A diagnosis of dementia mostly associated with cognitive impairment and memory loss can be such a terrifying prospect that many refuse to confront that reality at all. They prefer to say that confusion is just part of getting older or that everyone forgets things. They blame their forgetfulness on stress or mild depression or on a lack of sleep.
Most obviously, the intense denial is due to fear. The natural fear of life slipping away is aggravated by the knowledge that aging often spells dependency on others. And, as those around them notice their newly compromised mental capacity they fear further isolation from friends and family. Furthermore, they, and possibly their loved ones, may not be ready to deal with yet another debilitating chronic condition.
There are behavioral and psychological symptoms of dementia (BPSD) that occur in about 90 percent of dementia patients. These BPSD or non-cognitive symptoms are equally as important as those associated with function and cognition and can be even more distressing to the dementia patient’s family and caretakers than the cognitive ones. They include aggression, depression, anxiety, apathy, delusions, hallucinations, pacing, wandering, repetitive vocalization, agitation, disinhibition, screaming and changes in appetite and sleep patterns. Some prefer managing BPSD with medication. However, that adds to the already hefty arsenal of drugs currently taken by most senior citizens and increases the potential for dangerous side effects.
Fortunately, there are several non-pharmacological treatments that may help manage these symptoms and address some of the reservations associated with traditional approaches. At the very least, these methods can be used to augment any drug therapies recommended by your doctor. The website Nursing Home Tool Kit is a great place to start to research both the approaches and the training available to caregivers who would like to employ them. Some even sound quite pleasant and diversionary serving to counteract the gloom and doom that patients are likely experiencing.
- Sensory stimulation such as aromatherapy, music therapy and massage
- Behavior management such as communication training
- Cognitive/emotional approaches such as reminiscence therapy
- Structured recreational activities
- Social contact such as animal-assisted therapy
Reminiscence therapy is an interesting tool and has been defined by the American Psychological Association as “the use of life histories – written, oral, or both – to improve psychological well-being.” Using memorabilia from life events and hobbies, this therapy relies on deeper recall and meaningful conversations and is generally carried out in a group session. It builds on the long established interests of dementia patients and provides context for their lives today. This therapy was pioneered by the famed gerontologist Dr. Robert Butler in the 1970s and continues to be researched. While cognitive benefits are not as clear, the emotional support cannot be understated.
A popular and successful form of reminiscence therapy is memory clubs. These social groups are formed around shared and intense interests in which participants discuss their opinions, experiences and feelings. These groups could be focused on sports or hobbies like reading, gardening and art. Participants get to focus on topics in which they are knowledgeable and passionate, giving them an outlet where they feel they can really contribute. This is an enjoyable social activity at a time when opportunities for meaningful socialization decline. One St. Louis Chapter of the Alzheimer’s Association formed the Cardinals Reminiscence League which meets twice monthly for discussions, field trips, guest speakers and baseball related movie viewings.
Participants in memory clubs report both cognitive and social benefits and show improvement with memory and language abilities. Socially, they report having a stronger sense of self and improved positive mood. In these groups, they form meaningful friendships and enhance their coping skills while reducing their depressive symptoms. Because there is minimal training required for volunteers, there are many opportunities for family members to help and share in the lives of their aging loved ones.
While there is no cure for dementia, memory clubs are a very low budget and potentially beneficial way to treat and enrich the lives of our elderly population with dementia. If you would like to find a Memory Club in your area, consult resources such as the Alzheimer’s Association and MeetUp.com. Or, you can contact eldercare professionals to assist you in starting one yourself!
Anita Kamiel, RN, MPS, is the founder and owner of David York Home Healthcare Agency, licensed by the State of New York. She holds a master’s degree in gerontological administration and is fully acquainted with all factors related to eldercare services and the latest guidelines for seniors. Thirty years ago, she realized the need for affordable, quality home health aide services provided and supervised by caring individuals. You can contact her at 718-376-7755 or at www.davidyorkagency.com. David York Agency is also on Facebook, Twitter, Google+, and LinkedIn.