Should we treat them like children?

[Grannie G]

There have been quite a few posts on TP relating to the childlike behaviour of Alzheimer/Dementia sufferers, and the difficulty, faced by carers, to adapt to the new role of parent to parent, or parent to spouse/partner.

I wonder if it is the right way to go. Should we, instead, just acknowledge them as very ill people, and treat them as poorly adults?

When I was in hospital, a very young nurse was performing some extremely intimate care for me. I asked how she could do this for so many strangers. She answered, `I`m just helping you to get well.`

The ones we love aren`t strangers, even though the change in their personality and behaviour may make them seem like strangers at times. We know we can`t `help them get well`, but we can help them retain as much dignity as possible by never forgetting they are still adults.

Sylvia x

 

[Brucie]

Should we, instead, just acknowledge them as very ill people, and treat them as poorly adults

What an excellent question to ask!

From my point of view, there are two aspects I consider.

Firstly, behaviour, observation and care.

Behaviour reverts to a simpler thing with dementia. things seem to be reduced to the basics. There is no longer the plastic thin veneer that society thinks is civilisation now. Basics of course, is where we all start from. With dementia we simply return there.

Observation - I have noticed, only just being exposed to babies for the first time with Nina's latest grandchild, that there is so much similarity in expression. Expression through their eyes, mouths - body language generally. I believe that the observational similarities are what make people who don't delve further think of dementia patients as child-like.

Care of someone - particularly at an advanced stage - is very similar to caring for an infant or child. Feeding, cleaning, encouraging, are all very similar.

While caring for someone with dementia with just as much care and love as we would a newly born child, we need to treat them as if they were perfectly normal in conversation, etc. Inside, they are still them. It is we who are lacking so often in understanding that.

None of this is Gospel; it is simply my view and what helps to keep me going.

 

[Lila13]

When my mother was behaving like a 2-4-year-old, and telling others I was "the Mummy", it felt natural to start treating her as if she really were a child, however whenever she felt I was overdoing it she went into a strop. I had to keep changing from daughter to "Mummy" very quickly to suit the mood of the moment.

And of course if she really had been a toddler she wouldn't have had the power to send me away and Social Services wouldn't have let her stay alone in her own house.

 

[Skye]

Interesting question, Sylvia.

I'm not sure that treating them as 'poorly adults' is appropriate in all circumstances.

For example, we've spoken about money on other threads, and I've mentioned that John just has expired credit cards in his wallet. Patronising? Possibly, but it maintains his morale, while avoiding risk.

The same applies to his driving licence. He still carries an expired one, although he hasn't driven for three years. He tells people that he could still drive if he wanted to, and I go along with that, although we both know he wouln't remember how to start the car.

Now that's not treating him as an adult, but it has removed two areas of risk and anxiety from him, while still maintaining his morale.

Perhaps I'm lucky that John is happy to let me look after the money and the driving, and I recognise that not all circumstances are the same, but it works for us.

As for the rest, conversation is virtually impossible now, but I do consult him about any decisions.

He still opens his own mail, spends half an hour 'reading' it, then hands it to me saying 'it's yours'.

Hope we get a good discussion on this.

 

[Brucie]

Now that's not treating him as an adult

How not? I reckon it is.

Once when I took Jan to our GP, he talked to her in a loud voice, v e r y s l o w l y as if she was a young child. That is something that may well be appropriate at some stages, and only when one appreciates that this is essential, but that was not the case at the time and we were both furious about it.

 

[jenniferpa]

I do think there's a difference between "caring for them like children" and "treating them like children". The former is necessary - making sure they are safe, not allowing them to do things that are dangerous for themselves or others, making them feel as good about themselves as possible. The latter, on the other hand, is not something that I would wish to do (which is not to say it doesn't happen sometimes). That is much more patronising (and some medical professionals can be like this) and has as much to do with tone of voice as actions. Some of the management techniques that one uses with young children are appropriate (small choices, not big ones; avoiding situations which will set them up to fail etc) but I consider they come under the "caring" philosophy rather that the "treating" one. Very young children can pick up on who are talking down to them, and I think dementia sufferers can do the same. Even if they can't, they should be treated as if they can.

Jennifer

Edited to add: Cross posted with Bruce, who makes the same point!

 

[Margarita]

I never treated my mother as child, her behaviour my seem child like sometime , so my skills of motherhood has help me , over the time caring for my mother I have learn more about AZ, yesterday I came across this link http://www.alzheimers.org.uk/alzheimersforum/contributions.htm

Which gave me an insight in to how my mother my feel like, but because of her denial cannot express or tell me.

Brucie

It is we who are lacking so often in understanding that.

I do Agree with that .

need to treat them as if they were perfectly nowmal in conversation,

But I must shamefully say that sometime I do not do that , I do try but I have found it in the past hard, because my mum will start a conversation out of the blue , half way in her own conversation . seem always when I am in conversation with my daughter or friend If I can try to work it out what she trying to express, it does make sense and is relevant to her .

When I have a one to one conversation we can communicate better, but when my whole family around, or even just one of my daughters. My mother will talk about something completely different to what my daughter and I am talking about and normally its about her needs , that to me is a bit chides, like having 2 children one being naughty just to get your attention , while your talking to the other child I am only comparing it to that ,not disrespecting my mother, as it help me understand

 

[Tender Face]

On a global level not just a 1:1 caring aspect ...... Simply ‘Yes‘.

In terms of recognizing they are vulnerable but very valued members of society and deserve the same legal/statutory rights/protection and respect afforded to children.

