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Alzheimer’s patients remember joy and movement with yoga

Yoga helps calm stress and anxiety for those suffering from dementia and/or Alzheimer’s disease.
Julie Phillips-Turner

Maya Angalou once said, “You may not always remember what someone said or what they did, but you will always remember how they made you feel.”

And for some of the Alzheimer’s patients at Copper Ridge in Sykesville, Maryland, they do remember the warm smile, hugs, and positive feelings each time Cathy Rees visits them to teach yoga. And for others, every day is their first yoga class with her.

In the center hallway, 20 patients waiting for Reese gather sitting in wheelchairs, geri-chairs or even beds – some aware of what is about to happen, some chattering in undecipherable words, some screaming, or even sleeping – such as one couple cozied up in blankets on reclining chairs fast asleep.

Rees has seen these patients every week since February 2014, and she says that each day is a different experience.

“There are good days and bad days,” Rees explains, “one angry patient can bring down the mood of the others, the group is sometimes contagious. If the energy is high, oh boy it is high, and if it is agitated, that my swell a bit. But my job is to meet them where they are and use the energy in the room to their advantage.”

Engagement of the heart and mind through validation.

Before the class begins, Rees greets each patient individually with a handshake or a hug, as a formal acknowledgement that she is there to be with them – looking into each of their eyes or even rubbing their arms and feet – some respond, others may continue to slouch in their wheelchairs and rest, babble meaningless words loudly or even look past her to a distant space. But she bravely greets each one, as a validation to their presence in the room.

According to Rees, validation of each participant before, during and after class, lets the participants know that their feelings are acknowledged, along with the human needs that cause their behaviors.

“They have very telling eye gazes, says Rees about the participants at Copper Ridge, “When you meet many people, shake their hand, say hello, their eyes gaze past you on to the next person or thing, however, when you meet a person with dementia or Alzheimer’s disease, when you get close to their face and look them in the eye, they look deeply into yours and you feel like they really ‘see’ you. The eyes are a big part of yoga. Smiles, finger taps, and even staying awake.”

As the yoga class begins, Rees tells the class that they are there to do yoga – the participants follow her with their eyes around the room and begin to move their arms along with her, and some choose to watch. She guides them through several seemingly simple exercises from stretching the fingers, to lifting knees to march in place while seated in their chairs, and giving themselves big hugs with their arms snugly wrapped around their shoulders.

Rees constantly walks around the room keeping the acknowledgement of each student to potentially engage in the activity. Sometime she sees the acknowledgement of the class in their eyes, that they are there, observing, but not moving. And some days there are breakthroughs. It just depends.

“It’s pretty exciting when you see someone who has only followed me with their eyes, to actually reach out for my hand, or tap a toe, or move their hands to the rhythm of my voice. I would call that a break through.”

“Everyone comes to the class at a very different place. And, sometimes, every time they come, they are in a different place as well. One day the person might be friendly and talkative, but the next day, quiet and reserved/sleepy, or even a little agitated. We have to work to find out where each person is on that day at that moment,” says Rees, “It is a wonderful lesson in staying in the present moment and developing flexibility to adapt the class plan moment by moment.”

Opening the heart and mind with song.

Towards the end of the 30-minute class, Reese leads the group into singing “He’s Got the Whole World In His Hands,” and it seems more participants awaken to the spark of remembering simple lyrics from long ago. Smiles emerge from some as they add arm movements along with the words of the song. As the group sings together, Rees opens her arms wide asking for hugs and immediately has a lot of takers from the group as they smile with big hugs from Rees. This is validation in the highest sense.

Rees' caregiving expertise expands from nursing to yoga therapy.

After earning her BSN from the University of Maryland School of Nursing, and Master’s degree from Georgetown University, Rees has developed a rich nursing career over the past 30 years in a variety of settings from Shock Trauma and NeuroTrauma, to her most recent development of worksite wellness.

For the past 17 years Rees has had a passion for yoga, so becoming certified as a Yoga Alliance yoga teacher seemed like a perfect fit to balance and enhance all of her caregiving passions.

Rees states, “I’m aligning myself to become an expert in teaching gentle, adaptive and therapeutic yoga for a variety of populations, including dementia and Alzheimer’s disease.”

Currently, Rees is now working with Sherry Healy, Director Community Center for Health & Wellness at Copper Ridge, to develop a new yoga program for those suffering from dementia and Alzheimer’s disease called, Here and Now: Therapeutic Yoga for Dementia.

According to Rees, the program was developed as a result of her yoga training, her research and experience with program planning, and perhaps most importantly her personal experience working at Copper Ridge.

How the present moment brought about Here and Now.

Rees describes her first encounter with being in the moment with the Copper Ridge patients, after a moment of frustration that led to her actually connecting with the patients, and developing the idea for her new yoga therapy program for dementia and Alzheimer’s disease.

“The concept for the actual yoga asana (pose) component inclusive of dynamic movement sequences was born partly out of accident,” says Reese, “I had been teaching for a good part of the day, and admittedly I was exhausted. I closed my eyes, crossed my feet under my chair, and placed my hands on my head. After a few cleansing breaths, I opened my eyes only to see all eight of my participants assuming the exact same position. Remaining perfectly quiet, I turned the beautiful relaxing music up a little bit and moved through sequential movements and the participants imitated me perfectly (even itching my eye). They were fully engaged.”

“We had intense eye contact and a deep, personal and soulful connection throughout the class. By the end of the class I had tears in my eyes. It was the most intense and soul touching class I have ever experienced as a teacher or as a student. I knew I was on to something at that moment,” explains Rees.

During her classes, Rees typically plays calming meditative music, as they “dance” together, singing together, smiling at one another, and finding deep, soulful connections.

Rees says her experience teaching dementia and Alzheimer’s patients is unlike any other experience she has had teaching or participating in any other yoga class.

“It was a breakthrough for me as a teacher, when I realized that they had this ability to connect,” explained Rees.

About the Here and Now Yoga program.

According to a study that Rees and Healy have done while teaching the program at Copper Ridge, the Here and Now Yoga is described as effectiveness-based program designed using adaptive therapeutic yoga techniques for the person suffering from dementia and/or Alzheimer’s disease. Here and Now Yoga works to combine the positive effects of breath work, sequential dynamic yoga movements aligned with the seven main chakras, and simple meditation.

Starting with simple breath work helps to center the participant, create a sense of engagement and cultivate a calming of the nervous system so that the yoga postures can be done. Meditation at the end of practice is meant to integrate all that was accomplished throughout the practice and clear the mind ridding it of stress, anxiety, fear, or any other tension that may persist.

While yoga has evidence-based positive health benefits including reducing anxiety, depression, pain, and creating an overall benefit of positive well-being, the positive effect of engagement in the present moment is paramount.

By the end of class at Copper Ridge, one participant named Donald who came to class but felt too stressed to participate, and instead sat watching from his wheelchair on the outskirts of the circle, was clearly calm and singing with the group by the end of class. As Rees left the room after class, Donald waved and said with a smile, “See you tomorrow!”