A Special Approach to Dementia Care Helps People Feel Safe, Secure, and Valued
By Carol White
Alzheimer’s disease (AD) is the most common form of dementia (others include Vascular, Lewy Body, and Parkinson’s). AD accounts for 60 to 80 percent of all dementia cases, and if you’re living with AD or caring for someone who has it, you’re not alone. In fact, in the United States alone, this applies to 13 million women.
More than three out of every five unpaid Alzheimer’s caregivers are women. And women are more likely than men to get Alzheimer’s. Of the 5.7 million people age 65 and older with AD in the United States almost two-thirds are women.
Dementia is the result of damaged brain cells that can no longer communicate with other brain cells as they normally would. The exact cause of AD is unknown, but scientists believe the prime suspect is the build-up of two abnormal proteins in the brain. The average life expectancy after the onset of symptoms is four to eight years.
AD typically progresses slowly in three stages: mild, moderate, and severe. While no two people experience the disease in the exact same way, there are some common changes in each stage:
Mild: Memory problems, asking the same question over and over, loss of ability to manage finances, losing things, and withdrawal from social situations or a favorite hobby.
Moderate: Difficult behaviors (anger, suspicion, and paranoia), agitation in the late afternoon or evening (sundowning), resistance to bathing, getting lost in familiar places, and requiring assistance with bathing, dressing, and grooming.
Severe: Loss of ability to communicate, walk, and smile; inability to recognize people, places and objects; incontinence, weight loss, and full assistance required for personal care.
The moderate stage typically lasts the longest, and sometime during this stage (or in the severe stage), families consider placing their loved ones in a memory care community, a skilled nursing facility, or an adult care home.
Others choose to keep their loved ones home with assistance from a non-medical home care agency. The agency caregivers provide personal care, mobility support, medication reminders, meals, errands, and household chores. More importantly, they should be trained and coached on building a relationship with the person who has AD.
Home Care Assistance (HCA) uses the Best FriendsTM Approach to Dementia Care, which is based on the belief that what a person with Alzheimer’s needs most is a “Best Friend.” HCA caregivers build relationships with their clients through respect, empathy, support, trust, and humor – the essentials of friendship. This approach also works with seniors who do not have dementia but are struggling with other challenges.
Here are some things some of the HCA caregivers had to say about their experience with the Best Friends™ Approach to Dementia Care:
Cynthia: What started off as a job almost three years ago, changed my life forever. When [my “Best Friend” and I] first met, she was very prim and proper, and a little of that did rub off on me. I’m more fun-loving and sillier and that rubbed off on her! The other day she said something and then stuck her tongue out at me. She said, “Oh my! I have never done that in my life!” We laughed so hard. In the last few months, I’ve seen a change in her. She’s more forgetful and is losing weight. I’ve introduced her to the 600 calorie Mocha Frappe. She loves them! I don’t think she knows the impact that she has had on my life. She is very special to me and has a very special place in my heart.
Lavonne: People just want to be respected and treated with kindness. No one likes to be talked to like a child. Stop and listen to a story you have heard 100 times but act as if it’s your first time hearing it. Pay attention to details such as triggers that can make a person agitated or sad. Don’t argue. I tell my “Best Friend” how nice she looks and that we should go out somewhere. She loves music so I turn on a polka show because she used to polka. Encourage movement even if it’s just to the back door to see a bird sitting on the fence or the bunny that lives under the bush.
Peggy: [My “Best Friend” and I] have nicknames for each other gleaned from the relationship we have built and the experiences we have shared. I ensure that she shows up to life looking forward to it, seeing possibilities rather than “can’t do thats” in every way, from her being showered and dressed to making sure that big scooter is charged and ready to hit the road. One day she was a little teary. I asked her what was going on. She said, “When I am with you, I don’t feel like I have ALS.”
Caring for a loved one with dementia can be physically and emotionally taxing. The National Institute of Health concluded that “caring for a patient with dementia is more challenging than caring for a patient with physical disabilities alone. People with dementia typically require more supervision, are less likely to express gratitude for the help they receive and are more likely to be depressed.”
Professional caregivers know how to communicate with their clients so daily tasks like bathing go more smoothly and challenging behaviors are redirected. It’s easier for a professional caregiver to not take things personally, to never argue with their client and to coax them into meaningful activities. People living with AD can feel lost and lonely due to forgetfulness and confusion. Showing empathy, giving compliments and acknowledging accomplishments can go a long way to helping the person feel safe, secure and valued.
Carol is the owner of Home Care Assistance of Prescott. She is an active volunteer with the Desert Southwest Chapter of the Alzheimer’s Association and is also a Certified Master Trainer in the Best Friends™ Approach to Dementia Care. For more information call 928.771.0105 or visit her office at 377 Montezuma St., #110 in Prescott.