The Gift of Purpose

The holiday season has busy and joyful energy to it.  It often feels like there’s a buzz in the air where everyone is rushing somewhere or hurrying to do something.

 

Many people with dementia are sensitive to the energy and emotional state of those around them. They will often pick up on this energy of hurrying and they may want to help. They’ll want to join in the activity and be part of the buzz of energy.

 

Human nature desirses a sense of purpose.

 

We want to feel productive and we want to provide meaningful contributions.  This sense of wanting to contribute and be helpful and productive is not impacted by many forms of dementia, so people very much want to be involved and be helpful. When someone with dementia can sense that everyone else around them is hurrying to complete tasks, they will want to join in and assist too.

 

 

If someone’s functioning level has been impacted, it may be difficult for them to contribute in the ways they did previously.  In the past, your father may have gone to select a Christmas tree and cut it down himself, then tie it to the roof rack, drive home, and set the tree up. That may no longer be possible for him to do entirely on his own. Perhaps he doesn’t drive anymore; perhaps his physical strength or sense of direction is impaired.

 

Even though he cannot complete the task in full, is there a way that he can still be involved in the process?  Can he be part of the trip to select the tree? Can he manage some of the cutting? Or hold the tree steady while a grandson saws away?  Continuing to involve him in the process will be important to his sense of self-esteem and his need to feel productive. 

 

Many forms of dementia interfere with the brain’s ability to sequence an activity. 

 

Many tasks are actually a series of separate, smaller tasks that must be done in a particular order.  Baking, for example, involves many separate tasks that are all sequenced in the right order. Perhaps your mother-in-law baked countless cookies and squares during the holiday season. Now, she makes toast and tea, but not much more. Expecting that she can bake a dozen varieties of cookies is not reasonable, but involving her in a few favourite recipes will help her to shine.

 

When approaching a complex task like baking, break down each step into a separate task. If there are any tasks that can be a stand-alone job, get your mother-in-law to be in charge of that step. Maybe the walnuts need to be crushed for one recipe. You can get your mother-in-law set up crushing walnuts. It may be faster to do it yourself or tempting to use the electric food processor, but the purpose isn’t to be fast and efficient.

 

The purpose is to involve your mother-in-law in the traditions that she founded.  It’s pretty likely that she didn’t have an electric food processor when she first started baking that recipe.  Breaking the walnuts by hand is likely a familiar task from years gone by and something which she can feel successful contributing.

 

All too often, someone with dementia will say “what can I do?” or perhaps “I don’t know what to do…” and well-meaning family members will respond “you don’t have to do anything! You just relax and sit over here.”  In some cases, if someone is overstimulated and needs a break, that might be the kindest option. But in most instances, the person with dementia is genuinely reaching out and wanting to feel productive by contributing something meaningful to all that is going on around them.  By finding a task that matches their ability level, you are helping to meet that fundamental human need for productivity.

 

Remember that the task might not be about doing. It might be more about being—being close to you, being part of the action, being a contributing family member.  If many tasks are just too difficult or overwhelming, perhaps they can be involved in a being type of way.

 

Maybe the dog is overly excited by all of the activity and you can ask your father to hold the dog on his lap and pet the dog to keep him calm.  He is being a comfort to the dog…or perhaps the dog is a comfort to him, but either way, they are both content.

 

 

Perhaps you’re wrapping presents and the roll of tape keeps disappearing under all the wrapping paper and boxes. Your mother-in-law might like to be the keeper of the tape as you’re wrapping. She’s right there with you and she’s involved in her own way. You may even get to chuckle about how you lose the tape and she’s keeping you on track.

 

It may take more effort on your part, and it will definitely take more time and some creativity to find tasks that match ability levels and provide meaningful contributions, but the rewards will almost certainly be worth it!

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Dignified Care means Allowing Sufficient Time

Homecare can be defined pretty broadly and mean different things to different people. To some, it might mean dropping in to check on someone for 5 or 10 mins, for someone else it could be 24/7 care in someone’s home.  It could be just about anything in between!

 

To ensure that our clients receive the best possible service, we have placed parameters around the type of service we can offer to ensure top quality.  Here at Warm Embrace, the minimum visit length we offer is three hours. We have set this minimum to ensure that we are fulfilling our mission and our philosophy of care

 

 

Within the context of homecare, where an elderly client is living in their own home, apartment or condo, there are some additional reasons why the three-hour minimum is necessary.

 

Have you ever dropped by your elderly parents’ home with the intent of staying for a half hour visit?  How did that turn out?  I’m willing to bet that you stayed much longer than just 30 minutes! Why is that?

 

I’m guessing that by the time you got in the door and settled, got caught up with some friendly chit-chat and had a coffee, you were already at the 30-minute mark.  Just as you were thinking you would head out the door, your mother mentioned a new symptom that’s bothering her.  You discussed that and tried to track down whether a doctor’s appointment had been made since your mother couldn’t remember. Then your father mentioned that the microwave wasn’t working properly so they weren’t sure what they were going to have for dinner.  The next thing you know, you’re busy making dinner for them and your quick 30-minute drop-in lasted a few hours.

 

Of course, your parents tend to stock-pile all the issues until you arrive. Then it takes longer to address everything.  The same is true for our visits.  Clients may save up the dishes and the housekeeping and laundry pile up.  The items you plan in advance that you figure might take an hour or so end up taking much longer when the list keeps growing!

 

It’s not just about tasks; it’s also about pacing.

 

If you personally have a doctor’s appointment at 11 am, how much time do you allow yourself to get showered, dressed, ready and out the door?  Now, what if your parents have a doctor’s appointment at 11 am?  It takes a lot more time since every step in the process needs to be adjusted to allow the extra time they may require or prefer.

 

It likely takes much longer for them to manage to get in and out of the shower.  Selecting an outfit and dressing likely takes longer, as does personal grooming and other morning routines.  Physically getting into and out of the car may take longer, and your parents may prefer to be at the appointment 20 minutes early instead of arriving just on time. . .despite the fact that the doctor is always behind schedule and you know you’ll end up waiting anyway!

 

Out of respect for your parents, we allow significant time for outings to ensure that we can match their preferred pace, not our preferred pace.  We know that each stage will take much longer and that we need to allow lots of extra time should something unexpected arise.  If we’re just getting your parents settled in the car and your mother suddenly needs the washroom once more before leaving, we need to have allowed lots of extra time to deal with the (somewhat) unexpected. 

 

For your parents’ sake, we would never attempt to accomplish an outing in only an hour long shift.  Part of providing dignified care is allowing sufficient time for outings and errands and matching your parents’ pace, not necessarily just focusing on fastest efficiency.  It takes time to do things well and the minimum time we need to ensure top quality is three hours.

 

Granting your parents the dignity of matching their preferred pace, ensuring that we have extra time built in for the unexpected, and knowing that they may have a stockpiled list ready for our arrival are all part of how we plan in advance to meet your parents’ needs. 

 

Relationships are about so much more than speed and efficiency; your parents will thrive from the attention they receive from a wonderful caregiver who takes the time to appreciate them for who they are and who gets to know them on a personal level without rushing.

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