A 95 year old woman diagnosed with dementia, presumably close to the last stage was crying out loud "pains, pains, pains" and so on. She would not talk to anyone in any clear language. She could not eat, neither did she want to drink to lubricate her presumably dried throat. She was then placed on drip to prevent dehydration.
She set a fixed gaze at a particular nurse, who eventually tried to communicate with her in a non-verbal language. She was then softly caressed on her cheeks, hair and arms. She kissed the nurse's hands twice and asked the nurse not to go away, all in a very clear voice, took her drinking water and drank enough.
That is an example of "high touch" approach that is more appropriate than "high tech" in management of patients with advanced dementia. This strategy constitutes a nursing program called Namaste Care that places patients with advanced dementia in a comfortable environment, in presence of others and provides one-to-one attention described in the previous communication. Interested people may want to get "The End-of-Life Namaste Care Program for People with Dementia" by Joyce Simard, MSW, published by Health Professions Press in 2007 and available from Amazon.
It is a valuable information.
Recently, we find dementia problems on the higher side,among people who are "not so old"- I mean those who are in late fifties or early sixties? Is" mental stress" , a trigger for these changes OR anxiety complex?
Any research experience OR Evidence based observations are there?
There are many factors, depending on the person's place of birth and or where he grew up or became old. The term aged or being old may not only be quantified by numbers, rather by the factors surrounding the person's life style and profession. Alcohol abuse and the like, like heavy smoking may make the brain to start degenerating.
I once had a client, he was about near his 60s, but has had this problem earlier, so before his 60th birthday, he had been diagnosed with dementia. Where did it start from, heavy drinking and smoking. He became alcoholics and was on therapy. His condition became complicated, before dementia was diagnosed.
Basal Stimulation versus Basal Validation - which of the two methods is more effective and result-oriented in communicating with a dementia patient in the third stage? ***
About the dementia patient I was earlier writing about. I do not know why she is still lying in the hospital, she seems actually not suppose to be in that particular department. I think she does not belong there, rather, some other special unit for patients with dementia. Although she was brought from a nursing home, so I would not know if she has an organised biography, because I could have been able to trace how to locate her attention. One could get this from a family member or those that have been caring for her till now.
I was thinking of the Naomi Feil's method of Validation.
She spoke some words today, she said " bitte ein stueck Brot" meaning "a piece or slice of bread please" A what happened when I brought her the slice of bread? She took I wanted to help her, but she refused, so I gave it to her. Wow she actually ate everything up and drank herself. She still has a great resource. She does not completely rely on help, but support and guidance. She was calling "gross Mutter, gross Mutter", meaning "grand mother, grand mother". She does not like to be in bed, she always kept calm for sometime when allowed at the passage where she could see people.
When her daughter came around last week, she was mostly calm as she felt loved, her daughter's presence was like warmth to her.
I am afraid she may harm herself if she could, because she is sometimes weird.
Dr. Aledeh,
Thank you for providing your experiences with patients. But , I know a person who developed this; that person was not alcoholic but had so much of mental stress through out life, but courageously faced situations till the last 2-3 years before developing dementia and finally yielded to it..
It is an important thing to make more people- scientists, common man and society as a whole- about the causes of Dementia problems, preventive measures, if any (like 'yoga' or counselling when one is stressed) and how to understand the expressions of such patients.
Now many researchers are focussing on Alzheimers'(AD) and Rheumatoid Arthritis (RA) which have no cure but the patient has to be helped to live better. Thiese two diseases/conditions are now drawing more attention ,next to cancer and HIV that are already researched, for more than (1 to2) decades.
Thanks for the comments and response. I am but not a doctor yet. Regards
Dear author, thank you for sharing this excellent question.
I agree with Dr Ladislav Volicer and Dr Mohammad.
With kind regards.
See this link
ng-memory-loss-to-self-pathology/non-pharmacological-treatment-of-alzheimer-s
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