We are all familiar with the story of Goldilocks and the three bears. Whether it had to do to with the feel of the bears’ beds or temperature of their porridge, Goldilocks was not pleased by the extremes. She wanted something that was “just right” for her. If we are going to truly partner with and support individuals with dementia, we don’t want their life to be too simple or too complex; we want it to be just right for them. That means, we have to spend a lot of time being observers and putting ourselves in their shoes. We have to learn how to step back and provide just the right amount of assistance – not too much, not too little. Too little assistance, then the persons struggles or is at risk of being injured, too much assistance and the person loses self esteem and independence. We also have to figure out what is the right amount of stimulation – not too much, not too little. Too much stimulation and someone may become agitated and anxious, too little and boredom and depression sets in.
Over time, because of the changes in the brain a person with dementia experiences, the type and level of stimulation and assistance a person requires changes. As the disease progresses, we have to make adjustments in the way we interact in order to support their need for independence, meaningful relationships and purpose – all critical for their well being.
So, how do provide the right amount of stimulation and assistance? We watch, we listen, we try, until we find what’s just right.
Here’s an example we’ve encountered. You’ve probably experienced something like it yourself.
Often when discussing dementia care, sadly, we are told about all of the things a person with dementia can no longer do. For example, it is often assumed that a person with dementia can no longer wash their hands because when some people with dementia go to the bathroom, they do not wash their hands. Maybe we remind them to wash their hands and they still don’t do it. Why might this be happening? People with dementia often become confused when there are many steps in a sequence. You and I may not think that there are very many steps in the sequence of washing your hands, but there are. If you make a list right now, you can probably come up with 10-20 steps for washing your hands!
Think about all of the common tasks we complete every single day. We shower, make our bed, get dressed, fix our meals, etc. Each one of these tasks has multiple steps. A person with dementia can experience a breakdown during any of these steps. When you notice someone having trouble with something you think is simple, pause a moment, be patient, try to figure out which step caused trouble or confusion. When we break an activity into its individual steps (task breakdown) and present one step at a time, people with cognitive impairment are more likely to achieve success.
Please visit our Hand in Hand at Home section for valuable tips and strategies to help you adjust at home to living with someone with dementia.