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I take a look at her struggling with the sweater
and then tell her, "This is a bad sweater. May I get you a better one?"
She assents and lets me help her take it off. I take it into the next
room and turn it right side out. Then I come back and help her to put
it on. Everything now works fine. I blamed it on the sweater, not on
her, and helped her to do it right.
If I can manage to help her before she gets her dress tangled up, that's
fine, but she already had the dress over her head when I noticed she
had it on backwards. Too late! She managed to get it on and put her
arms through the sleeves. It wasn't comfortable but in no way would
she listen to me. I just let her wear the dress her way.
How could I handle this case? If I had remarked that she had the dress
on wrong, then I might as well forget about it. But I had said nothing.
Then I could wait for an hour (She is now feeling more uncomfortable),
and approach her like this, "We need to go the bank and I want you to
dress up to go out. I'll get your new dress to put on." Going to the
bank works with her; she probably will consent. I get the other dress
and help her change. Most likely she has forgotten about the bank by
this time but, if not, we go for a walk.
I used my imagination and strategy. I was positive all the way, and
stressed that I was helping her. I also made use of something I knew
would work with her - "going to the bank."
Later, problems became more acute. When she became incontinent, after
a stay in the hospital, I had to watch her carefully all the time. If
I saw her getting restless, I would ask her, "Do you have to go the
washroom, Norah?" When she nodded her head, I suggested, "Okay, stand
up and go. You know where the washroom is."
She then stood up and took a step forward. "The washroom is that way,"
I said, and pointed in the direction she should go. She took two steps
and stopped again.
"May I show you where to go?" I suggested, and she nodded her head.
Then I took her by the arm and led her to the washroom. Then she realized
she was wearing a diaper and didn't know what to do. I offered to help
her with it and took it off, and she sat down. Usually the diaper was
still dry. If not, I prepared a clean one for her. Once she was sitting
down she would forget to stand up when she was finished, so I had to
go in and remind her to get up. Then I gave her the diaper to put on.
She fumbled around and could not manage. "May I help you?" I asked,
and she was happy to let me do it.
I was careful to let her feel that she needed help, then I could help
her without a problem. This principle is very important with Alzheimer
persons. After a while, when she was used to me helping her, the process
became automatic, without any questions.
The problems you face will be different from mine, but I hope I have
given you some clues you can use in solving them.
The Alzheimer person is trying to retain his self-respect and any negative
remark on our part will hurt him.
If possible, ignore difficult behavior of the Alzheimer person (Does
it really matter?), or find some excuse for helping the person do it
right. If it's a dangerous situation then act decisively and there will
be few after effects.
NOTES:
Problem: "Daniel, my husband has been a difficult person to work
with all his life. Your advice to "never be negative" does not work.
He is only becoming more difficult as I try to be positive with him."
Answer:
I realize there are husbands like that. The male ego can pose a real
problem. If he was difficult before and you put up with it, then probably
my advice will not work. You need the help of your Family Services Coordinator
to lighten your load. Then, become socially active outside of your home,
make friends, and build a life of your own.
This will help you to distance yourself from your husband (See chapter,
Emotions of the Caregiver) so that you can now view him as a patient
in your care. Treat him as a nurse would. Probably by now he no longer
recognizes you and the ill-feelings he had towards his wife will not
be directed towards you. You can make a fresh start and maybe even develop
a new relationship with him. I did that with Norah and it worked.
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