As part of our LiveTalk series, Being Patient spoke with dementia care expert Teepa Snow about strategies for caregivers to manage the symptoms of dementia.
From coping with cognitive and physical impairments, to behavioral and psychological symptoms, people struggle to adjust to the progressive and unpredictable nature of dementia. But, there are strategies for coping with these symptoms that can help, according to renowned occupational therapist and dementia care educator Teepa Snow.
In an earlier Being Patient LiveTalk, Snow talked about improving quality of life for both caregivers and people living with dementia. This month, Being Patient sat down with Snow to discuss strategies for managing the symptoms of the disease, asking: How can people live better with dementia?
1. Staying Mentally and Physically Active During COVID-19
For many people living with dementia, their cognitive and behavioral symptoms have deteriorated as the COVID-19 lockdown has severely restricted their social and physical activities, but Snow encouraged LiveTalk listeners to get creative about ways to stay cognitively and physically active at home. She suggested that redesigning and reimagining one’s living environment in small ways could be a big help.
Bring the Outdoors In
Snow said people could create a comfortable space, perhaps a place of worship, with music, birdsongs, or sounds of a forest or a waterfall. They could also place photos of favorite sceneries of the outdoors, and walk around the house to browse through the pictures.
“I create this bigger environment than it really is,” Snow said. “I’m having to get up and look around and see what’s going on. Suddenly, I’m going somewhere. I’m actually not hardly going anywhere. But I’m giving myself permission to see the world in smaller views because the world is smaller right now.”
Surround Yourself With People You Love, Even When They Can’t Be There In Person
Snow also suggested that filling a space with photos of loved ones can serve as reminders of people to connect with over the phone or Zoom. Photos can also help those living with dementia recall details of meaningful events, tapping into the brain’s power to store old memories.
Finding Different Activities To Choose From
While caregivers may have a hard time finding an activity that interests the person with dementia, they could tailor it to their loved one’s past hobbies and expertise. For some people, however, Snow said the activity may bring a sense of loss as they are reminded of what they can’t do. Accordingly, caregivers should be sensitive to the person’s emotions as they pursue an activity.
If the person once enjoyed arranging flowers, the caregiver may ask them to help pick the best vase, and decide which flower should be the tallest one in the vase. A genuine request for guidance can provide a sense of purpose and value for the person with dementia.
When caregivers offer activities for a loved one, Snow said they should present ‘either/or options.’ Caregivers may ask whether the person would like to help them tend the garden, or go for a walk. Presenting different options empowers the person to make their own decisions and reinforces their cognitive functions.
2. Addressing the Hallucinations and Delusions of Dementia
The symptoms of psychosis can be distressing for families and their close ones. People who experience delusions may accuse a loved one of infidelity, believe that someone is following them, or blame others of theft.
Snow urged caregivers to acknowledge their loved ones’ emotional concerns without indicating that the event is true. If a person with dementia believes that someone has stolen their watch, caregivers should allow them to express their feelings: Try to understand their emotions and whether the person feels angry, sad or lonely.
“I would say, ‘Your watch is missing, and you’re pretty sure somebody took it. I hear you. That’s not my experience. I thought that was a watch that was gone a while back. But tell me about it,’” Snow said. “‘Tell me about it’ acknowledges [that] you might have a different side of the story, [and] I may need to listen to what you have to say because you want to be heard.’”
A person with dementia may also experience hallucinations, hearing, smelling, or seeing something that isn’t present. They may point to a child who is about to fall, when in fact, there is no one at the scene. Snow said caregivers should validate the person’s emotional concern by noting, “That sounds scary,” without indicating that the hallucination is true. Caregivers may ask for details of what the person is seeing to actively engage their visual cortex. In many cases, Snow said the individual would suddenly stop seeing the hallucination. But it is common for people’s hallucinations to reoccur, and she added that caregivers may consider seeking additional support or options if the strategy isn’t effective.
If a person experiences episodes of psychosis unlike before, Snow said they should see their doctor to identify potential factors such as medications, infections, worsening mental health conditions or other health issues that may also lead to symptoms of psychosis.
3. Living in the Present
Dementia progresses slowly for most people, and there are times of joy and sadness, celebration and grief. People’s symptoms can ebb and flow from hour to hour, morning to night, day to day, week to week, and from one year to another.
“There is no permanence,” she said. “There are moments of brilliance, and there are times of loss.”
Snow urged people to focus on the present, and to use the abilities they still have to live their lives to the fullest extent possible. A person with dementia may no longer have the ability to make a meal independently, but they may still help with preparing one. Perhaps they can shred the lettuce, place the sliced tomatoes on the salad, or put the salad bowl on the dinner table for the caregiver. By modifying everyday tasks, caregivers can help a loved one take part in life, depending on each other in journeying through dementia.
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