resident’s or member’s behaviors without truly trying to understand why they are behaving that way in the first place.  This is especially true when dealing with someone diagnosed with a form of dementia.  I’ll admit, many of our dementia-diagnosed members are very difficult to understand, and it’s almost impossible to walk a mile in their shoes.  Personally, I was challenged within this past week while I was attending the first MEPAP class (necessary for an Activity Director Certification) and our instructor, Cathie Coleman (who has really inspired me by the way!), said that 9 times out of 10 a “behavior” means that we have failed to meet one of their needs.

Today at our adult day care, the boilers at the building where we rent from were off overnight!  It was a whopping 16 degrees Fahrenheit and the rooms and hallways were downright frigid for most of the day.  We brought out a barrage of space heaters to try and make it feel livable, but I fear we barely accomplished even that.  Inside our activity and lunch rooms most of our members were comfortable, although some of them grabbed their hats and coats, but our hallways and restrooms are not heated.  We kept the doors to our rooms with the space heaters closed to try and conserve heat, but we overlooked the fact that going to the restroom felt like a reality show experiment.

One of our more challenging members, I’m going to call her Mrs. Daisy (because she can really be a sweetheart),  cannot express her thoughts through language clearly, and sometimes has difficulty carrying out simple tasks, such as sitting down, although she appears to understand what we’re asking her to do.  During and after eating lunch, Mrs. Daisy will get up and wander around, usually into the restroom, and requires a staff to accompany her and guide her through the toileting process.  Today, she would leave her seat, wander by the restroom, one of our staff would escort her inside, she’d quickly leave the restroom, we’d have to work at coaxing her back to her chair to eat, and few minutes later would start the process all over again.  Needless to say, this was quite frustrating for the staff, and I noticed a slight look of despair on my co-worker’s face.

“What’s going on with Mrs. Daisy in the restroom today?” I asked.

She said, “Well, every time I get her situated to sit down, I ask her to sit and use the toilet, she’ll sit on the seat for a quick second then jump up and grab her pants and yank them up to her belly button and not let go!”