My Auntie won’t talk to us anymore. Can she really enjoy music?
A: Different stages of the disease may be a cause for different behaviours; therefore she may be unable to talk to you anymore as opposed to not wanting to. Make sure she is not sick or in pain. A friendly approach is to softly sing to her songs she grew up with. You can also play her favourite music.
Music Therapy has been reported to improve the mental and physical well-being of the person with dementia. You may see positive changes in moods and emotional state; improvement with memory recall; managing pain and discomfort without the use of pharmaceuticals; may be socially active with others; encourages interest when other approaches have failed; and when used as a sensory and intellectual stimulant, it may improve or maintain the person’s quality of life. There is research with Music Therapy regarding the benefits for the older person in general as well as specific studies with people suffering with dementia which has shown evidence with remarkable results. It has opened the doors of communication with dementia sufferers that are silent.
My recommendation is to learn your auntie’s favourite music from her teens and early adulthood time and incorporate them in her day. You will like the results.
Q: My mum has started wetting the bed at night. Do I need extra care for her at night?
A: My first thought when I hear this kind of question is two possibilities before claiming the person is declining in the disease. First: Is the person sick with cold, flu, or infection of the bladder? Second: Are they on any new medications that may contribute to the change in behaviour? Once these questions are taken care of and the behaviour continues, then we can start looking at ways to reduce the concern.
Analyze the routine before the change and see if there is a change in the pattern before your mum went to bed. My goal is always thinking of ways to help the person remain independent as much as possible. So look for clues that might cause your mum to not get out of bed to use the bathroom. Is there an easy pathway to get to the bathroom? Can she see it? If she had no problem going on her own during the day, chances are that something is preventing her from going at night. It could be that she has become more confused and disoriented at night. Add a little light so she can see. And yes, she may need assistance at night to help her get to the bathroom. The other option is to see if she will wear protective underwear at night. Those usually need to be changed at night every couple of hours to prevent sleeping in own urine all night and skin break down, but if you find a brand that is specifically designed for adults overnight you can wait on the extra help at night.
Q: What non-drug approaches are useful for challenging behaviours?
A: In general you can start with recognizing that the person with dementia is not mean but experiencing more symptoms of the disease. Try changing the environment for comfort and security of the person with dementia after you identified the cause of the behaviour. I have mentioned before to get into the reality of the person with dementia and understand the emotion they are experiencing. See if the cause relates to their experience. Listed below are a few useful tips from the Alzheimer’s Association
• Monitor personal comfort. Check for pain, hunger, thirst, constipation, full bladder, fatigue, infections and skin irritations. Maintain a comfortable room temperature.
• Avoid being confrontational or arguing about facts. For example, if a person expresses a wish to go visit a parent who died years ago, don’t point out that the parent is dead. Instead, say, “Your mother is a wonderful person. I would like to see her too.
• Redirect the person’s attention. Try to remain flexible, patient and supportive by responding to the emotion, not the behavior.
• Create a calm environment. Avoid noise, glare, insecure space and too much background distraction, including television.
• Allow adequate rest between stimulating events.
• Provide a security object.
• Acknowledge requests, and respond to them.
• Look for reasons behind each behaviour. Consult a physician to identify any causes related to medications or illness.
• Explore various solutions.
• Don’t take the behaviour personally, and share your experiences with others.
I will add that you as a caregiver, will need to address your own cares and needs to include sleep, free time for self, and laughter!
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