In his book Thinking, Fast and Slow, Daniel Kahneman explains the existence of our experiential and remembering selves. Although Dr. Kahneman is not thought of as an expert on dementia care, grasping this concept will greatly enhance your success in caring for your loved ones or clients as they experience dementia.
The concept of our experiential and remembering selves parallels that of our two thought processes. We know that all of us have both rational and intuitive thought processes, and that some people prefer using rational thought while others are more comfortable in the intuitive or creative world. At DAWN, we see our clients losing memory and rational thought processes, but not their intuitive thought processes.
Regardless of their earlier preferences, experiencing dementia forces our clients to live in the intuitive world and become dependent on us to take care of rational thought processes for them. When we do, they begin to feel safe and experience a sense of wellbeing.
Just like rational and intuitive thought processes, we all have experiential and remembering selves as well. Dr. Kahneman explains our two selves by using vacation preferences as an example. He points out that some people select and take vacations for the purpose of enjoying the activities and experiences, while other people choose vacations that will provide them with pleasurable memories. The latter may frenetically take pictures when on vacation while the former might forget to take a camera along. We each have a preference for one or the other, but, once again, one self disappears with dementia (the remembering self) and the other remains (the experiential self).
What this means for dementia caregivers. Have you ever been in a care situation and overheard a caregiver say something dismissively or with sarcasm, or seen someone perform a task brusquely or without courtesy, and then excuse it with the statement: “Well, s/he won’t remember anyway.” I cringe when I hear or see people being treated as if they are not present, experiencing the moment, enduring what is being done to them.
Even though people experiencing dementia become unable to recount what has just happened, they still go through the experience – even without recall. The psychological present lasts about three seconds. We experience the present even when we have dementia. The emotional pain caused by callous treatment or statements occurs during that period. Our loved ones and clients’ moods and actions are expressions of what they have experienced, whether they can use language and recall, or not.
This is why person-directed care is so critical for people experiencing dementia. They are experiencing the present. We need to not only provide support for rational thought losses, but also remember that they remain experiential beings even when their ability to recount and recall their experiences has melted away.
So be careful to safeguard your loved one or client’s experience of the present. Doing so will pay dividends in positive moods and cooperation, but more importantly, not doing so is unkind.