University

05/18/2010

Food, baths, and bed aren't enough

Every 70 seconds, someone in the U.S. is diagnosed with Alzheimer’s disease. 

According to the Alzheimer’s Association, that means that there could be up to 16 million Americans with Alzheimer’s by 2050 – and that’s only one of many different kinds of dementia that afflict the elderly.

In the most literal sense possible, what are we going to do with all these people who can’t do for themselves?

For the most part, they get their physical needs met:  hospitals and clinics and care workers and families are increasingly good at helping people with dementia eat and bathe and take their medicine. 

But what about their psychological needs?  Does dementia condemn someone to a life of confusion, loneliness, and solitude?

“People with dementia are present, they live in the moment, and they still want to be met, noticed, related to,” says Doris Bersing, an expert on the psychology of aging and a faculty member in Saybrook’s PsyD program.  When people with dementia aren’t related to, their confusion often becomes depression and anger – the way anyone’s does. 

A recent discussion on a New York Times medical blog suggests that there are hundreds of thousands of people in America who want to do better for their aging loved ones than just make sure they’re bathed and fed – they want to love them in a meaningful way.  But how do you connect emotionally with someone who has Alzheimer’s? 

For many caretakers – especially loving but stressed and inexperienced family members – the task seems impossible.  But Bersing says there’s hope:  increasing research into the psychology of the elderly (a topic barely even recognized by most psychologists 20 years ago) is teaching us how to do just that. 

In particular, she says, engaging with the elderly in creative, artistic, ways can have extraordinary benefits. 

“For those with dementia, music therapy is one of the most successful interventions,” Bersing said. “In a review of special-care units, staff rated the effectiveness of different interventions, and music therapy was rated the most effective intervention for this population.”  Research has shown that it can reduce the need for tranquilizing medication and help the overall goals of rehabilitation. 

In one noted instance, a man in his 70s with Alzheimer’s, who previously did not talk, joined a local choir and was able to hold lucid conversations with his spouse just weeks afterwards.  Similar affects have been shown at assisted living facilities that offer karaoke. 

Other intergenerational pursuits proven effective through both qualitative and quantitative research include poetry, drama and play, and scrap booking.

For those whose loved ones are unable to participate in any of these activities, due to mental or physical incapacity, Bersing says there are still ways to spend time meaningfully:

  • Tell her stories about the world. Describe walking along the beach, watching a sunrise, children playing in the garden . . .
  • Go slowly through picture books, like art, garden, or travel books.
  • Give her things to hold and feel that have pleasing textures, like shells, leaves, or cotton.

 

The bottom line, Bersing says, is what her own clients have taught her:  “people with dementia are not necessarily de-mented, and if we make the effort to learn different languages, we can communicate with our elders and contribute to the richness of their experiences.”

When you can’t appeal directly to the mind, the most effective strategy is to appeal to the senses … and the soul. 

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