This is Part 3 of Leah Bisiani’s Person Centred Care series – Read Part 1, Part 2

Caregivers and people who understand a person’s cognitive limitations and deliver care and understanding to compliment the predilections of the person living with dementia, in a way that least depletes their abilities, are best able to minimise or prevent behavioural expression, which can undesirably impact on the lives of both person living with dementia and their caregiver.

“We must recognise the essential unity of all human beings, despite whatever differences there may be in their physical, psycho social and cognitive capabilities”. 

Instead be the one who: 

  • • Guarantees, replenishes, and upholds personhood in people with dementia
  • • Is positive, constructive and encouraging
  • • Focuses on what is really important, avoids making an issue out of things that are not really important and keeps asking themselves “does this really matter?”
  • • Looks for and creates situations where those we care for can experience success and be acknowledged for it
  • • Is active in preventing/understanding behavioural expression related to unmet needs
  • • Is active in dispelling the stereotypical ageist attitudes fostered by society in regard to people who live with dementia

“Aging is not lost youth but a new stage of opportunity and strength.” – Betty Friedan (1921-2006)

It could be assumed that many people living with dementia may, if they could communicate it, have the belief, trust and faith in those caring for them, to continually persist in searching for fresh and innovative methods of creating preservation of ability, and enabling self-expression for them to live a life free from the constraints that society place upon people that are different.

Therefore, in summary, it should be considered the basic, essential philosophy of care for people living with dementia is provision of a familiar routine including choices & preference of the person.

This upholds a more dignified and respectful environment for the person living with dementia.

It is the responsibility of us all to acknowledge people living with dementia as individuals, and not attempt to enforce our own sometimes rigid judgement calls, and practices, onto someone who no longer has the capacity to function as we can, nor has the memory ability to retain new information.

Our attitudes and methods can inextricably become duty motivated, detached, distressing, and invasive to a person with dementia, thus invade their personal space.

I express therefore, for us to remind ourselves continually that our objectives, procedures, priorities, and routines are not essentially nor automatically those of the people we care for.

Maintenance of the discussed seems practical, particularly if we recognize the negative and destructive impact related to removal of choice from any life.

Elimination of rights can be extremely disturbing, create distress and agitation, leading to a person feeling misplaced within their reality, with no sense of comfort or security.

This can exacerbate behavioural expression, especially anxiety.
Hence I personally believe we are often the triggers that incite more dramatic stress related responses.

Advocating a solution, and providing a supportive community, may be the catalyst to our population living with dementia, and their caregivers, becoming well informed, thus living life with a greater sense of wellbeing.

My suggestion is we make a concerted effort to be more aware of how our attitudes can be perceived by a person who lives with dementia, and let us be the change. 

“We must never destroy the spirit, the essence or the spark of life of a person. We do not have that right.”

“For the older person, often the most important moment is the present moment, tomorrow can scarcely be imagined or anticipated.
Life is most fully experienced in the now.
Our supreme challenge as caregivers is to embrace this attitude of living in the moment. 

It is here we find the best opportunity to experience a measure of joy and fulfilment during this caregiving journey”. 

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