By Lisa Wilhelm, Heartland Village Leader, Elmroft, Little Avenue
When you find yourself caring for a person with dementia one of the hardest question to answer is “Am I reaching them”. Virginia Bell and David Troxel developed the Best Friends Approach in the 1980’s to help answer this question. The Best Friends approach seeks to make life better by adapting a philosophy that is not difficult to understand. By applying the rules of friendship to the person living with memory loss, the relationship is allowed to take on a new definition and with it new understandings. The object is to share with caregivers an approach that is easy to understand, learn and apply every day. We have found with an emphasis on understanding a person’s unique life story, caregivers are experiencing success with memory care patients, particularly through enhanced engagement.
It is believed that what the person with dementia needs most is a “Best Friend”, this can be a loved one, or caregiver. Anyone that can empathize with their situation. The Best Friend gets to know the person, learns their life story and finds ways to relate this information to their present situation. A lot of the behaviors we encounter with persons with dementia could be considered miscommunications. Knowing a person’s story could allow us to connect the dots of what they are saying with what they mean. You are not just gathering the story but using it to customize activities and conversations you have with the person. Sometime knowing the past gives you a connection point that helps you get them up and moving. John was a career soldier. The care givers at his Assisted Living Center were finding it impossible to get John to allow them to assist with his activities of daily living. He was also refusing to come to meals. One day his care giver addressed John by his rank and told him it was time to get up that he needed to be in the mess hall for breakfast by 0800. This triggered a long held memory in John, he jumped up and got right to his daily care and down to breakfast. If you don’t understand who they are you’re operating with one hand tied behind your back. Dementia damages a person’s ability to make conversation. Best Friends understand the importance of slowing down and being present for the person with dementia.
Isolation can occur with a person with dementia since they can no longer take part in favorite activities or initiate new ones. This often leads to frustration. Best Friends know that socialization can fight depression, keep persons physically fit, and bring feelings of happiness. Best Friends will mix a balance of formal activities with spontaneous moments to fill the days. Greg is a former engineer with teaching experience. He is very aware of his decline in cognition. This was causing him to spend more and more time in isolation. Greg’s Best Friend knows of his background and begins asking Greg for help with simple tasks such as changing the batteries in the smoke detectors. Greg begins to understand he still has worth and can use his experience in new ways. He then has the self-esteem to join others in a daily conversation group.
Best friends know each other’s personality and history. A Best Friend becomes the other person’s memory, is sensitive to traditions and respects their personality. A Best Friend enjoys activities with the person with dementia, involves the person in activities and chores. A Best Friend listens skillfully, asks easy question and encourages participation in conversations. Mary traveled the world when her husband was still alive. Now that he is gone and Mary is suffering with dementia she feels like her traveling days are over. Mary’s Best Friend decides to hold an international day at the day program Mary attends. She asks Mary to loan them some of the things she and her husband collected during their travels. Mary enjoys setting up the displays and sharing her stories with the other attendees. For that day Mary is able to go back around the world.
When caring for a person with dementia use the language of friendship throughout your day. Rework job descriptions to emphasize the importance of relationships, during one on one time, let the person know that you appreciate the friendship. Using the phrase ‘Best Friend” and developing authentic relationships ultimately helps the person feel safe, secure and valued-and creates a caring community where all benefit.