Jennifer Harvey, RN, BFN, CDP
Co-owner and Clinical Director, Live Free Home Health Care
NEW HAMPTON — Caring for an individual with Alzheimer's disease isn't a walk in the park; in fact, it can be downright stressful. A person's understanding of the disease as well as attitude about the illness can have a large impact on the way day-to-day caregiving responsibilities are managed. However, just because this illness has taken over someone close to you, it doesn't have to conquer you as well.
So what do you do when your loved one blames you for something you didn't do or becomes paranoid that you are plotting against him or her? If your first instinct is to try to orient the person back to reality, you are not alone. Many family caregivers spend endless hours trying to do this, but to no avail. Their loved ones may continue to press the issue, and even become angry or hostile at the "evidence" presented to them. Fortunately, there are ways to manage daily challenges in order to minimize a caregiver's stress and improve the odds that an individual with dementia will respond positively.
One of the best approaches to use with people with dementia is validation – a technique that confirms their right to feel a certain way and express their emotions regardless of the situation. The validation theory, developed by Naomi Feil, suggests that an individual could be revisiting past events or trying to solve unfinished business. This helps explain why some people feel the need to go to work years after they retire or pay off a debt from decades ago. By validating their experience, you are meeting them where they are and sending a message that you still accept them no matter what. Here are a few examples of validation at work:
1. Scenario: Your sister says, "You stole my money! Give it back!"
Incorrect Response: "I'm sick of you accusing me every time you hide your money. You stuffed it in your drawer five minutes ago. I saw you do it, so stop blaming me."
Validation Response: "Oh no, your money is missing? I can see why you're upset. Well, don't you worry because I am going to help you look for it."
Understanding: It is common for people with dementia to hide items and forget where they are moments later. Since it can be embarrassing to admit this, individuals sometimes accuse others to take the focus off themselves. Rather than trying to deflect blame, simply let your sister know that you understand how she feels and that you want to help her resolve the situation. Then walk her over the drawer and ask her to open it. When your sister finds her money, allow her to take pride in finding it all by herself.
2. Scenario: Your wife says, "Get away from me, you're not my husband!"
Incorrect Response: "But I am your husband! Look at our matching wedding rings. You know, you really upset me when you don't remember who I am."
Validation Response: "You must love your husband very much. I can tell by the way you talk about him. Why don't you tell me about your wedding day?"
Understanding: Memory loss can cause individuals to forget even their closest loved ones. When your wife becomes agitated, respect her space, validate the love she feels for her spouse, and allow her to talk about "him" while you are sitting right beside her. Even though she may have forgotten you today, hearing her talk about you will demonstrate that you are still very close to her heart.
Another powerful approach to utilize is redirection - a behavioral intervention that shifts the individual's focus, by distracting the person or moving away from an undesired topic or behavior to something more pleasant. Here are some examples:
1. Scenario: During meals, your father refuses to eat, saying, "You're trying to poison me."
Incorrect Response: "That's ridiculous! Why would I ever do such a thing? Eat your meal and stop making up crazy stories!"
Redirection Response: "Dad, I understand you are feeling afraid, but I want you to know that I would never let anything bad happen to you. You are safe with me. By the way, this meatloaf is delicious. I am having a big plate of it myself. Let's have some together and you can tell me all about the fishing trip."
Understanding: It is difficult, if not impossible to rationalize with people with dementia. Instead of trying to orient Dad back to reality, instill a sense of safety, and demonstrate it by eating the same meal as him. Once you've established trust, you can quickly refocus him by shifting the conversation to something more pleasant, such as a fun day he had by the docks.
2. Scenario: Your grandmother says, "I have to leave now. I need to pick up Jimmy from school."
Incorrect Response: "Grandma, Jimmy is a grown man. He's 60 years old. You're not going anywhere."
Redirection Response: "Oh Grandma, you have always been such a loving mother to Jimmy. Why don't you come with me to get a drink of water and tell me all about what you love to do with Jimmy after school?"
Understanding: People with Alzheimer's disease often live in the past by re-creating experiences that happened long ago. Despite the fact that Grandma hasn't picked Jimmy up from school in decades, her maternal instinct is still very strong, and she feels an urgency to follow the same routine she did while he was growing up. Take this as an opportunity to reunite your grandmother with those happy memories. She will tell you all about those wonderful times she had with Jimmy and will forget about wanting to leave.
Accepting the world of the person for whom you are providing care, and utilizing the communication techniques of validation and redirection will result in less stress for both the caregiver and the person with Alzheimer's. To learn more about the best techniques for caring for a loved one with Alzheimer's disease, contact Live Free Home Health Care at (603) 217-0149 or visit www.LiveFreeHomeHealthCare.com.
About Live Free Home Health Care:
Serving the Lakes Region and Central New Hampshire, Live Free Home Health Care, LLC is dedicated to providing top quality care in the comfort of home, wherever home may be. Family owned and operated, Live Free Home Health Care offers a wide range of services, from companion care and assistance with activities of daily living to skilled nursing. All care is supervised and updated by a registered nurse, who is specially trained to watch for new or changing health issues. Whether the need is for short or long term care, Live Free Home Health Care works with each client's physician to provide a continuum of care unparalleled with other agencies, and the compassionate staff promises to treat each client respectfully and like a cherished family member. Live Free Home Health Care also offers medical alert systems to provide extra peace of mind should an emergency care need arise. For further information, contact (603) 217-0149 or visit www.LiveFreeHomeHealthCare.com.
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