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Transcript
The following is an excerpt from a DVD made by professional therapists working with dementias such as Alzheimer's at the Devon Partnership, NHS Trust and Torbay Care Trust.
Therapist: "It's helpful to think about trying to prevent the person you are caring for from being too stressed. Stress will often undermine their ability to cope. People with dementia take longer to understand what is happening arond them and this often leads to feelings of pressure, so take your time."
"It's always best to keep peaceful surroundings, as excessive noise can be confusing and cause agitation in itself. If possible, don't undertake something that you know will cause agitation if they are tired. Pick a time when they appear to be in a good mood."
"Remember: All stress reducing techniques need to be tailored to the individual and to the stage of their illness."
Moderator: "What sort of adjustments to caregivers have to make?"
Therapist: "Certainly, maintaining a calm, reassuring approach is important. Speaking slowly and clearly and also using a person's name is often very helpful. Tone is probably as important as what you actually say. Making eye contact and the appropriate use of touch is also beneficial."
"I think we should try to keep instructions simple and definitely try to avoid quizzing or arguing with the person. Try to avoid the word, 'no,' if possible. Endeavor to guide and gently encourage the person."
Moderator: "Anything else you might consider?"
Therapist: "Well, closed questions where the answer is either 'yes' or 'no' often helps reduce stress for the person you are caring for. For example, 'Do you want this short today?', rather than, 'Which shirt would you like to wear today?' It can reduce the stress of having to make too many choices for the individual, which may be difficult. But it still gives the person a sense of some choice and control."
Support Group
Caregiver: "When Don is lucid, we can have a good conversation, but it doesn't last very long. He seems to go right back into the past. I have had to lower my voice and talk to him in a softer type of voice. Otherwise I get accused of telling him off."
2nd Caregiver: "I find the easiest way is to try. She's not got much of a conversation, except very occassionally she becomes quite lucid and it is just like the relationship used to be. Other times, she is living in a different world altogether. I find then that just a few words, very simple words, suffice. Then I can get a reasonable answer from her. At other times, no."
This video is by DementiaEd, a team of doctors, nurses, occupational therapists, psychologists, social workers and carer developers.
Moderator: "What kinds of adjustments do caregivers need to make?"
Therapist: "I think caregivers certainly may have to adjust their expectations of what an individual can do and perhaps concentrate on the most important care tasks. For example, if shaving causes agitation, it might be preferable for an easy-trim beard to be grown. Another example, if dressing or undressing causes distress, they can try clothes than can easily be put on and taken off."
"Agitation may be helped by conversation that the person can be a part of. Perhaps playing some of their favorite music may be calming. However, if the problem persists despite your best efforts, I would always suggest stopping what you are doing and continuing later.
3rd Caregiver: "I now step back some times and just leave things if it is not life-threatening. If my father is happy, I just leave it. That's helped me to cope, really."
Moderator: "The person in the early stage of dementia may respond well to careful orientation, for example, reassuring them if they are disoriented about whether they are at home or not, and repeating this if necessary."
Caregiver: "Where are we now?"
Person cared for: "Where we live."
Caregiver: "Clever, you are trying to trick me. Where do we live?
Person cared for: "I don't know."
Caregiver: "Don't you?"
Moderator: However, this may not work well with a person with more severe impairment. An alternative approach would be to concentrate on more emotional support using distraction and less factual information.
"Carers often find taking a break useful. Depending on availablity in your area, this may be having a sitter for a period during the day or overnight. The sufferer going to a day center or even on a short break away from home can be especially stress-releasing. Don't let yourself get too run down. You need to look after yourself as much as the person you are caring for."
Caregiver: "Mind you, I can go off and leave him for a couple of hours. I do manage to get out in the afternoon, just locally, to have a game of bowls. I wouldn't go off for any length of time to an "away" match or anything like that. I just go down to Caily Park, have a game bowls, get some fresh air, talk to people, that's a big help. It just gives you a couple of hours break. And in the evening, once a week, I go and play bridge. So that gives me a break twice a week doing something different."
3rd Caregiver: "I'd cry sometimes, but I mainly treat myself to something. I get a DVD and say I am not answering the phone, it could wait. It's just two hours but it's time to yourself. It is like a little reward. We once booked a whole holiday abroad for two weeks because we were so fed up with it. But I think the other is, from a positive angle, it has made my husband and I re-evaluate our lives. Because we can look now and think, this could be our future. So it gives you a chance to re-evaluate, and that's been a very positive thing."
Speaking to people with Alzheimer's requires particularly respectful communication. A new study underscores the degree to which it "influences how they feel about themselves and how well they respond to those providing care," said Sam Fazio, Ph.D.
Watch this exceptional video for caregivers and professionals. It provides a compassionate and informative
overview of the personal and medical challenges of dementias such as Alzheimer's.
DementiaEd team in Devon UK aims to provide information for sufferers of memory problems and their carers.
We are a team of doctors, nurses, occupational therapists, psychologists, social workers and carer developers from Devon Partnership NHS Trust and Torbay Care Trust who work with sufferers and carers to improve information for all.
All the videos have been made by DementiaEd to help sufferers and carers and all participants have consented to the broadcast of the material.
The Videos are available on DVD from the University of Sterling www.dementiashop.co.uk. DementiaEd is non-profit making and all proceeds go towards new material and our carer education courses locally.
