Has your loved one become angry during the simplest of conversations? Perhaps exhibiting catastrophic responses and/or acts of aggression? There is a better way to interact. Psychosocial interaction eliminates many, if not all, of the unwanted behaviors without the use of heavy medications.
Over 5 million people live with dementia. Sadly, caregivers are finding little in the way of role models to glean from when problem-solving. Frustration and/or a sense of helplessness often seem to be the number one go-to options. This, as you know, can make problem-solving appear to be impossible unless you add medications to the choices. Let me repeat myself, there is a better way.
Dementia Today – A Better Way with healthy psychosocial interaction
Here’s why there is a better way to interact with your loved one. Cognitive decline. Your loved one is becoming cognitively more childlike. FYI, reference to “loved one” ALWAYS refers to the one who has dementia. The onus is upon caregivers to gently balance between the loved one’s childlike mind while offering respect to their age.
I put infants and loved one’s together. In many ways they have EXACTLY the same needs and express them EXACTLY the same way. Knowing this gives caregivers a deeper understanding as to what their loved one’s psychosocial needs are.
Equally important to understand, it creates an extra knowledge-based resource to draw from when problem-solving. Case in point, what if the loved one is exhibiting behaviors similar to that of a child? Ask yourself, “What would I do in a case with a 1/whatever year old?” Hopefully you will find problem-solving from this perspective increasingly more beneficial.
“Cognitive ability” equation leading to a better way
So let’s look at the similarities between the loved one’s cognitive decline and their age-related counterparts. Overall abilities, reactions, and behaviors are what determines the guidelines:
- Adult > Teenager = Stage I
- Teenager > Child = Stage II
- Child > Infant = Stage III
- Infant to Death = End Stage
Finding the missing link in dementia care
While working on my Master’s I was offered an internship to work with the dementia population. Initially I wasn’t too sure how this was going to help me. The very idea kind of went sideways from my preconceived counseling goals. Fortunately my very wise mentor did. She said, “College is teaching you how a healthy brain operates. Working with dementia will help you better understand how the brain works under adverse conditions.” From that moment on I was totally hooked.
KABOOM! shouted the huge metal door as it slammed shut behind me. Taking a moment to catch my breath, I stood perusing the room that ominously stood before me. My very first time inside a locked dementia facility. Its surreal world stood before me. “Where’s my father? Have you seen him?” an 87 y/o woman desperately asked. “Hey! Did you bring my car here,” a 78 male inquired.
I saw, felt, and heard their needs. Not in the answer to their questions. Psychosocial needs were crying out to me in every direction. How easy it was to fall completely in love with this population. That high-rise office with a secretary and a view goal? Gone because I knew I was exactly where I was meant to be.
Truly we have come a long way in the care and treatment of mental health. Even so I could clearly see more changes were needed. Medical and physical needs were always carefully addressed. Little if anything, however, was done regarding psychosocial needs, the missing link regarding quality of life.
Finding the fork in the road leading to a better way
Two models of care are used in the healthcare industry. Medical Model and Psychosocial Model. Some of the misunderstanding comes from the belief these are options. Do I ‘need’ Psychosocial Model or do I ‘need’ Medical Model? Pick one.
Most importantly, not only are they not options, they were never meant to be. Quality mental health is produced through a blending and overflow of both. Ombre’s unique effect is created by blending two colors together. Similarly, quality of life must have a blending of two healthcare models. I sincerely hope that comparison makes sense.
A better way to meet psychosocial needs – learning to understand what they are
Currently Psychosocial Model of care is only used during 72-hour psych ward visits. Often that comes with the assistance of mood altering meds. Eventually the loved one is returned home with no mention of psychosocial needs so the problem(s) become cyclical.
Admittedly, some of the confusion stems from the lack of understanding caregivers experience regarding psychosocial needs. Just what are they and how do they meet them? Following is a short list of some basic psychosocial needs we all share as humans.
Everyone needs to sense:
- autonomy- we are in charge of our own destiny by the choices we make,
- that we are loved,
- others need our love,
- success in contributing to our community,
- perceive we are a person of value and worth,
- daily we are successful in achieving goals.
Unmet needs produce depression, unwanted behaviors, and even suicidal ideation. Our loved ones are no longer able to finesse these needs themselves. They need our help.
To survive we must have food and water. Physical health does not ensure longevity. Unfulfilled psychosocial needs after time will shorten our lifespan, sometimes by decades.
Infants and loved ones indicate needs much the same way
Compare the behaviors of an infant with the unwanted behaviors exhibited by a loved one. An infant cannot speak, cannot understand their urges or needs, yet has a drive to survive. Their needs are expressed through crying, fussing, and cooing.
A loved one who has lived decades on their own abilities — not only surviving in their world but literally thriving — now finds they are sliding back down that cognitive hill. Unable to verbalize many of their needs, they are returning once again to that same form of communication once used as an infant.
Incorporating Psychosocial Model of care into the loved one’s daily care plan will eliminate many unwanted behaviors. Consider the world of an infant who now has all their physical, medical, and psychosocial needs met to that infant that needs a diaper change or needs some serious cuddling time.
Psychosocial Encouragement
- By simply asking the loved one to choose between two options, “Would you like to wear the blue sweater or the green sweater,” returns their sense of autonomy.
- Asking, “Is there anything else I can do for you,” ensures they are still loved.
- Holding their hands or caressing them and saying, “I sure do appreciate/love you,” renews their faith others need their love.
- Express a need for them to help you, “Would you please help fold the laundry,” offers a great opportunity to feel they are contributing to their community.
- Allowing them to give to others, like helping cook dinner or sweeping the front porch, gives them a sense of value and worth.
- Reminding the loved one of their successes, “I loved the way you dusted the bookshelves. Thank you so much,” increases their perception of successfully achieving goals.
