Focusing on the person and not just the physical environment is another important building block in creating a dementia-friendly home. Clearly, it is more than just putting locks on cabinets and alarms on doors. What are your loved one’s hobbies? Which activities did he participate in on a daily basis before the diagnosis? When she had time for herself, what did she do? A diagnosis of Alzheimer’s does not mean these activities cease; in fact, it is vital to continue these activities as long as the individual is able or interested.
According to the Alzheimer’s Association, effective activities bring meaning, purpose, joy and hope to the person’s life; use the person’s skills and abilities; give the person a sense of being normal; involve family and friends; are dignified and appropriate for adults; and are enjoyable.
“Meaningful, purposeful activities allow persons with dementia to stay home and be successful,” notes James Siberski, MS, coordinator of the Gerontology Education Center for Professional Development and an assistant professor of gerontology at College Misericordia. Siberski is also an adjunct professor of psychiatry at Pennsylvania State University.
Christa Caruso, BA, is a research interviewer at CARAH (Center for Applied Research on Aging & Health). She agrees with Siberski’s assessment that the CR should stay involved in regular activities around the home, such as setting the table for dinner or helping with laundry (provided that the CR does not get frustrated with these tasks). These responsibilities affirm that the person with dementia is still contributing as an active member of the family.
Siberski believes that maintaining the brain is a fundamental part of creating a dementia-friendly home, whether this is achieved through computer programs, Sudoku puzzles, or other brain-related exercises. “We have to keep challenging the person,” Siberski says. One of his clients, a 95-year-old woman still living at home, just finished a major exercise that challenged both her brain and her physical dexterity: sorting a massive collection of nuts and bolts. Although the project took months, Siberski’s client enjoyed the task – and it served a purpose.
Look to the individual’s life history for cues on activities: tasks like snapping peas or husking corn might be comforting and familiar to the woman who grew up on a farm or prepared meals from scratch. Taking a small motor apart and putting it back together could be highly rewarding for the man who was fascinated by mechanical objects. Tailor the activity to the person and remember that the diagnosis does not erase their who they are as people.” As long as the activity holds meaning and purpose for the individual, it does not matter whether the caregiver really needs the nuts and bolts sorted or the peas snapped.
The television is a central component in many American households and is often misused or abused regardless of a dementia diagnosis. All too often, persons with dementia either in home or residential care settings are placed in front of the TV for hours on end for any number of reasons, such as lack of activities, staffing, or overmedication. At home, situating the PWD (person with dementia) in front of a television for extended periods of time may be a product of caregiver burnout; perhaps the caregiver would assert that their loved one enjoyed watching TV before the diagnosis, so the activity is justified.
While there may be some value in viewing certain programs or movies (and by no means should the caregiver feel overwhelmed with the idea that they must “entertain” the PWD every minute of the day), Siberski cautions specifically against watching news programs.
The PWD can pick up on the dire tone of most news programs, which increases agitation even if they cannot comprehend the topics covered, says Siberski. However, game shows are great in Siberski’s book. Most game shows have an overly positive tone. Think “you’ve just won a new car” as opposed to “Forty innocent people were killed by a car bomb in Iraq today.”
If watching the evening news was a regular, meaningful activity for the person with dementia prior to the diagnosis, you may want to closely monitor their response for an increased agitation level and perhaps reduce the length of time that the individual spends watching the news. Also, be sure that when the television is on, the volume is not too high. If you need to ask the care recipient a question, mute the TV so that your loved one can focus on your question without competing noise.
Remember, respite for the caregiver is important and necessary, and it can be accomplished in a number of ways – perhaps an appropriate video or TV program that engages the CR’s interest provides one of these opportunities. However, opportunities for respite must not come at the expense of the care recipient. Ultimately, keeping the care recipient’s agitation level down is the goal – and by doing so, the caregiver’s agitation level will also be held in check.
- Michelle Seitzer
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