The goal of this course was to emphasize the importance of caregivers’ putting themselves in the place of the person with dementia and then using common sense to figure out what they need.
Without this understanding, staff responses in caregiving situations are often partial and inadequate. Getting to know more about your patients—and taking the time to learn about what they experienced in their earlier lives—increases the tools you can use to prevent or manage problematic behaviors.
Knowing why someone would behave strangely, or understanding the reasons for their delusions or negative behaviors, means you can address these issues without causing distress to the person with dementia. “Getting into their reality” often leads to simple, common sense solutions to potentially harmful situations. It also helps to improve the quality of life of the individual by fostering trust in the caregiver and reducing the dependence on medications to manage negative behaviors.
Geriatric nursing was not my goal when I graduated from nursing school in 1961. But after working three years as a public health nurse, doing home visits for the chronically ill, I realized how much I enjoyed working with elders, especially those with cognitive loss. I began to realize how fragile and needy this population really was, and how my interventions could help families to understand their care needs and perhaps make their lives a little better.
At the same time, George Mason University began offering an MSN in geriatric nursing. I graduated from this program a few years later, just at the time the idea of separate dementia units for nursing homes and assisted living facilities was becoming a reality. Shortly after I graduated I was asked to coordinate the development of a dementia unit for a nearby assisted living facility. That took a year, and it was during this time I met Elizabeth and several of the other dementia patients I wrote about in my book. Their problems, behavioral issues, and the ways in which they responded to the type of care we provided were not taught in the classroom. The staff and I had a lot to learn, not only about our patients but also about the ways our own behaviors and responses affected our patients. We quickly discovered that to solve some problems we had to think outside the box, and I loved the challenge.
It should be clear from the stories that the guidelines for common-sense care came from my responses to what the residents in various facilities taught me. Even today I can clearly see Elizabeth’s face light up after she got her kiss, and I can still feel the hugs from Hannah. This is what made dementia care so important and so enjoyable for me. A friend once asked me how I could work with people who had dementia. “Isn’t it depressing?” she asked. How could it be depressing to make someone’s life a little better?