Daisy was having a lot of trouble walking. The less she walked, the more anxious she became about having to walk. She suffered from Alzheimer’s disease as well as a lifelong history of anxiety. This anxiety manifested itself physically (as well as emotionally) in that she would sit in her chair and firmly stroke her thighs and knees, causing her so much pain that she was confined to a wheelchair.
When Bonnie (a nurse) and I first met Daisy, she was very pleasant and easy to engage, but she needed us to keep the conversation going or her anxiety quickly surfaced. Bonnie assisted Daisy and held her while she stood up. She was very nervous about falling, but Bonnie assured her that she would not let her fall. This was the beginning of a new life for Daisy.
Fast-forward a month. Daisy was now under the care of health professionals, who were trained in best care practices for people with dementia. She had a daily routine and cueing throughout the day to help her keep the routine. In addition, she was surrounded by people that loved her. All of these efforts resulted in a woman who became very care free, something she had not known her entire life. Instead of being confined to a wheel chair, Daisy would walk up and down the hallways after she ate breakfast. When someone asked her where she was going, she would answer, “Nowhere. I am walking simply because I can.”
Mr. Kane had suffered a massive stroke that left him with limited mobility in his left arm and a limp in his left leg. This stroke also affected his brain and his ability to manage his emotions and make good decisions, among other things. His family moved him into a beautiful memory care home and most days he was sad he had to be there. He was sad that he needed help to use the bathroom and sad that he needed help to get dressed. He would often try to do these things himself and this often led to frustration on his part and then more sadness at the reality that he had to depend on others.
However, these sad days were quickly forgotten whenever there was a party or event with delicious food. On one hot summer day, the chef brought everyone outside and hosted a huge BBQ with unlimited servings of seconds and thirds. Mr. Kane was so happy and kept eating! Unfortunately, that afternoon, Mr. Kane complained of a terrible stomachache and when we asked him what he ate, he responded, “seven hot dogs!” “What?!? Why did you eat so many?” “Because I could”, was his entire answer.
Very often, people with dementia do things that cause us to question their reasoning. Since we do not understand, we often think they are confused, wandering, mixed up, etc. However, they have a reason or a purpose. Just because we don’t know why they are doing what they are doing, it is not helpful to intervene before we ask them why they are doing something or try to figure it out if they aren’t able to verbally communicate.
Frequently, a person with dementia does very little for self because we, the care partners, have taken over the job of doing. Yet, all of us desire to take care of ourselves and to do things for ourselves. People with memory impairment are no different. When we minimize the things that a person with dementia can do, they sometimes do something simply because they can.