Great Honors for Small Investments June 3, 2015 | 0 Comments

By Karen Love

In an article recently published in the Australian Journal of Dementia Care, Dr. Al Power tells a story about a retired farmer living with dementia in an assisted living home in Iowa. The farmer repeatedly was trying to exit a back door. Each time he was redirected by a staff member because they did not feel he was safe walking outside alone. His attempts to go outside became more and more insistent. The administrator asked the staff not to interfere the next time he opened the door, but simply watch from the doorway to see what would happen. The former farmer walked to the fence at the back of the property to watch the cows in an adjoining field. After watching the cattle graze for 10 minutes, he turned around and came back inside. The staff learned from his family later that ‘checking on the cows’ was a daily pattern of his as a farmer. Since he could see cows out the window at the assisted living community, it was normal for him to want to go check on them.

With good intensions, care partners can sometimes overreact when a person living with dementia starts to do something unexpected. Instead of observing to see what the individual will do - such as go watch the cows - there is the tendency to stop the action immediately assuming something untoward will occur. Stopping the action can diminish their personhood. In her book, “Dancing with Dementia: My Story of Living Positively with Dementia,” Christine Bryden states –

“How you relate to us has a big impact on the course of the disease. You can restore our personhood, and give us a sense of being needed and valued…Give us reassurance, hugs, support, a meaning in life. Value us for what we can still do and be, and make sure we retain our social networks.”

Care partners are right to be cautious as dementia affects executive functions that include appropriate decision-making and wayfinding, so the individual could go out and become lost. There is a fine line sometimes between being cautious and diminishing an individual’s personhood. The administrator has a great approach; observe to see what the person may do. It may be a perfectly safe action that has meaning and value to the person. If it turns out to be unsafe, then observation mode changes to redirecting the person.

We get great honors for making small investments. Taking a few minutes to observe what might happen sounds like a valuable and important investment of time to support an individual’s personhood. People living with dementia already experience the loss of many capabilities.

Care partners have the ability to help them retain meaning and value to their life --- what a great honor…and for such a small investment.