“Doris” loved washing dishes. She was in her eighties with advanced dementia, but she loved washing the dishes. The problem was that the dishes usually went from the table to the sink to the drying rack with bits of dinner still stuck to them. Doris was also a pincher. If things didn’t go the way she wanted them to, she’d pinch anyone in her way.
The solution to this was that caregiver Debbie let Doris wash and dry her dishes. Then, when Doris was occupied in another room, Debbie would wash the dishes again to make sure they were sanitary for the next meal. It was a win-win solution. Doris and her husband were living in sanitary conditions, and Doris wasn’t spending her life agitated about not being able to wash her own dishes.
People with dementia live totally in the moment. When their children come to visit, people with dementia may not always remember them, but they feel the warmth of their love. If Grandma feels loved for thirty minutes because her daughter is there visiting, it makes that visit very meaningful. Unfortunately, it’s easy to spend those moments arguing with Grandma over her age or what month it is instead of spending quality time with her.
Here are just a few tips to help you maximize the time you have with your loved ones who have dementia:
1. Understand that memory loss and confusion is not a choice.
No one chooses to experience memory loss or confusion. The resulting effects—anger, frustration, emotional displays, argumentativeness—are natural outcomes any one would have if placed in a similar situation. No actions on the part of the family caregiver will ever change dementia. Punishments (such as time outs or yelling) are ineffective and should never be used. Also do not attempt to argue with a person who has dementia. Their reality is just as real to them as yours is to you, so it will not be fruitful.
2. Establish a relationship.
If the person with dementia doesn’t recognize you, get to “schmooze” with that person before starting to help her. Treat her like a friend, and realize that you will be able to do more for her if you have a bond with her. You would never let someone provide standby assistance for you in the shower two seconds after meeting her, but you might if you had some time to get to know and trust that person. Don’t hesitate to butter her up.
3. The person with dementia is always right.
It is not helpful or useful to make people feel bad about their memory loss. Don’t contradict their memory loss or ask them to recall details. Never use phrases such as, “Don’t you remember that we were going to go to the store?” There is no point in making them feel bad about forgetting.
There is also never a point in arguing with a person who has dementia. You will never win the argument about today not being garbage day or that they no longer go to work. It is more effective to distract or divert them.
4. Therapeutic Fibbing
It is okay to fib to people with dementia to avoid arguments and power struggles. Do what you can to distract, divert, or validate their concerns so that you can help them and move on.
Grandma, age 83, is insisting that she must wait for her mother to pick her up. Instead of arguing with her that her mother has been gone for many years, tell her, “Oh, your mom asked me to take you home for her.”
While at the store, Grandma insists you buy syrup even though she has five bottles at home. Allow her to put the syrup in the cart, then take it out when she’s not looking.
Grandpa is concerned about someone stealing his money. Instead of trying to argue with him, try saying, “You know, I’ve wondered that same thing. I’m going to call the bank later today and ask them about it.”
5. They like to help you.
Everyone wants to feel needed and valued. Ask Grandpa to help you with simple tasks that he is still capable of performing, keeping in mind that he may not be able to attain perfection. Ask Grandma to teach you her favorite hobbies, such as knitting or playing cribbage. Asking for help can also be a way of distracting those with dementia from their concerns or worries.
6. Respond emotionally.
If someone is having a hallucination or a re-occurring fear, you will not be able to reason the fear away. Instead, respond by meeting the emotional needs that are rooted in the fear. If Grandma is seeing tigers coming at her, assure her that you are there to keep her safe.
Please keep in mind that what works for one person with dementia may not work for another. Due to the ever-changing nature of the disease, tactics need to be constantly assessed and reevaluated as behaviors change.