One of the most difficult problems of aging is staying in contact with those we love. We are social creatures. We need to be around other people. But how much social contact we need—and what kind is best—differs from one person to the next.
Introvert or extrovert?
Some of us are more extroverted, while others are more introverted. What does that mean when dementia comes into the picture?
When using the DAWN method, one of the first things we assess is what types of social interaction will be best for our new client. We talk with family members to learn about their earlier preferences and personality traits, then watch closely to see if those earlier traits have been changed by dementia.
Extroverts with dementia enjoy more commotion
Some people come alive in groups; others are overwhelmed and do better in one-on-one situations. When we are working with people who are extroverts, we support their need for group conversations and group activities. We try to keep them involved in the activities they have always enjoyed, such as book clubs, quilting groups, and card clubs. As they progress further into dementia, they do well in crowded coffee shops and restaurants where there is lots of interaction and commotion around them. They enjoy sitting in the middle of the audience at plays and movies. In conversations with others, we voice the facts they cannot remember so that they can take part and feel socially successful.
Introverts with dementia enjoy quieter interactions
When our clients are more introverted, they still need social interaction and companionship, but find groups and group activities more intimidating than stimulating (this is another reason why a move from home to an assisted living facility is not necessarily beneficial). Often family members tell me that their loved one is too isolated living at home and would have more companionship in a facility. However, for the introverts among us—and most of us are more introverted than extroverted—being forced to live in group situations is even more isolating. Rather than feeling safer and more comfortable in the midst of many people in the dining room or common areas, they feel more at risk. And, being in a crowd and unable to interact feels more isolating than being home alone.
For our introverted clients, we design care plans that include lots of one-on-one companionship. These clients enjoy sitting on the periphery in cafes and coffee shops, where they can look out at the group and watch. They enjoy sitting on park benches and watching mothers and children in the playground. They enjoy matinees in quiet theaters, especially movies about families and animals. They enjoy scenic drives and walks with a single caregiver or family member.
Getting the right kind of social stimulation is as important to our sense of security and well-being as is getting enough sensory stimulation. When people get appropriate social and sensory stimulation during the day, they are relaxed and tired by dinnertime, ready to wind down and rest. We have had remarkably little trouble with our clients wandering or sundowning, and I think it is because we are so careful to ensure that they get the right kind of social and sensory stimulation each day.
Providing the right amount and type of social interaction is essential when we care for people experiencing dementia.