People who have dementia are constantly losing things – a tremendous source of stress for not only themselves but their caregivers, housekeepers, friends, and family members. When you don’t have the ability to recall what happened a few minutes ago, let alone this morning, it can seem more likely that someone took your wallet or hairbrush than that you misplaced it. And, because dementia is part the picture, more often than not the missing item will eventually be found someplace very odd.
So how do we help someone who is distressed about losing something? Here, with our clients, we face this issue almost daily. Our response is to take their focus off the problem – the absence of some item – and help them focus on the process of finding whatever it is that has gone missing. We never get upset ourselves; losing things is just part of dementia. But there are two primary benefits when we focus on the process of searching instead of joining in our clients’ panic over the loss, or reacting with frustration over the inevitable.
Building teamwork and de-emphasizing mastery. People experiencing dementia are becoming ever less able to accomplish tasks or solve problems on their own. Losing competency is very distressing. We spend our entire lives becoming masters at tasks, activities, and problem-solving. Children gradually acquire the skills needed to perform their own personal hygiene tasks, feed themselves, and follow directions. They grow older and drive cars, navigate the education system, and become more tech savvy than their parents. They learn to cook, mow lawns, find a good mechanic, order take-out. The list of daily tasks that we master as residents of 21st Century America is endless.
Dementia takes away these abilities one by one. When we repeatedly fail, we eventually give up and retreat into passivity. Dementia requires teamwork – someone who will help you learn to give up being a master and accept being a teammate by partnering with you to accomplish tasks. Searching for something together is an excellent way to partner in solving a problem, so long as the caregiver is helping the loved one or client focus on the process of finding the item.
Relief in following a process. If I am missing my purse or my hearing aid or my glasses, I have a big problem. Something essential or valuable is beyond reach, so I will feel distressed. But if I have dementia as well, I have an even bigger problem – I’m also missing the two tools I most need to solve my first problem: memory, and the rational thought processes that would allow me to form a plan or follow a series of steps. I’m unable to arrive at the place where I can say to myself, “Well, I’ve done everything I could have done to find it. It will eventually turn up. I can turn my attention to something else now.”
If I am with someone who will partner with me and lead me through the process of searching, my first problem will likely be solved. A systematic search usually turns up a missing item. However, more importantly, having someone partner with me will also keep me from repeatedly internalizing the feeling of being out of control and at risk. There is a degree of success and control just in being able to take steps and follow a process.
We, as caregivers, need to give our loved ones and clients the sense of success in following a process. When we lead them – without getting angry or worried – through a systematic search for whatever it is missing, we turn an episode of panic into an opportunity to show them that they are safe and empowered through partnership with us. We prevent failure at mastery from defaulting into passivity, by introducing teamwork. This is our goal whenever something goes missing.