© Danielle Robertson Consulting Pty Ltd t/as DR Care Solutions
As World Dementia Month 2020 closes, I would like to discuss the often difficult exercise of organising care for someone living with dementia.
In my experience, the most challenging scenario is where the person living with dementia lives alone and receives ad hoc care from visiting relatives and friends.
While currently there is no cure for dementia, research tells us that we can improve a person's quality of life by managing the symptoms and providing a supportive environment.
Today we focus on providing a supportive environment in the scenario where the person lives alone.
Now what one person finds supportive may be very different to another, and this is true for someone living with dementia.
Providing a supportive environment involves person-centred care in its most genuine sense.
It is common for a person living with dementia to not accept their diagnosis. To them, nothing has changed, there is no need for change, and they do not want anyone bothering them. They are stoic and want to remain as independent as they always have.
The situation can be very worrying for visiting relatives and friends who see their loved one lose weight, wear the same clothes, stop showering, and vaguely answer questions on medication taking, eating meals and drinking water.
Getting someone who lives alone to accept some supportive care can be challenging. They do not see the need and they will not like changes. Suggesting that they might move into residential aged care may bring you comfort but it is likely to be rejected outright and bring on great distress and often hostility.
The goal is to understand the care and support your loved one is willing to accept. This is what we call person-centred care. To establish what care may be accepted, you need a good understanding of the person's background, personal history, social and family history and preferred activities and hobbies.
Through this understanding you will find ways of unobtrusively introducing care and support at home. Using the word ‘support’ at home is often more conducive than the word ‘care’ at home.
While every scenario is different, I will share an example of where I was able to introduce regular care having understood the background of a fiercely independent client whose carer spouse had died.
It was quickly established that the client, May*, had a regular cleaner who she was fond of and trusted. The cleaner came in once a month. After some encouragement, drawing on her personal history of "keeping up appearances", May agreed to having the cleaner come once a fortnight.
The cleaner was given more detail about May's condition and ways in which they could help build a supportive environment through their cleaning. As an extra set of eyes, the cleaner was given the contact details of two relatives to contact if the cleaner had any concerns.
The next step was to introduce two carers, engaged through an accredited aged care provider, to make alternate visits during the week to prepare lunchtime meals and leave a smaller nighttime meals in the fridge. It was arranged that the carers buy the groceries at a local grocery store and butcher where May could keep an account.
In organising this type of care, it became clear that May would not accept carers who came in uniforms and drove badged cars. Again, this came with understanding the person, and their fierce desire to appear independent.
In addition, May indicated a preference for older and more mature carers who, from the outside, looked like her friends rather than carers. Being older meant they could share conversations and discuss common interests.
This care scenario is now in full swing and the concerns of relatives have been dissipated to a great extent. For the moment, with the dementia appearing to have levelled for a period, May and her family are enjoying a supportive caring environment.
* Names have been changed to protect the identity and privacy of subjects.
To help visiting relatives and to recognise World Dementia Month, DR Care Solutions has created a "Living In The Moment; Enjoying The Present Activity Poster For Visiting A Loved One With Dementia".
Click the image below to get your free activity poster!
For advice and assistance on how to set up the right care, support and assistance for your loved one, at the right time and in the right place, please feel free to contact me, Danielle Robertson, at DR Care Solutions, for an initial discussion.