By: Steve Mankins, PT
Imagine waking up in an unfamiliar room to unfamiliar faces, struggling to answer simple questions and complete routine tasks; all while you are unable to accurately communicate what you are experiencing. A stay in a skilled nursing facility can be a frightening time for a patient with Alzheimer’s disease or dementia and interacting without consideration for his or her disease can make that experience worse. Interactions with these patients can lead to frustration on both sides or a positive experience that leaves the patient feeling valued.
The goal of working with patients with dementia is to understand their abilities and establish a plan to maximize those abilities. In general, we as therapists typically focus on deficits in patients and how we can improve those deficits. Unfortunately in patients with dementia, we need to focus on the present abilities and how those abilities can be improved on to maximize the patients’ independence. Many patients are unable to provide the therapist with accurate assessments of their abilities, which can lead to disconnect between patients’ and therapists’ goals.
An excellent way to gain a better understanding of these abilities is an in-depth discussion with family members and/or close friends. This conversation can provide information about the patient’s mobility level and learning style, as well as likes/dislikes, hobbies and activities of enjoyment that allow the therapist to develop a global picture of the patient. This global view gives the therapist the opportunity to intertwine therapy objectives with activities or topics that are of importance to the patient. Therapy sessions can be a difficult time for patients with dementia because they may have difficulty communicating their needs with the therapist as well as completing tasks that are challenging and frustrating that may have been completed before with ease. Incorporating hobbies or discussing topics of interest can add enjoyment to an otherwise stressful situation and allow the patient to feel that the therapist working with them has a genuine interest in them as a person.
The last key to every interaction with a patient with dementia is patience. It is important to remember that the patient is experiencing changes in their living environment that they may or may not understand, meeting a large number of new people, and are being instructed to do and not do specific tasks; all of which can be very confusing and frustrating. Allowing additional time for the patient to process information and explaining tasks in a variety of ways gives the patient the best chance at understanding; drastically changing your interaction and their experience.
Interacting with patients with Alzheimer’s disease or dementia can pose unique challenges and can leave both parties feeling frustrated and confused. Focusing on the patient’s abilities, getting the family involved, and incorporating hobbies and topics of interest can lead to everyone receiving the maximum benefit from the experience. Above all, be patient because your caring and understanding nature reminds them how valuable they are.