After a care plan has been established by a highly trained neurologist, determining capabilities is the next step after diagnosis in order to establish a treatment plan. Symptoms of memory loss occurs depending upon which section(s) of the brain is involved. In early stages, only one area may be damaged. In some cases, interrelated sections or lobes may be damaged.
The caregiver must understand that the person with dementia is not being obstinate or frustrated out of choice. The brain dysfunction is ruling actions and reactions.
Verbal interaction for persons with dementia
Become familiar with the person's level of understanding, independence and stage of dementia in order to better communicate.
Because the Frontal Lobe behind the brain or other interactive lobes may be damaged, a person with dementia may be un-cooperative, rude or even combative.
- Caregivers should not take any words, actions or reactions personally.
- When a demented person makes a negative statement of frustration or hopelessness, the caregiver should reply with a paraphrase positively to affirm that the person’s feelings are being heard.
- Don’t give answers as advice or lecture the person in any way. Give short suggestions that might help and remember that the person may reject all alternatives. However, later the person may take the advice, if it is remembered.
- Speak slowly, simply, calmly and succinctly and refrain from using too many words.
- Speak directly to the person. Make eye contact when possible.
- When other people are in the room, involve the dementia person in the conversation.
It’s best not to tell the person what to do, but to suggest or ask. Questions would be structured, depending on the level of understanding.
Example: For later stages of dementia. "Susan, it's time for a bath."
For mild cognitive impairment (MCI), and those with understanding and desire for independence. it may be better to ask questions. “Thomas, would you feel refreshed if you had your bath now?” “Mary, I’m here to assist you with your bath." “How do you feel about your bath today?” Give them choices (but not too many) as to whether they want to have a bed bath, sit on a stool for a sponge bath, have a shower or tub bath.
Of course, all options depend on the person’s capabilities and mood for the day. It is also a good idea to establish with the MCI person a day or so before first event of care, such as bathing, the best time of day and the preference of type of bath, etc.
For those more impaired, don't be surprised if the person says "no". This may be to establish independence or it could be that the responsible brain area is thinking in the reverse. "No", may mean "Yes." Continue to prepare the bath water and reword the question. "Your bath water is ready."
Personal activities of daily living should be done in a safe and unhurried manner. Time for people with dementia is slow paced and hurry frustrates them.
Social interactions for persons with dementia
Remember that the person with dementia diseases need space and are confused by too much chatter and noise. Too many people in the home can be frustrating and cause confusion. Sudden actions, fast movements or taking care of the person in a fast pace can set off anxiety and adverse reactions.
Outings should be limited to quiet parks or other peaceful places where the person can feel relaxed and comfortable. This may mean that family gatherings should be avoided if there are too many children or if there are boisterous activities.
Alzheimzer's Association, The Michigan Great Lakes Chapter will be promoting and raising funds for research of dementia diseases with the Walk to End Alzheimer's, Sunday, October 2, 2011. Registration and the start of the walk is at the Celery Flats Interpretive Center and Historical Area, 7335 Garden Lane, Portage Michigan. Registration is at 12:00 p.m. and the walk starts at 1:30 p.m.