If persons with dementia could speak, they would tell us about their needs and desires, and particularly what they don’ like –or what leaves them in a state of frustration. Instead, we are compelled to read the signs and decipher their feelings based on their body language and occasional agitation, a task which is not always easy, and one that frequently leaves us with a profound sense of inadequacy.
Is our Interpretation Correct?
Are we reading the signs correctly? Some messages we can decipher easily, such as, for example, when they rub their hand on a table, meaning they want to wipe the table, so we just hand over something to do it with. Other times we’re comforted by our patient continuing to hold our hand after we’ve started a new activity, such as sorting, or bringing out the deck of playing cards, and we take that as a green light, at least for the time being.
Nothing like Trial and Error
It is up to us to keep things as simple as possible, creating an array of activities that will keep our patient happy and nicely occupied. Research has made it abundantly clear that a person with dementia benefits greatly from a lifestyle that includes good nutrition, plenty of exercise, socializing, and indoor/outdoor activities –particularly those that encourage patient engagement.
There are tons of activities for us to engage our patients with. They may not like some of them, which is part and parcel of the trial and error process. The rule of thumb there is not to persist with any activity if they get frustrated with it. The thing to do is to discard that activity for the time being, but bring it back on another occasion. We never know what images are being evoked in our patient’s mind, so he or she may be more receptive on the second try. If that fails –again- that is a sure sign to put that activity away for a long time.
Chores around the House
Housekeeping is one handy way of filling the long hours in a day. We can turn housekeeping tasks to good use, engaging our patient by explaining what we’re doing. This could involve vacuuming, dusting and mopping, tidying up, tasks to do with laundry and folding clothes and linen, organizing drawers, getting our vegetables ready to prepare meals, some gardening when we have a yard or patio.
As we know, the “sorting” activity is a favorite, and it can be employed by using playing cards or any multi-colored and multi-shaped objects such as buttons or poker chips. First though, we need to try the activities that the patient used to like before they got sick. We could start an activity and show our patient how to participate. If they get stuck or agitated, we can either help them out or switch to another activity.
Signs of Physical Worsening
We have to stay alert to what our patient is feeling, for they will not be able to tell us if they’re experiencing difficulties seeing or hearing, or if fatigue is setting in faster than at earlier times. These are signs and symptoms that we may have to pick up on and take care of. Naturally, we would make appropriate and gradual changes to our routines and activities, trying to feel what our patient is still able to do. At some point, hopefully early on in that sequence of events, we would want our patient to be examined by a doctor.
As the Disease Progresses
We can also gear our efforts to our patient’s senses, for as the disease progresses and their mental faculties decline, patients tend to retreat further onto their sensory abilities. They may thus revert to liking some activities of the past, though now they start liking them from a sensory perspective. To cite an example, patients who all their adult lives enjoyed going to church, may now like to go to church because the sounds and smells are familiar, and because of the pastor’s distinctive way of speaking or the comforting feeling of being in a congregation.
Maintain a Hefty Sense of Humor
We know well how daunting, if not overwhelming, caring for a patient with dementia can be. Our carefree and lighthearted sense of humor is one of the critical pillars that make us stand out in the face of the challenge. At another level though, one of the things our patient appreciates the most is our sense of humor and lighthearted approach to overcoming obstacles. In addition, many of us caregivers expend a lot of our energies taking care of our patients, so we mustn’t fall in that trap. Instead, we mustn’t let a day go by without taking good care of ourselves.
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