Sunday, December 4, 2016

What Remains Is Only Love!!

Lori and her mother rented a van to travel to her mother's hometown. Her best friend Betty had called months ago to remind Lori of their high school class reunion and was focused on making a reunion happen for Lori's precious mother who endlessly talked about going home. Home, to Lori's mother was a green and white trimmed cottage on a lazy street in a small town where Lori's mother was birthed by a country doctor in a back bedroom underneath the shadows of the summer trees in 1930.  It had been 3 years since Lori and her mother had ventured North and there were a million details to review. Details common to people living with dementia such as: door alarms for wandering, provisions for bed wetting, personal hygiene items, healthy snacks, word searching puzzle picture books, ambulatory implements to avoid falls, and 3 or 4 soothing items for personal peace and security which included a stuffed dog, a favorite pillow, three stuffed pigs for cuddling and a framed picture of Lori's grandmother.  All in all after packing suitcases, boxes, medications, nutritional supplements and a few bags of shoes, Lori and her mother were ready for the drive.

After settling in with a seat belt and pillow, Lori's mother was ready for a snooze. Lori drove 3 hours up a mountain to pick up her sister and the three women continued driving North! After a night in a hotel room and 7 more hours of driving, the three women were only 45 mins away from their destination. And then it happened, a stab to the heart. Lori's mother woke up energized and with full awareness started commenting on cornfields and passing cars saying, "I can't wait to see the look on her face when she sees me. She will be so surprised and I am going to raid the icebox, first thing as soon as I walk in. It's been way too long, and I am going to be so happy to be home again in my own house! I miss my mother so much, I can't wait to see her again!  It was nice of you both to bring me home, I can't thank you enough!!"

Heartbreak. The visual impact of such a precious, sweet memory of love, acceptance, and longing left everyone in the van silent because 2 of the three women knew that there would be deep disappointment if Lori's mother knew the reality of the situation. Lori's grandmother had been gone of over 30 years. Her mother would not only miss seeing Lori's grandmother on this trip,  but her childhood home had been sold and remodeled. What would happen if they drove by and Lori's mother would insist on going in to see her deceased mother??? The women in the van both knew enough to keep silent and to allow their mother to reminisce. The moment of recognition and sudden awareness needed to be honored and led by the person with dementia, not the other way around.  The knee jerk reaction with such discomfort felt by caregivers would be to correct the person with dementia and to orient them back into the present time reality. This is so incredibly cruel and plays out every day by people who do not intent to be cruel, but who fail to look at each situation that comes up from the eyes of the carer (ie: the person with dementia.)  Both women in this situation knew enough to follow their mother's lead and thus remained silent.

Lori's mother was in her own reality of splendor smelling her mother's freshly baked cookies, seeing her mother's loving face, raiding an antiquated 1940's icebox filled with her mother's own cherry pie and ice cold baked chicken legs. These emotions  were able to bring about comfort and great happiness to Lori's mother who beamed radiantly with a smile from ear to ear as she rode in the back of the van. So, sometimes rather than anticipating a possible scenario and how it relates to what is being said, having no reaction or level of judgement is the best policy.

Validating the memory experience of our loved ones with questions via Naomi Feil's Validation Breakthrough book is a great reference for building qualified dementia communication skills.  Questions that Lori asked her mother were: "What cookies did grandma like to bake and store in the icebox? What do you think grandma will say to you when she sees you again?"  Is Lori wrong or right engaging in these questions??? It is important to validate BEFORE we redirect in order to honor the emotion. (And who's to say that Lori's mother will not one day see her beloved mother again in heaven having the ultimate reunion of unconditional love and eternal oneness?? Right??)

  Many times in life our memories are not so much about WHAT happened, but how we FELT in the moment about what happened which is what comes up when we remember things. So,  this type of questioning a person with dementia offers a way to give comfort, and to nurture the memory of the moment thus bringing the moment back to the person in present time consciousness. So, an important consideration for caregivers who are working with loved ones who are challenged with dementia is this:   Caregivers need to follow the lead of the person with dementia and go with them into their own reality. FOLLOW THEM, that is the most important skill a dementia caregiver can attain.  And do this with love and reverence for the process without the need to control, to prematurely redirect or to judge - THAT is the key and it takes practice to master this!  Give them a space of silence and then give them an opportunity to lead into their own healing experience. It is about THEM not YOU. (I mean this in full respect for everyone who is a caregiver. This is a very difficult road we are all on, and all of us can easily feel victimized by our care-giving opportunities. Many family caregivers never expected to be caregivers in the first place. )  However, if dementia caregivers begin to allow themselves to be led by the person with dementia into their own reality,  they will find a level of deep and profound connection and peace in all care-giving activities.

 Remember, this journey of dementia is to walk them home. And what is home??? The elderly will constantly reference home and the caregiver whether he or she is working in an institutional setting, or in a home setting will have huge pangs of emotions where they know they can never ever provide a visit home for the person under their care. This can bring up guilt, sadness, anticipatory grief, etc.  But what is home to the person with dementia??? This is a very interesting question. According to Naomi Feil, MSW, an expert on dementia communication - home has to do with feeling secure.  It is not merely a physical place, but a feeling of being heard, and being safe. And this is what we create for the person when we connect with them on their own terms. Home is what we create for a person with dementia when we follow their lead, etc.

After visiting with friends at the class reunion,  Lori's mother mentioned that she wanted to see her house. So, Lori and her sister drove her mother by her childhood home. As the van pulled up to the house it was painted in another color, the hedge by the sidewalk was gone, the swing by the garden was gone and a deck had been constructed in place of the old porch on the back of the house. Lori and her sister sat in silence with their mother and waited for her reaction, following her lead. "This is it. This is where my mother lived for so many years. So many memories, and look at that deck. That was never there before. So many changes." That was it. There was an immediate connection to reality and a desire to visit her mother's grave. No other mention of seeing her mother or eating snacks from the icebox.

As the women drove out of town their mother thanked them for bringing her home. After they returned, Lori's mother completely forgot about her visit to her hometown but has enjoyed the pictures of her friends at the reunion and her family that she was able to see. Ironically, since her visit to her hometown, Lori's mother rarely mentions wanting to go home, which in the past always referenced wanting to go home to see her mother.

Positive Communication methods for people living with dementia:  We recommend seminars by Teepa Snow,M.S., OTR/L.FAOTA, Naomi Feil, MSW,, and her books, all of them. And the life changing, ground breaking books, "Contented Dementia," by Dr. Oliver James, "The Mindful Caregiver," by Nancy L. Kriseman, and "Deeper Into The Soul," by Nader Robert Shabahangi, Ph.D, and Bogna Szymkiewicz, Ph.D

Copyright 2015 Caregivers Get Fit! Mama  Nicey

 DISCLAIMER:  The information in this blog is information only for educational purposes. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. It is advised that before starting an exercise program, or making dietary changes of any kind, to seek out the advise of your own individual health care provider first.  Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.

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