Anne Hanenburg is a landscape architect specializing in Dementia Design and Healing Gardens. She was gracious enough to speak with us about the significance of the physical environment in dementia care settings. Whether your loved one is living in a memory care community or at home, these dementia design principles can be very insightful. Listen below, or wherever you get your podcasts.
PK Beville is the founder of Second Wind Dreams and the creator of the Virtual Dementia Tour. In this interview, PK discusses the Virtual Dementia Tour and the research behind it. The VDT is a dementia sensitivity training designed to educate and empower caregivers by offering better understanding of their loved one's experience. The training involves a simulation of the dementia experience, as well as an opportunity to reflect on observations made during the simulation. In creating the Virtual Dementia Tour, PK was attempting to offer useful insight to individuals tasked with providing care to dementia patients. Here, she discusses the initial research that supported the development of the VDT, as well as the continued efforts to perfect the training.
Author: Thomas Baird, LCSW, MDiv
Quick reminder: In this space, we will regularly be writing about topics pertinent to dementia care, while focusing on articles, books, or online publications that have caught our attention. See our first post for more details.
"Dolls bring comfort and offer the ability to nurture. They aren't something I would offer to someone newly diagnosed with dementia but rather for someone in the latter stages of the disease. Seeing your parent interact with a doll as if it were a real baby might make you, the child or caregiver, uncomfortable, but this is usually not the case for your parent." (Activities to do with your Parent who has Alzheimer's Dementia, Judith A. Levy, EdM, OTR; p. 55)
"Consider purchasing a doll and leaving it on your parent's bed as a decoration. He or she will choose to hold it or not when he or she is ready. Whether to interact with the doll will be your parent's decision, but you will have provided the opportunity." (Activities to do with your Parent who has Alzheimer's Dementia, Judith A. Levy, EdM, OTR; p. 56)
This subject is a very controversial one. Dr. Levy is not alone in her suggestion to provide people with dolls, as many Memory Care communities have used dolls to promote a sense of responsibility, nurture, and attachment for their residents. Her method is purposeful, as well. She specifically asks that the doll be left in a public place so that the individual can choose whether or not to take it. Several studies have revealed positive outcomes for residents that interact with dolls. On the other hand, some family members and dementia care professionals will question the effect doll therapy has on a patient's dignity. As Dr Levy mentions, it may be extremely difficult to see a distinguished, accomplished, adult playing with a child's toy. This article explores the ways that doll therapy may be perceived as inappropriately childish. Other articles will point to pet therapy as a more dignified alternative, as it allows individuals to exercise their need to nurture while not evoking child-related themes.
There are many congruent and competing psychosocial interventions for individuals with dementia. This integrative review of psychosocial interventions, by Bridget Johnston and Melanie Narayanasamy, categorizes the varying goals of each intervention. It identifies legacy, personhood, and engagement as three essential themes that caregivers wish to instill in their caregiving work. In my brief eight-year experience in this field, I have found these three categories to be consistently reflected in care. Johnston and Narayanasamy found in their review that psychosocial interventions will often do one or more of the following: 1) promote one's legacy, 2) reinforce their personhood, or 3) encourage engagement/comfort among our patient population. These interventions thus appropriately honor the history and ongoing legacy of our patients, while also acknowledging the needs caused by their cognitive impairment.
I personally find that our interventions should be measured collectively rather than individually. We should make efforts to reinforce personhood, provide engagement, and promote legacy through a combination of interventions. With all that said, these decisions come down to what family and patient find most appropriate and engaging. None of these themes should be deemed unimportant.
In closing, I leave the decision regarding Doll Therapy to our readers and their families. There are certainly documented benefits, but there are also emotional costs for loved ones, and possible dignity concerns. Feel confident in your educated decisions, and know that people may disagree with you. Diversity in care will only improve how we as a society continue to view individuals with dementia. We must above all remain open-minded, continually educated, and focused on the continued well being of our loved ones.
We are back with another interview! This week, Thomas interviews Lisa DiPalma, Physical Therapist Assistant. Lisa has been working in the field of Physical Therapy for ten years, with the majority of her work being with the geriatric population. During our interview, she discusses the benefits of physical therapy for individuals living with dementia.
We recently released an episode about mindfulness meditation for people with dementia. However, let's not forget that you (caregivers, family members, friends, professionals, etc.) can also benefit from this practice!
Mindfulness has become a bit of a trend lately, and there's a reason for that. It is something that anyone can learn and, for many people, it works! It reduces stress, improves mood, and according to one study can even reduce bias. But what about for caregivers?
Well, as it turns out, there are numerous studies that have looked at mindfulness specifically for caregivers of individuals with dementia. It's not a magic cure, but the studies do show that it can help reduce stress and anxiety for these caregivers. I find it especially relevant because mindfulness is all about being present in the moment, and for many individuals with dementia, the MOMENT is all they can see. It may not work for everyone, but it is certainly worth trying.
I'm including my sources below as well as a quick handout I made about mindfulness meditation. We hope you find them useful! Let us know if mindfulness meditation has worked for you.
Epstein-Lubow, G., Mcbee, L., Darling, E., Armey, M., & Miller, I. W. (2011). A Pilot Investigation of Mindfulness-Based Stress Reduction for Caregivers of Frail Elderly. Mindfulness, 2(2), 95-102. doi:10.1007/s12671-011-0047-4
Li, G., Yuan, H., & Zhang, W. (2016). The Effects of Mindfulness-Based Stress Reduction for Family Caregivers: Systematic Review. Archives of Psychiatric Nursing, 30(2), 292-299. doi:10.1016/j.apnu.2015.08.014
Oken, B. S., Fonareva, I., Haas, M., Wahbeh, H., Lane, J. B., Zajdel, D., & Amen, A. (2010). Pilot Controlled Trial of Mindfulness Meditation and Education for Dementia Caregivers. The Journal of Alternative and Complementary Medicine, 16(10), 1031-1038. doi:10.1089/acm.2009.0733
Whitebird, R. R., Kreitzer, M., Crain, A. L., Lewis, B. A., Hanson, L. R., & Enstad, C. J. (2012). Mindfulness-Based Stress Reduction for Family Caregivers: A Randomized Controlled Trial. The Gerontologist, 53(4), 676-686. doi:10.1093/geront/gns126
Thomas Baird LCSW
Maggie Dawson MSW