It’s not about the end result, it’s about the process!
by Brian and Heather Rahrig, Owners of CarePoint
Cognitive health is a person’s ability to think, learn and remember. The most common cognitive health issue facing the elderly is the loss of those cognitive functions, or dementia. According to the Alzheimer’s Association, dementia is the decline in memory or other thinking skills severe enough to reduce a person’s ability to perform everyday activities. The most common form of dementia is Alzheimer’s Disease.
As an RN and the Director of a home care agency, all too often I have gone in to do an initial home care assessment on clients that have dementia only to have their families tell me their loved one “can’t do anything.” Unfortunately, the stress of watching a loved one lose cognitive function takes a toll. Eventually the day-to-day essentials of eating, bathing and dressing are all that seem to matter.
That’s where home care can truly make a difference during the remaining years of a person’s life. Before home care can begin, an assessment is needed which is typically done in the client’s home. Part of this assessment focuses on who the client is, who they were, their occupation, spouse’s name (even if deceased), children, grandchildren, as well as hobbies and any other interests. People with dementia tend to remember things that happened in their distant past, usually during their teens, 20s and 30s. From there, a customized care plan is created to encompass all of these important elements of his/her life.
Not all care plans are created equal! The better the care plan, the better the picture of who this individual is, which in turn fosters more meaningful interactions between client and caregiver. A thorough assessment is so important because it can truly be the difference between your loved one living a richer, more active life and merely existing.
The care plan is not just for the home care staff but also family members to help them develop a routine with their loved one. Completing an activity from start to finish is not always the objective. The process and stimulation that the person gets from the activity is what is fulfilling, not only for the person with dementia but also the caregiver. We never know exactly what the person with dementia is able to process which is why the ability to spark a memory from the past and possibly bring out an emotion is satisfying and makes them feel useful again even if only for a short period of time.
Cooking is a great example. Typically a person with mild to severe dementia can no longer follow a recipe from start to finish. A solution is for the caregiver to breakdown the tasks to help the cook focus on the senses and individual steps in the cooking process rather than just the end result. For example, baking cookies requires all 5 senses along with motor function and this activity can be modified by the caregiver to incorporate the person with dementia to participate which allows them to feel useful. Stirring the dough requires motor function by holding the bowl and rotating the arm, shaping and rolling the dough utilizes the sense of touch and fine motor skills which are often under used. The smell of cookies baking is not only pleasing, but recalls past memories while hearing the oven timer go off provides audible stimulation, and of course seeing and tasting the cookies before and after baking is very satisfying.
Men who previously enjoyed card games can benefit from sorting poker chips, holding and laying out cards, and looking at the different suits. The task of sorting by suit, number or color can have positive impacts by utilizing parts of the brain that may not have been used in a long time. For others, utilizing various objects such as small pieces of PVC pipe can be stimulating as well as a relatively inexpensive activity to assemble. Simply picking up, putting together and observing the different shapes can be an enjoyable activity. Again, it’s all about the little things that engage a person with dementia in order to spark past memories and get them thinking and communicating.
The simple task of folding towels can provide a sense of accomplishment for people with dementia. Keep a small collection of towels that are just for folding and unfolding. You can do this as many times as necessary. Simply take the towels into another room, unfold them and bring out another “load of laundry” to fold. It is surprising how even during the late stages of dementia, folding towels is still something that can bring about a memory with an added feeling of purpose.
Balloon volleyball is another great activity that can be played even by late stage dementia clients. Bright colors are appealing to the eye and the automatic response of hitting the balloon works large motor skills as well as hand eye coordination. Listening to music from the era when the person is in his or her teens can bring back a world of memories and summon emotions in everyone. If they are able, try having them dance to the music. This typically enhances the experience and brings about many smiles.
Remember, when it comes to older adults with dementia it’s not the end result that matters most – it’s the process of getting there that is most fulfilling! A thorough assessment is so important because it can truly help your loved one live a richer, more enjoyable life. After all, the little things like a smile, a laugh, a word that is mumbled because a memory was sparked or even a tear are what become the most important part of life’s late stages.