People living with dementia often have a desire to feel purposeful and needed just as much as anyone else. Having your loved one help with household tasks can be both therapeutic and crucial to restoring sense of purpose.
The natural reaction of many caregivers is to try and explain to their loved one why they should or should not do something. Sometimes we try and convince them it is for safety purpose, for their own good, or it is because we care about their wellbeing. While all of these reasons may be true, the trouble is that explaining things to someone with moderate to late stage dementia often isn't helpful. The care recipient no longer has the capacity to understand reasoning and sometimes an explanation can further confuse or frustrate the person. Other helpful suggestions in this situation are to distract, divert or agree.
When we debuted the Caregivers Ballad to a group for the first time and asked the audience for feedback, one listener said, "I think there may be a typo with the line, 'I forget not to explain.'" This listener thought we meant to say I forget to explain, and we discussed with her that the sentence was intended as such to remind the caregiver that explaining is not always helpful with someone living with dementia.
Ocassionally as a caregiver you may be faced with the uncomfortbale task of telling a "fiblet" to a loved one. A fiblet, also known as a tiny white lie, is often neccesary in working with someone who has memory loss when we know that using logic or explananing things won't help. For example, if your loved one gets up in the morning and tells you that they need to go to work but you know they haven't worked for a decade or two, you may be faced with a dilemma.
Disorientation to time and place is common with memory loss: if a person believes that they need to work, disputing this will only lead to agitation and possibly aggression. It might even evoke other anxious concerns such as, "how will we pay the bills?" Rather than explain the circumstance, it is best to distract and divert with the use of a fiblet. "Your boss called, they said that the office is closed today and that you do not need to come in."
The primary function of a fiblet is to calm the person through comfort and distraction. It validates their worry and gives them a workable resolution. Remember, it is important to join "their reality" because trying to convince them otherwise may only create negative feelings and resistance.
Homemaking activities can be modified in ways that match a person's abilities. Example: If setting the table is confusing because it involves many steps, hand the individual just one item at a time and give instruction where to place it. Once that step has been completed move on to the next and so on. Templates can also be created as a reference guide of what the finished product should look like. Some caregivers have outlined the shape of utensils on reusable placemats to aid in successful placement.
Simplify tasks or break down the steps. For example, if setting the table is confusing because it involves many steps, hand the individual just one item at a time and give instruction where to place it. Once that step has been completed, move on to the next.
An episode of agitation or aggression can be due to an inability to communicate basic needs. Check to see if your loved one is hungry, thirsty or needs to use the bathroom.
If the time of day marks a particular routine in your loved one’s life, try to mimic what they may have done. Routine activities are comforting. Reading the newspaper at breakfast time or helping to set the table at dinnertime are some examples.
If someone sleeps a lot during the day, they are less tired in the evening. However, a short nap in the early afternoon may be needed.
When memory and cognitive function declines in someone who has dementia, the brain compensates by an increase in emotional reactivity. Mirroring can be helpful in influencing the response of your loved one. In other words, model the behavior and temperment you hope to see in your care partner. For instance, a smile evokes a smile or calm elicits calm.
Calming activities are encouraged that are "failure free". Favorite puzzles or music that is quiet and relaxing. Having a specific task to focus on helps the brain to create new thought patterns.