Caregivers confront loss and helplessness in their loved ones with dementia every day. But individuals in both the earlier and later stages of cognitive decline often retain select knowledge and abilities. Being able to identify and encourage these skills not only helps the person with dementia, but enriches the lives of everyone in the family. In this excerpt from a recent Johns Hopkins Memory White Paper, Peter V. Rabins, M.D. Director of the Division of Geriatric Psychiatry and Neuropsychiatry at Johns Hopkins, discusses ways that caregivers can engage their dementia patients.
Keeping a family member with dementia focused and engaged in activities can be a challenge, but he or she may light up if offered the opportunity to give advice or teach, according to a pair of recent studies in The Gerontologist.
In one study, researchers tried to engage individuals with early to advanced dementia at an adult day care center in a purely social way, asking them to talk about their marriage, children, and church activity. Later, the investigators approached them for guidance: "I'm thinking about having children. What kind of advice can you give me on that?" The researchers reported that the participants took their advice-giving role seriously and were more coherent, informative, and focused than when asked strictly for information about their personal life.
A second study examined the effects of offering people with dementia the opportunity to instruct. The elderly participants -- some with dementia and others who were cognitively intact -- received a booklet of pictures to help them teach someone how to prepare food from a recipe. Participants in both groups successfully taught their "students" how to prepare the food. The individuals with dementia needed some prompting to keep the process going, but they still accomplished the teaching task.
The researchers speculated that the advice-giving and teaching roles enabled the people with dementia to access knowledge gained when they were younger that was essential in their parenting or mentoring. The fact that other people needed the information empowered them to assume an established social role and probably motivated them to complete the tasks.
Finding ways to include a family member with dementia helps relatives remember the person who has difficulty participating but is still there. Plus it imparts a sense of belonging and competence that may improve his or her mood.
People with dementia are often able to take part in various family-oriented pastimes. Reading aloud, for example, is a skill that can persist even in later stages of cognitive decline. With simple, large-print books, individuals may be able to read to grandchildren or other family members. As with leading or mentoring, reading to others gives the person a social role in the family.
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Reminiscence is another activity that can be particularly beneficial to the dementia patient while also strengthening family bonds. The idea is to use objects, art, music, or other items with personal meaning to connect to the past. Sorting old photos or making a scrapbook may trigger shared memories from your loved one's youth or early adulthood, which can add to a family's sense of history. Smells also are powerful links to the past. Although the sense of smell may diminish in a dementia sufferer, an emotion-linked aroma like that of freshly baked cookies may encourage the individual to talk about his or her childhood.
These and similar activities help family members connect. They encourage communication and may help take the edge off what can be an exhausting and frustrating caregiving situation.
