If an individual’s psychosocial needs are not met the person can and usually does act out. I will explore these 9 needs. These include:
Sense of control
Love which includes intimacy
Try to remember just because your loved one has AD does not mean that they don’t recognize when they are dirty. For example, poor hygiene can make them feel bad even though they can not always express this. Clean hair or hair that is not brushed should be addressed in a dignified fashion. Make certain that their clothing fits properly, clothing that is too tight or too loose can make them feel undignified.
It is very easy to fall into a pattern of treating the person without respect without knowing you are doing it. For example, failure to look into the persons eye when you speak to them. Speaking too quickly is a common complaint. Make certain that your verbal cues are clear. Watch your body language. Try to avoid embarrassing moments of prompting the individual in public. You think you are being helpful; the older generation looks at this as lack of respect.
It is very important to reinforce who your loved one once identified themselves to be. For example, if they are a plumber have items around that remind them of being a plumber. I.E. PVC pipes. When I owned and operated my adult day center Lowes donated small kits which they used in their weekend workshops. The carpenters loved to make small bird houses, small cars and airplanes. It took minimal amount of work on the part of the staff and within a day were able to complete the project from start to finish.
I refer to this as their personal key. Every person has a specific key to break through their memory barrier.
One of my guys was an engineer. I purchased light bright and he spent the day filling in the pegs. When he completed this task, we placed the battery into the light bright and had him switch the board on. He believed he just build a circuit board. The joy on his face when he completed this task as priceless.
These are a few ideas to help the individual identify with who they use to be and making a connection to today. As a family member you can help caregivers outside your familiar circle communicate with your loved one. Provide items that have meaning, pictures with the names and dates of their loved ones.
Sense of Control
This section is helpful when your loved one gets frustrated easily. Find simple tasks that are easy to complete. For example, puzzles are a great task that can start out as difficult I.E. 1500 then 1000 down to 500, 300, then children’s sizes. I found puzzles very useful to give the individual a sense of control. Puzzles are also very helpful when you are attempting to have simple conversations. Be very supportive and provide a safe environment.
Whenever possible plan activities to highlight your loved one’s strengths. Always praise accomplishments. Show acceptance and be non-judgement. Simple Activity of daily living (ADL) can be a challenge. Always praise their effort. Try not to fix the buttons if they are not correct. It can frustrate the individual and make them feel useless. I learned this the hard way when I offered to assist with helping with putting on boots. I was very quickly reminded that my help was not appreciated and that the person I was trying to help was not incompetent. I thought I was being helpful and considerate. It was not at all received that way. Important side note. It is not about you at this moment. Try not to take it personal. They forget within a few minutes, you on the other hand must remember its not personal.
It is easy to believe it’s faster and easier to get the task done by excluding the individual. Unfortunately, you are inadvertently decreasing their sense of belonging. Depending on the individual it can cause them to act out. To avoid this mistake, include others in the family. Invite all age groups to participate. Children are a wonderful positive distraction. Be aware if you made this mistake your loved one could suddenly become introverted. They may use words like; “I just want to be left alone”. If possible, allow them to pick the activity. Remember this is your loved one. You know them best. Go with your gut. Keep trying different things to help them remain part of the group.
Humans need love. Plain and simple. Regardless of age. Simple tasks can include holding hands, soft touch, and hugs. As a professional, I always ask, as a family member you know the limitations of your loved one. In certain cultures, and religions touch may or may not be acceptable. Speak softly whenever possible. Even if you are getting frustrated. I can honestly say this is very hard to do when the person you love is being difficult. Always make the effort to respect traditions, share memories and hug when possible.
This section is not only about the environment in which your loved one resides, but also their personal sense of security. Always, provide a calm and predictable environment. Consistency is crucial. For example, the what time they wake, shower, dress, eat, and activities need to be as close to consistent as possible. Offer physical and verbal assistance. I still make this mistake because I want to help and just start doing. I assumed and I forget to ask first. If you provide an accepting and loving environment, negative reactions can be avoided.
Meaning and Purpose
Provide structure and consistency as discussed. Provide meaningful activities that can be completed in a timely manner. This gives a person a sense of purpose. One of my clients would wander. I could get him to sit still if I gave him a pile of towels to fold. He would spend hours folding them. I knew he had a helpful personality and I told him I needed his help. He felt honored. He also loved to help in the kitchen. I allowed him to wash the veggies, and fruit. He was also allowed to help set the table. He had purpose.
One of my favorite stories is about one of my veterans. He was an officer in WWII. He had what is called expressive aphasia. This means he would jumble his words. His brain knew what he wanted to say but there was a disconnect when he tried to speak. I could not figure out what to do to keep him engaged. I tried music, card games, puzzles, and crafts with no success. One day I was setting up the activity board for the month and had placed colored pencils, paper and stencils on the table. He walked into the room and saw the supplies. He clearly and with joy said; “Stencils”. He picked up the stencils and paper and started to color. It became his job to help with the activity board. He had meaning and purpose!