Care – understanding people with dementia

18.10.2012 19:03

Mr. K. suffers from dementia and has been living in a nursing home for a long time. Today he wants to visit his mother. He therefore puts on his coat and leaves his room. The only problem is: it's four in the morning, Mr. K. is only wearing pajamas under his coat and his mother died 18 years ago. Anyone who has contact with people with dementia is familiar with such situations - people with dementia are often driven and restless and have things they really want to do. However, according to gerontologist Adriano Pierobon, the obvious reaction of confronting the patient with reality is wrong in such situations! According to Pierobon, people with dementia are fixated on certain projects because they want to counteract the loss of control and the feeling that they no longer have anything under control and demonstrate self-determination and competence. That's why the attempt to expose the project as wrong and "nonsensical" is experienced as humiliation and shame. The reaction of people with dementia to such corrections and instructions is often to insist on their intentions. Sometimes aggressive reactions, withdrawal or resignation can also be observed. Such reactions are easily understandable because we all react in a similar way to continued instruction and improvements.

But how can you dissuade Mr. K., who insists on visiting his long-deceased mother at night, from his plan? Pierobon has done this in his company, the nationwide nursing service HUMANIS (www.humanis-pflege.de) developed a concept that focuses on always treating customers with dementia in an appreciative and understanding manner. In this specific case, this means that you have to take the request for a visit seriously and develop understanding on an emotional level (“You haven’t seen your mother for a long time!”); When Mr. K. feels that his wish is emotionally understood and accepted, a level of communication has been found from which a careful correction of the project will be possible.

In this context, it should be noted that people with dementia always have impaired cognition and mental performance. However, the ability to perceive emotions remains intact. Understanding, appreciation and solidarity are therefore perceived, even in the advanced stages of the disease, as are contempt and rejection. This even applies if verbal communicative exchange with the sick person is only possible to a limited extent. Emotional messages are still perceived reliably even at this stage of the illness, because they are not only conveyed verbally, but also on a non-verbal level. Therefore, in Pierobon's opinion, it is important not just to feign understanding, but to develop and convey genuine understanding. Nurses who engage in this are much less likely to be confronted with aggressive behavior and unproductive arguments.