Jan 17, 2016

Preserving Dignity in Dementia Patients

Dignity is about enabling persons who are deeply forgetful to do things for themselves. Sometimes all it takes is a little patience, and a bit of guidance and understanding.

By Rachael Wonderlin
Alzheimer's Reading Room

Dignity is about enabling persons who are living with dementia to do things for themselves.
The concept of “dignity” comes up often in dementia care. I work in a memory care community with about 50 residents. It can be difficult, at times, to meet the needs of each and every person. The bottom line is this, though:

preserve someone’s dignity and you preserve what makes them, them.

For example, your mom used to wake up every morning at dawn and greet the day with a cup of coffee and hot oatmeal. Now that she has dementia, her routine is more challenging. She has been making her own coffee and oatmeal for decades, but now she struggles to even start the coffee maker.

Because you feel so badly for her, you begin to help.

You get up before she does and you make her coffee. You pop the oatmeal in the microwave and set it down at her spot on the table.

After a few months of this new routine, your mom begins to have trouble even feeding herself. She’ll sit down at the table, look at the spoon, and then ignore it. She goes into the bowl with her hands, pouring the oatmeal her mouth.

You’re horrified, and so you begin to feed her, day after day. After all, she needs to use a spoon, right?

Consider this: although you’ve helped your mom get through the morning, you’ve also taken away a lot of her independence. Sure, she struggles to do basic tasks, but that doesn’t mean that you should stop challenging her.

What if you helped her help herself? 

Some residents at my community are at the point in their dementia where they've forgotten how to properly use a utensil. Before feeding the residents, however, we first try to guide them.

If you cup your hand under your loved one’s hand, you can guide the spoon from the bowl into his or her mouth. You could also hook your thumb with her thumb and guide this way. She may even start to feed herself after a little guidance.

When you've done a task your whole life, sometimes all you need is a physical reminder.

It’s also okay if she gets to the point where the extra help isn’t working. It will be a little messy, but so what if she doesn't use a utensil?

Get a wet, warm washcloth and clean her hands off before the meal. Spread out some napkins (or purchase a “plate guard”) and let her eat the way that she sees fit. It isn’t the way that many cultures are taught to eat, but that is still okay.

The most important thing is that your mother is preserving her independence, one breakfast at a time.

This is what dignity is about: enabling the individual to do something for themselves.

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I have, on more than one occasion, been told by a coworker that we shouldn’t allow the residents to have sharp scissors. Why? Our residents have dementia—they aren't felons.

If it’s clear that your loved one will accidentally harm themselves by using scissors, then that is one thing. But if he or she loves to sew and needs that sharp tool, why should you assume that it’s suddenly “too dangerous”?

I always explain this to people who take objects from residents: just because someone has dementia doesn't mean that we get to take away what makes them human.

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Rachael Wonderlin has a Master’s of Science in Gerontology from the University of North Carolina at Greensboro. She works as a Memory Care Program Coordinator and Manager at Clare Bridge of Burlington in Burlington, NC. Rachael also writes on her own blog at Dementia By Day.

Original content the Alzheimer's Reading Room

Excerpt from a pervious article written by Rachael Wonderlin.

Don't Want to Lie to a Person Living with Dementia, Why Not Embrace Reality Instead

If there's one is one lesson that you can walk away with today after reading this article, it is this phrase:
“Embrace his or her reality.”

I once overheard a nurse arguing with a man who had dementia.

“That’s NOT your wife, you can’t come in here while we are getting Mildred *changed,” she said.

The more the nurse told him this, the more frustrated and angry he became.

“That is my wife. That’s my wife, let me in there!” he said, slamming his walker into the door.

Granted, Mildred was not actually his wife, but that was not the point. I walked up and put my hand on his shoulder. “Hey, let’s wait out here for her.

She’ll be ready soon,” I assured him.

He calmed down immediately and sat with me. I looked to the nurse and suggested that she avoid arguing with him. She became defensive and stated,

“I don’t want to lie to him.”

If there's one is one lesson that you can walk away with today after reading this article, it is this phrase:

“Embrace his or her reality.”

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