Posted by Beth Soltzberg

For family caregivers of people with dementia, everyday activities such as bathing, dressing, eating, and conversing can morph into periods of conflict, exhaustion, and grief. For this reason, JF&CS hosted trainer Sue Blackler of Hearthstone Alzheimer's Care on October 7. Thirty-five spouses, adult children, and other relatives and friends who care for a person with dementia participated in this free day-long training.

Because symptoms begin in middle or more typically older age, one of the challenges of dementia is that family members must reshape their expectations of someone they have known for years, or perhaps all of their lives. Understanding the brain changes that cause symptoms of dementia can help care partners adapt to a changed relationship with less frustration and blame. For this reason, Sue first helped the group appreciate the effect of brain changes on field of vision, recall of information, and the speed with which a person processes information. One of the exercises called "dementia eyes" helped the group imagine how the person with dementia sees them and the world.

The training included practical tips for many tasks of daily life. For example, because of reduced field of vision, it is important to approach someone with dementia from the front and then get at their at eye level before beginning to talk to them. A home environment contains many fall and safety risks. Non-skid floor strips and footwear, adaptations for appliances, good lighting, and carefully placed gates and locks as well as regular exercise can reduce these risks as the person's dementia progresses.

Because dementia changes a relationship, one of the most broadly useful topics was that of communication. Care partners must be mindful of both their verbal and non-verbal communication like body language. The person with dementia may react strongly to verbal or body language that makes them feel judged or rushed, and on the other hand, warmth and a relaxed attitude may help them release tension, feel safe, and be open to the next experience. Rather than saying, "Do you remember" or asking questions that can make the person with dementia feel quizzed, the care partner may offer their own reminiscences. Then the person with dementia can respond, without fear that they will give the "wrong" answer. For example, instead of saying, "Dad, do you remember the person in this picture?" the son or daughter can say, "I loved Uncle Earl. He was such a funny guy!"

Sue also introduced a technique called "threading," in which the care partner lets a conversation unfold to follow what the person with dementia says, even if the topic meanders. It is a tremendous challenge to change the communication habits of a lifetime, but one that often pays off in more harmonious interactions with the person who has dementia.

The underlying message of the training was that the person with dementia continues to need the things that everyone needs – love, understanding, interaction with others, a sense of purpose, a sense of home. Dementia, and particularly the loss of the former relationship with the person, can make it very hard for care partners to know how to help the person with dementia attain these things. Caregiving is incredibly demanding in any circumstances, but is less arduous and more satisfying if techniques can reduce conflict and increase the person with dementia's safety and well-being. As the number of people living with dementia continues to rise, these skills become vital for more and more of us. JF&CS was pleased to partner with Hearthstone in making this training available.

Beth Soltzberg, LCSW, MBA, coordinates Living with Chronic Illness, a program of Jewish Family & Children's Service encompassing support, education, and the arts. Beth's work includes facilitating caregiver support and education groups, and designing new offerings for families affected by Alzheimer's disease and other dementias. Beth earned her MSW and MBA from the University of Chicago and a certificate in end-of-life care from the Smith College School of Social Work. She holds an advanced credential in hospice and palliative care social work.