Roll on the day we see the UN Convention on Rights of Dementia Sufferers…..

http://www.unicef.org/crc/

..... makes interesting 'parallel' reading (and I'm a huge advocate of Children's Rights, BTW)

Now, if I were Head of the UN (don't worry - not had a nomination as yet!!!) I'd reword : "because people under 18 years old often need special care and protection that adults do not" with "that MOST adults do not".

Sorry, my political soapbox hasn't had an airing for a while......

Karen, x

 

[angela.robinson]

SKY ,i think that is exactly what you are doing,treating JOHN as an adult ,and with the dignity he deserves, you are not patronising him , far from it ,yes there is a BIG difference in giving them the care you would a child and treating them like a child , could say more but ,i get upset just thinking about this,ANGELA.

 

[Lonestray]

The child within

Hi Grannie G, The question might be how do you treat a child? The Americans have an expression "Hooking your Child". We say winding someone up. We are all children who time has taken it's toll. One need not have Alz to revert to childlike behavour. With a drink too many a Head Master or priest may carry out a childish prank.
Years ago when my wife was very upset dashing around putting on odd socks:
"What's the problem?" I camly enquired.
"I'm late for school"
"It's OK I'll have a word with the Head Master" calmed her down.
Two days ago I was trying to gee her along with her food. She was taking time chewing part of a chocolate coated wafer, I pretended to take a bite off the remainder. Upset made a 'pet lip' (N. East expression) I couldn't stop laughing as I told her Iwas only joking.
Bruce, you have it bang on, the years have fallen away and she is back in a safe loving environment. On Wed th 27th we had a visit from our ealdest G'son, wife and 4 yr old great G' daughter. I was entralled as I watched Jean's eyes and facial expression as she watched every move of the child. Rarely have I seen her so alert. I find I love her all the more and dote on her, and like the Irish say of a child: "God love her isn't she a dote".
God bless and may all you wish yourselves come through for the New Year. Padraig

 

[Tender Face]

Grannie G... I thought of this thread today as mum attended the opticians.....

(I had 'pre-warned' the clinic that since last routine eye test she has had a diagnosis of Alz+LB .....)

I/we were greeted with such a professional who made her feel so comfortable I couldn't believe how well it all went ...

He spoke at 'her level', without being patronising, directly to her ... (well, if an optician isn't good at eye contact, who is? ) ...... he treated her with respect ... he sympathised with her 'memory problems' without making an issue of it ... in fact positively congratulated her in how many letters she could recognise ... found appropriate humour to make her comfortable ... and mum ... well, mum just rose to the whole occassion like I have never seen in months ....

How many consultants and doctors have we seen together where mum has been totally 'flumoxed' by a simple instruction and had to rely totally on me because they haven't - well - just haven't embraced where she is..... or how to communicate with her?

This was special - and to use a favourite phrase of mum's from the past - "if only you could bottle it you could sell it!!!!!!"

Well, that was one spot in a 'mixed day' which just gladdened my heart and thought I'd share it.......

Love, Karen, x

 

[Skye]

Hi Karen

Glad you had such a positive experience at the optician's. I had a similar one last year. I had pre-warned them that John wouldn't be able to recognise letters, but he surprised me.

Now I've got to take him again, as he seriously mangled his glasses in his fall. He deteriorated so much last year, I can't imagine he'll do as well.

But like you, I was pleasantly surprised at the way they treated him. Perhaps opthalmology schools have a module on care for the elderly? Wouldn't that be wonderful? And wouldn't it be even more wonderful if all medical and nursing training included such a module -- with a compulsory practical exam?

Love,

 

[jenniferpa]

When I took my mother to the dentist to have a new set of false teeth made, he was wonderful too, as was her optician. I think they must spend more time on "chair side manner" training than other health staff.

 

[Grannie G]

It`s so good to hear of positive experiences for a change.

My husband has regular foot care because of his diabetes. I phoned the clinic, as his condition deteriorated, spoke to the receptionist, explained the Alz. and asked them to be vigilant in case he became confused. [I go with him but still encourage him to check in by himself.]

The last time we went, he was greeted by the receptionist as he looked around, not quite sure where to go. It did make a difference, he was so pleased.

I think we can do a lot to help, as carers, by thinking ahead and preparing the ground.

 

[mel]

Hi Karen
its lovely to read your post......I'm glad you had such a pleasant experience.....though I suspect you were dreading it beforehand
Love x

 

[mel]

...... I was horrified when, after taking mum for a blood test last year,having explained that mum had dementia, the nurse gave mum a sticker afterwards which said "I was very brave at the doctors today".......I suppose the nurse was trying to be helpful but mum was confused by it and I thought it was quite demeaning..........

 

[Tender Face]

Pleasant experience .....????

Look I'm doing my best to share the one 'good bit' of today ... .... wanna hear about the advisor at the bank who is paid for ME to explain to HER the difference between a tax code and a sort-code .... and the saga of the EPA????? No - it's just too funny ... can't inflict that on my pals here ..... must save that for another day .......

SOME paid professionals oughta be treated like children....

K, x

 

[jenniferpa]

...... I was horrified when, after taking mum for a blood test last year,having explained that mum had dementia, the nurse gave mum a sticker afterwards which said "I was very brave at the doctors today".......I suppose the nurse was trying to be helpful but mum was confused by it and I thought it was quite demeaning..........

Seriously??? My God, I'm speechless.

 

[Tender Face]

Just crossed there, Wendy ....

Do they do stickers for ... oh, never mind, you know where I'm going ....

K, x

 

[mel]

Yes Jennifer........so was I .....speechless I mean!!! The only good thing was that mum was confused and not hurt by it.........

Karen........I'm so sorry but I had to laugh at the sort code/tax code

Can't wait to hear the saga of the EPA !!!