While connecting with our Social Work Services department to craft a plan of care for George, the social worker discussed the possibility of Claire attending Caringkind’s Family Caregiver Workshop. This ten-hour workshop is facilitated in four sessions and meets once a week in two and a half hour increments. It provides friends and family members the opportunity to explore best dementia care practices in a supportive, non-judgmental environment. Topics discussed include: communication techniques, managing difficult behaviors and creating meaningful activities. The workshop is available in the afternoons and evenings to accommodate a variety of schedules.
Session One: Claire registered for an afternoon session while her daughter stayed home with George. During the first session, Claire spoke about the difficulties she was having caring for George and expressed a sense of loss because she could no longer connect with him as she had during earlier years in their married life. She talked about a recent doctor’s appointment where it was suggested that George take medication to reduce agitation which would help inhibit his desire to wander. After having received some suggestions from our social work department, Claire asked for a delay in the prescription and was hopeful that during the workshop she would learn more about dementia and how to implement interventions that would prevent George from wandering again.
During this first session, the caregivers learned what dementia is and how it affects the whole person, memory, cognition, behavior as well as physical functioning. Claire reflected during the discussion that she had been frustrated with her husband because he could remember everyone’s name on his mail carrier route but could not remember the names of their grandchildren. However, after learning how dementia affects memory loss, she understood why that would happen. Claire also began to recognize how much her emotional state affected the interactions that she had with George.
Session Two: Claire returned for session two where the group discussed common symptoms experienced by people with dementia during the middle stages of their disease as well as best communication strategies. She relayed that George had a compulsive need to leave their home in the early morning after working for many years with the postal service. She realized her reaction and emotional state was exacerbating the problem. Due to all of the care George required, she was not caring for herself properly, was not getting enough sleep and often woke up exhausted. When George would attempt to leave their home in the morning, she would become frustrated and argue with him, countering his desire to leave by informing him he had been retired for years and had no need to be anywhere. Claire would speak to him at length, hoping to jog his memory. This frequent scenario always escalated into an argument. Claire’s children would try to intervene in other ways, ranging from a tough love approach mandating that George “stay put” or pleading with him to remember he had to stay home so he wouldn’t get lost.
During this second session, Claire realized how a person with dementia often mirrors the emotional state of those interacting with them. She now understood that recognizing and meeting her own needs was a crucial step in mitigating many of the problems she was experiencing. The group also questioned the value of arguing with a person with dementia, and connected how a caregiver’s opposition to a person with dementia’s view of reality will often increase agitation, anxiety and frustration.
Session Three: At the start of the third session, the trainer explained the common causes of challenging behaviors and strategies to alter those behaviors. Claire was very animated and smiled when she relayed how she applied the skills she learned in session two in the early hours of the day when her husband was determined to leave the house. She made an effort not to argue and instead connected with his emotional state. She also spoke slowly and said only one thing at a time. George responded well to the change in Claire’s approach and even though he continued to want to leave in the morning, she was able to more easily redirect him five out of seven mornings. Claire reported feeling hopeful for the first time in a long time. She noted her children were cautiously optimistic and after witnessing her success, began to mimic her approach.
Claire was surprised to learn the many possible motivations behind her husband’s behaviors. The group learned how the environment, the person with dementia’s physical body and emotional state, as well as how caregivers can impact the person with dementia’s behavior. She reported that she was going to call a family meeting and ask her children and grandchildren to be detectives with her and investigate all of the factors that might influence George’s behavior. She wanted to develop a plan on how to best mitigate those factors.
Session Four: Claire reported that her family met and came up with many possibilities that may be contributing to George’s most challenging behaviors, as well as a few interventions. Claire discussed the methods of managing behaviors she learned in the workshop and using those principals, developed strategies for the family to implement. Strategies included holding off bed time for an hour to offset the early morning rising and using black out shades to obscure the early morning light. She altered her bed time so she was well rested when her husband woke up. She made sure her husband went to the bathroom before bed to reduce the need to go early in the morning. The whole family rallied and came up with possibilities. They all knew that they would have to maintain the dialogue as the illness can quickly precipitate changes in behavior.
During this last session, the group was presented with an opportunity to sum up all they had learned throughout the workshop. Basic concepts such as disease process, common symptoms, communication techniques and managing behaviors were reviewed. The caregivers explored how to use this information to support the person with dementia’s level of independence and capacity while engaging in an activity.
Claire explained how her husband had loved his job as a mail carrier and how she had thought up ways to bring that job back into his life. She decided to buy stickers, which would serve as stamps, paper, and envelopes for him to address and mail. Claire would ask his help in writing cards to family members and mailing them. She also allowed him to sort the daily mail. Claire also finally understood the importance of self-care and reported feeling that she forgot what it was like to do something for herself. She was encouraged to list self-care activities she would enjoy and to make a plan to implement them. Attending this workshop proved to be extremely helpful to Claire and her family.
George and Claire’s Journey continues on the next page...