Rosie I enables the reader to compare outcomes resulting from using two different scenarios.  In Rosie I, Psychosocial needs were addressed and met while using dementia-wise interaction techniques in . Rosie reveals the outcome when these techniques are not used.

Sadly enough, experiencing inappropriate interactions enough times in the workplace enables me to pretty much predict their failing outcomes.

Frustration ruled my day in my beginning years with the lack of understanding I saw in caregivers as they interacted with the dementia population.  Unable to reach the masses, I decided to educate one person at a time.

Focus is placed on the importance of addressing a loved one’s psychosocial needs while using dementia-wise interaction.  That, along with becoming “that one that will cause them to survive” will produce quality of life without the use of meds in most cases.

The eye of the psychosocial storm

Come along with me now as we go through Rosie’s story one more time.  Only this time we will ignore her psychosocial needs and minimize dementia-wise interaction.

We would have been asked to come to the lobby to assist getting Rosie through the lobby double doors.  We see and hear Rosie and Pam in a rather heated argument.  Approaching, we wait for a break in the arguing so we can introduce ourselves.

She could have cared less who we were.  Rosie was determined to never see any of us again.  We’re bothering her because we are interrupting a private and very serious moment she is having with her daughter.  And because in Rosie’s eyes we are “on her daughter’s side,” we instantly have become her enemies.

You on one side, me on the other.  Gently taking her by the arms, we head for the lobby doors.  Physically resisting, Rosie pulls and tugs with all her strength to free herself from our grip.  You and I are talking to her at the same time.  That always happens.  Metal against metal is all Rosie’s ears hear.  Contorting now to view her daughter while continuing to resist our direction, she is almost completely out of control.  Adrenaline strengthens every punch, bite, and kick.

We know we will be “attacked.”  Part of our job description really.  But nonetheless we need to get her through those lobby double doors “for her safety.”  We maintain a hope we will be able to calm her down on the other side.  “We know you like tea,” we explain.  “You’ll love our tea, it’s the best,” we boast hoping this will cause Rosie to suddenly flip around and begin to comply with our requests.

To our surprise she is not calmed by that and instead blasts out, “I DON’T WANT ANY TEA!  I HATE TEA  AND I CERTAINLY WILL NOT DRINK ANY OF YOUR TEA!!  NOW LET GO OF ME OR I’LL CALL THE POLICE!  I JUST WANT TO GO HOME!!!  All the while trying anything to wrench her body free from our “clutches.”

Entering into the chaos

Finally through the lobby double doors, we bring/force her to a sofa which faces a beautiful river-rock fireplace.  Maybe the calming effects of the fire might distract her for a few minutes… we hope.  Well it’s too late for that because Rosie is now in survival mode.

She doesn’t feel safe. “Pam’s allowing these people to kidnap me?!!” she asks her bewildered self.  Ominous shivers race through her body as she glances around recognizing nobody.  Everything smells different, looks different, and feels different.  Other than hell, she has no idea what “this place” is all about.  Unable to answer her own questions, Rosie remains focused solely on getting out of there.  At any cost.

By now nursing is on the phone to Rosie’s physician.  An order for mood-altering meds to help calm her during this “time of transition,” is on its way.  At this point it would most likely be a topical med because nursing is pretty sure she is not going to stop her “tirade” just to pop a pill and take a sip of water.

The calming moment – not filled with quality of life – but with meds

Finally medicated, Rosie rests in a chemical-induced dreamland still sitting on the couch.  I don’t need to remind anyone this is not quality of life.  Eventually the meds will wear off and its “anybody’s guess” what will happen next. 

Even after counseling Rosie’s daughter goes home in a barrage of tears.  Sick to her stomach at how things turned out ensures another guilt-ridden, tear-filled sleepless night.

How very different things could have gone for Rosie and Pam.  And the whole point is it just doesn’t have to be that way.  There is a better way.  Learning to work within a loved one’s reality while using dementia-wise interaction can completely fulfill the needs of not only the loved one, but for family members and friends as well.

Psychosocial encouragement

• Validate their feelings by echoing back their own words.
• Keep your eye level even with or lower than the loved one’s as this shows respect.
• Give choices rather than orders.  “Would you like to read or help me dry dishes?”
• Watch their body language and listen to their intonations for mood clues.