Dementia changes relationships, it doesn’t end them. An individual with Alzheimer’s disease or another form of dementia still has the capacity to form and enjoy relationships. They are still capable of giving and receiving love, of engaging in meaningful activities, and of interacting with others. One of the sticking factors is their ability to self-motivate. There is a lot of apathy that goes along with Alzheimer’s disease and other dementias. It becomes important, therefore, for caregivers to create an environment where the individual can thrive and flourish.
Every individual is unique.
Every individual is unique in their interests, personality, and situation. The approach to creating that environment for thriving must take these factors into account. I recall attempting an activity that included speaking about the upcoming wedding of Prince William and Kate Middleton. The woman I was working with did not like the Royal Family and she needed to tell me that – quite strongly. She was asserting her interest, or in this case non-interest, in the subject matter. It was important to her to state her feelings and it was important for me to listen and accept them. We changed activities and she was content.
While a small incident, my honoring her opinion improved our relationship. We became closer friends. She felt understood and appreciated for her unique perspective.
The need for human connection.
Individuals have an intrinsic need to connect with other humans and this doesn’t change with a dementia diagnosis. Individuals with dementia have reported the need and desire for more human interaction. Keep this in mind and think about ways to create connections. As well as creating connections, create rituals that help to support these connections.
One family took their mom to Mass on Sundays and then to their home for a family dinner. One Sunday, she was falling asleep during Mass so they decided to just take her back to the nursing home. They felt the day was probably too much for her. She was drowsy until they reached the door and then she perked right up and demanded to know why she was back so soon. The family dinner was an important and valued ritual to her. She didn’t want to miss it.
Help in building relationships.
When dementia or other cognitive challenges enter the picture, you may need to provide more support to maintain relationships. The individual may require others to take the lead. They may no longer have the capacity to organize coffee dates, visits, or trips but they still enjoy them. It is important to not let the disease come before the relationship.
Individuals with dementia may require more cuing to support relationships. You may need to provide photograph albums with every individual tagged by name. You may also find a simple family tree, with pictures and names a useful cuing tool. Then and now pictures can also provide a helpful cuing function. Having a picture of their siblings as young children or young adults and then a current picture is also helpful for avoiding confusion. Make sure every picture is tagged with the individuals’ name so that name recall is not an exercise in frustration.
The range of and capacity to feel emotions remains very strong even when an individual is suffering from dementia. In fact, you may find that the individual communicates more about emotions and feelings than facts and events. This is a normal reaction, since their emotional landscape is very much alive. When you are talking about emotions make sure you let them know that you are aware of their feelings. Being validated through listening and understanding is important for self- confidence and self esteem.
Body language and emotional cues.
Since the individual is much more sensitive to emotions, they will pick up body language and emotional cues very quickly. Often, they will react to the smile (or lack of one) on your face rather then to the words you are using. Let them know how you are feeling. They may find it easier to communicate about feelings rather than facts.
Keep this in mind, as well, when dealing with difficult situations. Don’t let anxiety or frustration overwhelm you. Your emotions will transfer to them and their anxiety levels will increase. This can make solving challenging situations even more difficult.
Even though an individual with dementia may be more emotionally aware, they may have difficulty in expressing themselves. Verbal expression can remain challenging. Loss of verbal fluency is common in Alzheimer’s disease and other dementias. This means the individual does not have the same capacity to pull on the appropriate words or phrases. They may become frustrated when they are trying to express themselves. Encouraging your mom or dad to slow down when expressing their thoughts can help. As well, give them time to process information when you are asking questions. Making them feel unhurried can help with verbal expression.
Non-verbal expression by individuals with dementia becomes an important element of communication. Finding activities that support this type of expression can enrich the relationship between caregiver and care-receiver. Some non-verbal activities that you might try are:
- Watering or trimming plants
- Brushing or feeding pets
- Listening or singing to music
- Repetitive physical activity such as shredding paper, digging the garden, or walking
- Holding hands or brushing hair
- Sorting cans, socks, or other simple household chores
- Feeding or watching birds
Non-verbal activities are important for building warmth in a relationship. They can add richness and variety to interaction.
When challenged by your mom or dad’s dementia, don’t neglect meaningful activities that exercise their brain. You can check out the Fit Minds Enable Program for activities that can engage your mom or dad across five areas of cognition: language, visual/spatial orientation, memory, critical thinking, and computation.
Individuals living with dementia may have trouble expressing themselves in way that are easy to understand. Their ability to cope with stress and changes in their environment will be compromised. Creating an environment that supports both their intellectual and emotional needs is important. Continuing to give them opportunities to interact and express themselves will help maintain quality of life for them. You will build a legacy of love and caring that will create a framework for your children and your children’s children.
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Nicole has trained hundreds of professional and family caregivers who have touched the lives of thousands of individuals living with a cognitive impairment. Nicole also holds a law degree from Osgoode Hall Law School, a Master’s in Law from Queen’s University specializing in Negotiations and is a Certified Professional Consultant on Aging.