By Thomas Baird LCSW, MDiv
In this space, we will regularly be sharing resources that we find may be helpful for caregivers. The content provided is intended for informational purposes only. The materials included do not constitute an endorsement of the authors or their materials by Awkward Story.
TimeSlips offers training, guidance and resources promoting what they call "Creative Meaningful Engagement." They acknowledge that communication can be difficult for family members, and claim to provide tools and framework to create positive engagement and interaction. This post is certainly not an endorsement or a critique of their program. I am posting this because the primary advertisement below does a fine job at capturing the role of imagination and exploration in our efforts to engage our loved ones with dementia. In my opinion, they correctly identify the barriers that occasionally get in our way when we communicate in a traditional fashion. Please see the video below, and feel free to explore their website here.
They also provide an example of a creative story telling session which captures the myriad responses one might receive when prompting elderly individuals with pictures.
By Thomas Baird LCSW, MDiv
In this space, we will regularly be sharing resources that may be helpful for caregivers. The content provided is intended for informational purposes only. The materials included do not constitute an endorsement of the authors or their materials by Awkward Story.
The Alzheimer's Poetry Project (APP) was created by Gary Glazner to promote engagement and creativity among individuals with Alzheimer's, through poetry. Please feel free to review some of APP's media below. Like the TimeSlips program, this one promotes expression through creativity and imagination, rather than relying on concrete memories that might not be readily available.
Spoiler Ahead: We recently interviewed Gary Glazner and will be featuring the interview on our podcast in the near future. I started writing this post before we booked the interview, and published it after speaking with Gary.
In this episode, Maggie and Thomas interview Jason Bloome, founder of Connections Care Home Referrals. Jason started Connections nearly 20 years ago after being inspired by his own personal caregiving experience, with a desire to help low-income families find caregiving options for older adults. Jason discusses how certain policy limitations effect access to assisted-living care for older adults. He specifically discusses the limitations of Medicaid programs in California and how policy changes could potentially make Medicaid money available to individuals seeking assisted living options.
Raman Mohabir is a Hospice Bereavement Coordinator specializing in grief, bereavement, and support group facilitation. She has over five years of experience facilitating bereavement groups for children, adolescents, young adults and adults. In this interview, Raman shares her insights concerning the many manifestations of grief, and the group gives particular focus to the caregiver's experience of loss and grief.
Ymkje Dioquino, MS, LMFT is the Chief Operating Officer of the Presence Care Project in San Francisco, CA. She is also a Family Care Therapist at the Ray Dolby Brain Health Center in San Francisco, where she provides psycho-therapeutic services and support to persons with Dementia and their families and friends. She has practiced mindfulness since age 19 and started teaching Mindfulness Based Dementia Care (MBDC) in 2014. She was kind enough to speak with us concerning mindfulness practice and caregiving. Mindfulness practices can be an excellent, life-giving resource for caregivers feeling exhausted from their work. Please listen!
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.
Thomas Baird LCSW
Maggie Dawson MSW