“Even though people experiencing dementia become unable to recall or recount what is happening to them, they still have the experiences. The psychological present lasts about three seconds. Their moods and actions are expressions of their experiences in the present.”
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From The Dementia Handbook
Table of Contents:
- Chapter 1: Bad, but Not All Bad
- Chapter 2: Not All Is Lost
- Chapter 3: Designing Person-Directed Care
- Chapter 4: Person-Directed Care in Action
- Chapter 5: Why Should We?
Intuitive Thought / Rational Thought
Although people with dementia lose rational thought skills, they retain the more enjoyable ones: intuitive thought. It’s intuitive thought that lets us enjoy creativity, beauty and feelings. When we understand this, we can fill their lives with positive moods and beauty.
Experiential Self / Remembering Self
People with dementia lose memory but they don’t lose the ability to experience the present, because they continue to receive information through their senses. This means we can fill the present with beauty and creativity and enjoy it with them.
Mindlessness / Mindfulness
When we lose the ability to focus, we lose the ability to be mindful. But mindlessness includes two very important tools for those losing memory and rational thought. When we design care to extend our loved ones’ ability to function mindlessly, we enhance their dignity and autonomy.
When dementia caregivers recognize these three pairs of skills, living and working with people who have dementia becomes much easier. Caregivers experience less stress and their loved ones experience a greater sense of security and well-being.
“When people begin to experience dementia—as memory falters and fails, and rational thought processes become intermittent and then elusive—any sense of security evaporates. There is nothing scarier than realizing that you can no longer trust your brain to correctly interpret the world around you or supply you with accurate information. Even when people are unaware of how impaired they are, they seem to know their futures are at risk. Living with worsening forgetfulness and confusion and knowing that you will become completely unable to care for yourself is rightfully terrifying.
“People experiencing dementia need help in recovering a sense of security before they can recapture any lasting sense of well-being. Unless their caregivers and loved ones show them that they can still be safe despite dementia, that ever-so-necessary sense of comfort in the day-to-day routines of life will be fleeting.
“[At DAWN,] we help our clients begin to feel secure even though they are confused, because we use our own rational thought skills when analysis is necessary, and we use our own memories to supply the gaps in theirs. When they ask questions, we remind ourselves that although they have lost the ability to retain information, they still need to know what’s going on as much as we do. We never jog their memories, knowing that testing memory only serves to prove and prove again that they’ve lost the ability to remember, not just the memories themselves.
“We also help them find what they’ve misplaced or complete a task without ever saying, “I’ve already told you” or “I can’t believe you don’t remember that.” When we offer help as an equal and teammate, rather than a superior or instructor, our clients’ dignity and sense of autonomy remain intact. There is no loss of control or hurt feelings. With our own rational thought skills, we foresee the next step in a task and work with them rather than direct them.
“Further, as their sense of reality becomes increasingly divergent from ours, we accept it as the inevitable result of progressive cognitive impairment and accommodate it, rather than demand that they use skills that no longer exist. While we are doing this, our clients begin to relax and feel secure in the knowledge (through experiential learning while with us) that we will take care of them despite their growing needs and escalating confusion.”
Someone is diagnosed with dementia every 66 seconds. By 2030, the rate will be someone every 33 seconds.
Paying for homecare is expensive, but the cost of institutional care is astronomical—over $92,000/year in 2016. We need to learn how to provide effective dementia care at home. This book equips families to do so.
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