“How Did You Know to Do That?”

Blog #18

She was crying so, so loudly! I could hear her down the hallway through my closed office door. This was not a small whimper, she was not in a good place emotionally, or maybe physically. I left my office, approached her slowly and calmly in the large group activity, wheeled her wheelchair to a quiet place down the hall, and gave her some mini-chocolate chip cookies and cold red juice that was nearby in the dining room. She went silent. At that point, a caregiver approached me, met my eye contact a bit mesmerized, and said, “How did you know to do that?” I responded, “How to do what?” She pointed to the cookies and drink, and a very peaceful and content resident. 

I’ve said it about one million times in my career, that dementia care is not intuitive. I will also say that being human caring for other humans is (or should be) intuitive. Humans have basic needs. We get hungry, thirsty, have to use the bathroom, value companionship, and the list goes on and on. As we age, or get dementia, those basic needs do not stop. In addition, it is good to know that some people with dementia can be very easily over-stimulated by being in the thick of a large group activity where the music is loud or people are laughing loudly. 

So how do we know that escorting a person away from some chaos and offering them a snack and cold drink might be for the win? Practice. Dementia care is chock-full of needing to be creative, intuitive, insightful, and most importantly, we need to know the person that has the disease. We need to know their personality, preferences, favorite snacks, what they don’t like, and what makes them comfortable. 

I often compare it to the acronym used in Alcoholic Anonymous groups: HALT. The idea is that if a person is Hungry, Angry, Lonely, or Tired, they are more apt to turn to an addictive substance or behavior. In many ways, dementia care is asking ourselves some of those same kinds of questions: are they hungry, angry, lonely or tired? But the list of additional options goes on and on. Do they need to use the bathroom, are their clothes too tight or scratchy, do they have a headache or pain somewhere else in their body? Are they constipated? Do they miss their loved ones? Do they feel out of control of their lives? Are they grieving? You get the idea. 

How did I know to do that? It is a mix of knowing the person and her preferences, and starting with the basics. I was lucky I figured it out that time. It may not have worked that gracefully the second time I tried. The point is, we need to stay flexible and curious, always looking and researching the need behind the behavior. Once it is figured out, life is much more peaceful for you and for them.