I first observed John and Evelyn arguing. John, filling out paperwork to admit his wife into our locked dementia facility while Evelyn’s logic told her they were about to spend too much money. Simultaneously he struggled to maintain his wife’s calm in an unfamiliar moment.
Judging by the paperwork her husband was filling out, Evelyn deduced they were about to spend money. She was right. With no clue as to what they were purchasing, her budgeting concerns were triggered. In her reality they could have been broke.
Logic motivated by adrenaline
“Dear, we have plenty of money,” John consoled before reminding her she JUST checked their account an hour ago. Feeling very unheard Evelyn cried out, “Well don’t you think I know that?!!! Do you think I’m stupid or something?!!! That’s EXACTLY why I need to check the register!!!”
As you might have guessed, that was a wrong response by John. Wrong because he was addressing the reality of her statement. In fact, he needed and Evelyn wanted him to address her feelings.
John looked at me quizzically shocked. I smiled a calming smile. “You need your checkbook and I’m the gal that can help you. It’s in the top drawer of your dresser. Let’s go get it.” Calm suddenly burst out and filled that tiny office space like a ray of sunshine. Confirmation Evelyn’s psychosocial needs were beginning to be met.
Certainly she didn’t know who I was. Yet she allowed me to disclose personal information without questioning. Evelyn needed her soul calmed. I spoke words that gave her that opportunity. Immediately her brain began telling her an important dementia-wise survival message. “This is the one who will cause you to survive.”
I took her hand in mine suggesting we were longtime friends. We headed off to her room. John followed closely behind. Listening, watching, learning helpful dementia-wise techniques along the way.
Venting with validation creates quality of life — it’s simple logic
“He never worries if we have enough money to meet our needs! Someone has to worry! What if we’re broke? Does he think about that? Noooooo!” Evelyn huffed. “He never worries, but you do. I can tell,” I affirmed.
For a moment we stopped. Staring eye to eye while holding hands I proudly told her, “How very blessed you are to have this ability! Would you like to work again? I really could use an assistant and I think you would be perfect.” Certainly Evelyn’s sense of being lovable flared to new heights. Above all, her sense of value and self-worth were rekindled.
“YES! I’ll take the job! When do I start?” she eagerly asked. We both began to giggling like school girls. “You didn’t even ask me how much it pays!” I chuckled. “Let’s go to my office and finalize the paperwork.”
Redirection of thought
Initially the goal seemed to be finding Evelyn’s checkbook. Adventures “along the way” began shifting her thought pattern away from unhealthy ideation. Our topic(s) of conversation were purposed.
Together we toured the building. Introductions of Evelyn as our new Policy and Procedures Manager allowed her to stand tall and proud. To nobody’s blame, how long had it been since she last really felt so good about herself?
Eventually morning drifts into lunchtime. Admittedly Evelyn is hungry and ready for a break. It’s been a long, wonderful morning for her.
This event is a perfect textbook example regarding the loss of logic as the disease progresses. How very important, literally, crucial, the use of validation and dementia-wise interactions now becomes.
Common mistake
A common mistake many family members make as did John was to point out the facts; the logical facts. Yes the facts were logical but Evelyn’s thinking was not. He did not recognize her inability to follow his logical flow. Wanting to bring Evelyn to his reality doesn’t work. He must join in hers.
Evelyn eagerly reported to my office every morning to find out what her duties for the day were. Above all, it caused her to thrive. I provided an activity where she would get up in front of the other “staff members” to lecture. She even had a question and answer period.
The audience remained enthralled even though the flow of thought was disconnected. They respectfully attended the meetings and even asked questions at the end. I recall Evelyn talking about a bathroom towel that was folded incorrectly and how irritating it was. At any rate, the audience appeared to listen intently to her every word.
As always she concluded the meetings by asking if there were any questions. Every meeting held an audience full of questions. One time a male resident raised his hand and totally unrelated to the topic asked, “So did the snowman die?” Professional as ever, Evelyn responded, “You know what, I haven’t heard. I’ll need to check on that and then I’ll get back with you.” Can you see why everyone looked forward to Evelyn’s lectures?
YOU lead them into quality of life
For quality of life it is important to regularly ask yourself if your loved one is experiencing these kinds of adventures. Are they assisted by you to interact with their environment, use all their senses? Maybe retrieving some old memories while creating new ones? Remember the old quip, “Today is the first day of the rest of their life!” You have the wherewithal to help make it a great one.
Psychosocial encouragement
- Echo their words back to them as this allows them to feel validated.
- It is not the content of what they are saying, it is their feelings you want to focus on.
- Go to their reality as they cannot come to yours.
- Learn to confibulate.
