Dementia and Dignity

Dementia and Dignity

January 5, 2021 | Health

When a loved one such as mom or dad has dementia, they may spend an increasing amount of time in a confused state.

This can make it difficult to remember the person they were before the disease. However, it’s important to remember that he or she is an adult, not a child, and deserves to be treated as such. Honoring your loved one’s wishes, including helping him or her maintain a similar lifestyle to the one they had before they got sick, will bring them a great deal  of comfort and reassurance. 

Here are some ways to help those with dementia maintain a sense of dignity:

Do Not Be Condescending
When you’re caring for someone, including helping them through the everyday burdens of daily life, it can be hard not to take a parental tone. In fact, it might even remind you of what it was like raising children. However, you need to remember that you’re caring for a fully aged adult and not a child. Coming across as condescending or disrespectful can make the person you are caring for feel lesser, and that’s something you never want your loved one to feel. So watch your tone and word choices. Try to speak to your loved one as an equal whenever possible. Avoid using words like the following:

  • Bib: Call this an apron, or actually use an apron if your loved one needs something to protect his or her clothes during mealtimes.
  • Potty: Use the words your loved one commonly used pre-dementia to refer to toileting. “Do you need to use the bathroom?” is a perfectly adequate phrase for all stages of life.

Ask Easy Questions for Easy Answers
This might be a little trickier early on, but once you get used to it, this technique will really help guide conversations smoothly. You just need to train your brain the way it asks questions, because it is possible to set your loved one up for conversational success. 

What you need to do is replace open-ended questions with ones that are easier to answer. Again, this might be difficult because you’re used to things flowing in a more conversational style of talking. You’re more used to asking open ended questions, because you genuinely want to hear someone’s perspective on the way an event or action played-out. Unfortunately, getting such a response from a dementia patient might be difficult. They might get hung up on certain details. Therefore, say something like “Mom, tell my friend how much you enjoyed raising your 10 children,” instead of “Mom, tell my friend how many children you have.” By giving them more details in a conversation, they can participate better in it.

Therapeutic Fibbing
“Therapeutic fibbing” is a concept designed to relieve the guilt that often comes from lying to a loved one. We know that the first lesson in every Philosophy 101 class begins with, “Is it alright to tell a white lie?” It’s a shame we weren’t the professors. We’d have closed the book immediately and said emphatically, “Yes!” The debate and the lesson would have been over right then and there.  

We certainly know that lying is bad. However, those with dementia often struggle with logic, rational thought, sequencing and emotional control. Your therapeutic fib might be the kindest thing you can say to them in a specific situation. It could also be the most sensible approach to what they’re asking or what they’re looking to do. 

Therapeutic fibbing may be appropriate when telling the truth would cause pain, anxiety or confusion, or when the person with dementia is experiencing life in a different “time zone.” For example, say your loved one wants to drive to the grocery store, but you do not believe that she should do that due to her dementia. Instead of telling her that she’s no longer safe to drive, you could tell her that the car is in the shop for repair, that you’ve misplaced your keys, or that you’ll drive her to the store, since you need to go out anyway. It’s a much happier ending than telling the truth.

Plan Successful Outings
When you care for someone with dementia, it’s easy to become isolated out of fear that social situations will be difficult and stressful. This does not have to be the case. With some planning and thought, an outing can be rewarding and a welcome change of pace from the routine of everyday living. When you’re in charge of an outing, consider the following factors:

  • Distance: How far away is it? Is this a trip that is tolerable or even enjoyable for everyone? 
  • Time of Day: When does the person you care for tend to be in the best spirits? Is it early morning, lunch-time, or after an afternoon nap? Plan extra time to get there.
  • Setting: Does the person enjoy watching others, children in particular, in a restaurant or park? Or does the person you care for react negatively to ill-behaved children or extra stimulation?
  • Food Choice: Does the restaurant have foods that are easy to eat, cut, etc.?

Preparing Others
It may be important to prepare others for the special needs of your loved one. This can be done by calling ahead to the restaurant and speaking to the manager, or by discreetly speaking with the host or hostess before you are seated. You could also make a customized card and bring it with you to the restaurant. Hand the card discreetly to the hostess as you enter the restaurant and ask that they also share the information with the server for your table. Information to include on the card includes things like whether you will be ordering for them, how you would like the server to speak to the person you care for, and any special seating needs.

Relax and Enjoy
This might be something that’s quite difficult to relay to a person with dementia. However, this advice is actually for you!  If you are nervous about things going well, that anxiety can be projected onto your loved one. One of the many effects of dementia is the loss of filters. As a result, this makes a person with dementia affected by the emotions of people around them much greater. That’s why we suggest you remain calm in anticipation of your day out or whatever adventure you might be on with your loved one. We know, we know. This is something that is much easier said than done. Although, if you just follow all of the tips and techniques up above, there’s no reason you should be worried about the day’s outcome. Also, it’s important to remember that if you’re trying your best and doing everything possible to help and entertain your loved one, there’s no real reason you should get discouraged. Family caregivers are some of the strongest and toughest individuals we know. It’s alright if you wish to give yourself the benefit of the doubt from time to time.

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