What is "Person Centered Care" in Regards to Dementia Caregiving

Today's ingredient is, if you know one person with dementia you know one person with dementia.

Just like every human being is different, this does not change just because the human now has dementia.

It is very common for people to lump them all together. Billy. Susie, Sarah and John all have dementia so we shall approach them all exactly the same way.

 Believe me, this never ever works.

You need to learn about Billy, Susie, Sarah and John.

Then you will be able to base your cares around who they are and what they love not around their disease.

Each of these folks has their own set of likes and dislikes. Each one of them came from somewhere and even though those memories are fading, their core beliefs are still inside of them.

Maybe Billy loves baseball. When spring time came around the first thing he did was dig out his old ball and bat and go out to the field to hit the ball around for a while. As he got older and things got a bit harder he would stop for a game of catch with his grandson. When even that was too tiring he would just sit in his old comfy chair and watch his favorite team. Whether they got wallopped or they won he really didn't care, he just loved to watch the game.

So now Billy has come to your facility with dementia and it's your job to get him in the shower. He has decided it is a definite "not gonna' happen" and you need to figure out how to change his mind. If you know that Billy loves baseball you can center your care around baseball. This may be just the thing you need to get Billy to willingly let you help him with his shower.

Hey Billy, I heard you used to be quite the ball player. Who's your favorite team?

Oh yeah, I love them too. Do you think they will make it to the World Series this year?

Ehhh, you're right, teams from around here usually do choke but they're still fun to watch, right?

Hey look what I found, it's your favorite ball team shirt. We should put this on so we can cheer for them. 

Oh, ya know what, I remember at dinner I accidentally spilled that chocolate milk on you. We don't wanna' get your favorite shirt dirty. Do you think we could get you cleaned up a bit first?

That would be ok? Great. Thanks, Billy.

I just love this shirt!

Now don't get me wrong, I definitely understand that this is not going to work every time. It may not even work more than one time but the more you know, the more chances you have to connect on a real one on one basis. 

You learned that Susie was a vegetarian from the time she was 16 until she started losing her memory. So now, to the amazement of her family, she will eat meat once in a while but she still prefers a vegetarian meal. If you are sitting around a table with four other residents trying to get them dinner you may be able to avoid any frustration with Susie refusing to eat simply by replacing her pot roast with asparagus.

You remember Sarah from church. She used to sing in the church choir every Sunday morning. It's Tuesday evening and you can see that Sarah is really having a tough time. She is antsy and walking all over the unit. She has gone in and out of other resident's rooms and you can tell all the walking is making her very physically tired. You are afraid she might fall.

You take her by the hand and walk with her to a more quiet space in the house. You turn on her favorite gospel music and you can instantly see Sarah start to relax. You spend a few minutes sitting with her and she starts to mouth the words.

(Music is one of the last things to go.)

Not only have you made your job easier you have made Sarah safe and most importantly provided a moment of joy in a very frantic life.

Moments of joy are what it's all about.

John is a tough case. He can get very aggressive especially at mealtime. Sundowners is very real for him and inevitably at dinner time John is ramped up. He sits at the table guarding his plate like an angry bear. Not only that but recently he has taken to trying to stab you with his fork every time you try to feed Mary a bite of food off her plate. Your automatic reaction may be, ughhhhh out of control behavior, sundowners once again. Maybe we should talk to a nurse about a prn.

However, you know that John and his little sister grew up in an orphanage. Every time they sat down to a meal another child would try to steal the food off of his sister's plate; so much so that often times she would go hungry. John had to resort to guarding her plate until meal time was over. Every time a kid stuck his hand out to grab her food, John would stab them with his fork.

So here you sit reaching your hand/fork towards Mary's plate. John doesn't understand you are trying to help her. He thinks you are stealing her food. He thinks he is protecting Mary.

In this scenario it may not help you eliminate the behavior but if you understand it you can approach it with love and compassion and not with exasperation.

Person Centered Care, in my opinion, is one of the most important things a dementia caregiver can learn.

Anyone can learn how to do cares but person centered care can change their world and yours.

It can provide those precious moments of joy that we are all hoping to see.

There are several programs and educators out there that teach this way of caregiving.

One of my favorite Dementia Educators is Teepa Snow. She has been in the business for over 40 years. She is able to make you "see" what she is teaching.

Many years ago I had the opportunity to attend one of her day seminars.

I spent the entire day trying to soak in as much as possible. I even got to partner up with her on some of the activities.

I learned more in that day than I have in weeks of other training courses.

You can find many of Teepa's videos on YouTube. They will be a great resource for you moving forward in this world of Dementia cares.

Teepa also has her "Positive Approach to Care" videos available for purchase. These would be good for any facility looking to upgrade their staff.

I would encourage you to reach out to the Alzheimer’s Association as well as they are always there to help teach and guide you throughout your journey.

Person Centered Care will make you a better aide. It will make your job easier and it will make the dementia patient happier. It is a win for all.

Never forget that the person we are caring for is a person with a disease not just a disease.