The other day a good friend called to talk about her mom, Anna, who moved in with her five years ago after a dementia diagnosis. My friend was concerned that her mother was depressed.
Anna was an independent single mom who never missed a day of work at her small business. But once she retired, she seemed lost, and cognitive changes became more apparent. Anna struggled to find words and would ask the same questions at 5-minute intervals. Sometimes she confused family members, like the time she deeply upset her sister when she called her by their mother’s name.
Anna loved seeing family and could grow lively in their presence, but was less responsive in general. It seemed like she knew that her brain was changing, but was reluctant to talk about it. My friend wondered if I had some ideas on how to help, since I’ve worked with adults with dementia for about 20 years as a music therapist. She wondered if there were ways that she could help stave off cognitive and physical deterioration.
Here are some of the things I suggested:
1. Give purposeful work.
Many older clients express that without work, they feel “useless.” I would suggest giving them a job to do and praise their work regularly. For people with mild to moderate dementia, you can ask them to help with tasks such as cooking and cleaning, projects with grandchildren, anything at which they might enjoy and be successful. Even people with advanced dementia can help out: at some nursing homes, residents fold towels for the staff. You’d be surprised at how much calmer they appear while doing this activity.
2. Encourage hand use.
Along those same lines, don’t take away everyday tasks such as cleaning, lifting, folding, and cooking. I have observed that many older people tend to stop using their hands when they stop doing the tasks that make them independent.
Unfortunately, “Use it or lose it” is a grim reality. But these skills are not gone forever- we learn through repetition, so if we do a task every day, we will improve. Tread carefully, however, if her hands are arthritic, because sometimes movement can make inflammation worse. When in doubt, consult a doctor, physical or occupational therapist.
3. Provide many sources for love and physical affection.
I work on Memory Care with people with severe dementia and bring them calendars with cute photos of cats and dogs. One day I left for a couple of hours and when I returned, I realized that the calendar I brought had circled the entire room! They all loved looking at it. This actually releases oxytocin and makes us feel good.
Give them experiences with children and pets if you can. If they’re allergic, show them pictures or movies with kids or pets.
4. Provide structure as much as you can.
Give her a sense of belonging to the world. Even if she doesn’t read anymore, still bring her a newspaper or magazines. She may not understand what she reads as she once did but having the paper can feel normalizing. Remember that she is feeling confused about her role and could use some cues. Besides, reading is a good cognitive stimulus and a useful skill worthy of retention.
5. Come together through music.
Dementia tends to leave musical memory intact, especially “overlearned” songs: ones we have sung many, many times.
Think about what she listened to when she was younger. If you can’t remember, consider that our tastes are usually developed in our teenage years, so google popular songs of that decade.
Put on some recordings and see how she reacts. Does she hum along, tap her foot, sing with you, maybe dance with you? Some people can’t talk very much anymore but can still sing. Others who are less affected may have memories that they would be willing to share if you ask the right questions. It might take a little time, but can be very worth it!
Ask her what she remembers about the song. Maybe she shared a love song with her spouse, and this can lead to a story about how they met. Even if you’ve heard these stories a million times, you would be surprised at new details that spring up from hearing recorded music.
Additionally, learning the music she loves can help calm them later on if she sundowns or resist care.
6. Manage your expectations.
With dementia, professionals usually set goals to maintain existing skills versus improvement. You can still work on improving skills, but remember that this is a progressive disease. With that in mind, it can be helpful to redefine your expectations of your loved one.
To me, the gold in any relationship is the connection, such as the moments you come together and laugh or talk or sometimes just make eye contact. I know that our relationships with family members can be complicated and difficult, especially after a lifetime of knowing one another. But this can be a time when this relationship changes as our loved one changes.
*Name has been changed.