Many older people can follow maps, understand plans and quickly grasp abstract concepts. Why do I make this statement? Because I was pulled down a peg or two for thinking otherwise.
The fact is that I‘m not that great at these things myself. This led me to assume that people in their later years would be even worse.
I was wrong.
I addressed a group of elderly residents at Heathlands Village the other day about the progress of our building project. I spoke v e r y s l o w l y, mindful of their cognitive challenges and the complexity of the plan I was showing them. They told me off.
I admitted to them that it had taken me ages to fully understand the somewhat technical drawings. They brushed off the comment, tartly and told me to hurry up.
Eighty per cent of our residents live with dementia but we can make the mistake of underestimating what a person is capable of. Abilities fluctuate. Long-held skills like piano-playing, knitting or reading may be maintained far into the disease’s progress.
Having dementia is a life sentence but it doesn’t necessarily mean it will be a miserable one. We have fun here and no two people are alike.
For some, dementia is just part of their identity; for others, it is, at times, a living nightmare. Others have lost their past and live without landmarks.
Pitching care at the right level for the individual is a huge challenge to us; one that could be made a lot easier with the right funding.
We are doing the best we can with improved design of buildings, outside spaces and furniture; with an array of activities and by employing staff of the highest calibre possible.
We enter into the world of the person with dementia giving them the props they need to live out their version of reality. Sometimes we accompany residents to the sea-side and circus without leaving the building, encouraging the use of memory and imagination in Storybox drama and storytelling sessions. We use dolls and prams to bring comfort, in living out who they believe they are – a young mum with a baby to care for.
Right now we are making plans for our new secure dementia gardens, complete with washing-line, potting shed and an old car to tinker with. The right care is not just about washing, dressing, toileting and feeding people. It’s about using creative measures to boost people’s sense of well-being by giving them a sense of purpose and of self.
At times it means taking seriously what is unlikely or indeed mistaken – one lady was agitated because there were swarms of bees in the hedge outside her window – there were no bees. But as soon as we cut the hedge back her distress abated.
One gentleman was convinced that his trousers had been stolen. This caused him relentless anxiety. Although we showed him the pairs of trousers hanging in his wardrobe we could not budge his belief. So we bought him a new pair of trousers and that was an end to his misery.
In looking after people with dementia we have to keep our own thinking elastic – as I learned when my wrists were slapped – don’t assume that dementia brings about blanket impairment in cognition – people have good days and bad days; the damage is patchy; we shouldn’t be surprised at the skills and areas of knowledge that are long maintained.
And at the same time we must be flexible and creative in our responses, so that even if a request or worry defies the facts, we must be ready to enter the alternative reality of those we care for.
Removing non-existent bees; replacing non-stolen trousers; a little mental gymnastics and expense can work wonders.