At DAWN, we believe in allowing people to age in place for as long as possible. However, it’s not always feasible to keep someone who is experiencing dementia at home through the end of life.
How can families make moving someone with dementia less distressing? Let’s consider the ways we’ve helped our clients here at DAWN adapt to new living situations, but first let’s think about why being able to age in place—in one’s own home—is so valuable.
Mindlessness is to dementia what mindfulness is to the healthy brain
In 1989, Ellen Langer published a little book titled Mindfulness that is packed with wisdom about aging and staying young. In it, Langer describes not only how to be more mindful and live a more conscious life, but also the two tools of mindlessness. Although she didn’t identify a use for mindlessness, she introduced me to the concept and, when I began working with people here at DAWN, I immediately saw how valuable mindlessness is for people experiencing dementia. Let’s look at its first tool.
The gift of automatic thinking
We perform innumerable tasks and activities each day. Making a cup of coffee, setting the table for dinner, using a dishwasher, microwave or lawn mower—each task involves a series of steps that must be performed in sequence. We may have had to concentrate the first time or two that we performed the task, but after a few repetitions we no longer need to pay attention and can follow the steps without thinking. We have developed an automatic thinking script.
If the dishwasher breaks down and we buy a new one, we must again think about which buttons to push and how to best load it, but our healthy brains soon build a new script and we begin performing the task just as mindlessly as before.
However, when people are experiencing dementia, they lose the ability to learn new skills because they are losing memory and rational thought. This makes it extremely valuable to be able to stay at home where they have numerous automatic thinking scripts in place. Their ability to function is enhanced by automatic thinking scripts. The bad news is that these scripts are seldom transferable. This is one reason why we see such a marked drop in functioning when someone with dementia moves into assisted living.
The effects of moving someone with dementia—they lose their automatic thinking scripts
One of our clients moved from home to an assisted living apartment recently. Her family understood the value of automatic thinking and did their best to help her continue her routines such as waking up with a hot cup of tea. But even with an electric kettle and her special mug and favorite teabags, she couldn’t do it. Her new kitchen was just too different. Sadly, she lost what she had relied upon—an automatic thinking script—and lost the comfort of making herself a cup of tea each morning.
Before we move someone from their familiar surroundings, it’s important that we consider how their ability to function will be impacted by the loss of their automatic thinking scripts.
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