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Sunday, 19 March 2017

Best Friends with Dementia and Alzheimer’s

Every person diagnosed with Alzheimer’s disease or other dementia deserves:
o   To be treated as an adult, listened to, and afforded respect for one’s feelings and point of view
o   To be with individuals who know one’s life story, including cultural and spiritual traditions
o   To experience meaningful engagement throughout the day
o   To live in a safe and stimulating environment
o   To be outdoors on a regular basis
o   To have welcomed physical contact, including hugging, caressing, and handholding
o   To be an advocate for oneself and for others
o   To be part of a local, global, or online community
o   To have care partners well trained in dementia care

Also at the core of Best Friends is the understanding that good dementia care begins with acknowledgment of a person’s life story

Because people with dementia often can no longer tell us their histories, care partners must become their biographers, even if it means becoming a good detective.

The more any care knows about a person, the more he or she can use the Life Story to improve interactions and care, including a good detective.
o   Greeting the person and improving recognition
o   Introducing the person to others
o   Reminiscing
o   Improving communication through clues and cues
o   Designing appropriate activities
o   Pointing out past accomplishments
o   Helping to prevent challenging behaviours
o   Incorporating past daily rituals
o   Broadening the caregiving network and resources

Knack: Defined as “the art of doing difficult things with ease,” the Knack represents an attitude and set of skills that guarantee the success of the Best Friends™ approach.
Having the Knack entails
Knowledge: understanding Alzheimer’s disease and the experience of the person with the disease
Nurturing: through the Life Story, making care relevant to each person
Approach: effective communication with the person with dementia
Community: facilitating successful activities
Having the Knack entails
Knowledge: understanding Alzheimer’s disease and the experience of the person with the disease
Nurturing: through the Life Story, making care relevant to each person
Approach: effective communication with the person with dementia
Community: facilitating successful activities
Kinship: including family and friends in the care program*

* Source: The KNACK Learning Framework™ from the licensed Best Friends™ Approach Associate Trainer Program created by Alzheimer Society Calgary (Canada).

The elements of Knack central to the Best Friends approach include:
o   Valuing the moment
o   Being well informed, having empathy and Respecting the basic rights of the person
o   Maintaining integrity, using common sense and Communicating skilfully and Being non-judgmental
o   Maintaining optimism Setting realistic expectations
o   Using humour, employing spontaneity and Maintaining patience
o   Developing flexibility and Staying focused
o   Maintaining self-confidence

Communication: The Best Friends philosophy of communication is grounded in a set of core principles:
o   Remember the basics of good communication
o   Understand the person’s desire to communicate
o   Make a good first impression
o   Create an environment that facilitates good communication
o   Treat the person as an adult
o   Maintain caregiving integrity
o   Respond to emotional needs
o   Remember the importance of nonverbal communication
o   Remember that behaviours communicate a message
o   Do not take the person too literally
o   Employ good timing
o   Use repetition to facilitate better communication
o   Do not argue or confront
o   Screen out troubling messages or news
o   Speak using positive language
o   Employ humour in communication
o   Do most of the work

Mindful Listening: Learn to Communicate Without Words

Bringing Joy to a Person with Alzheimer’s Isn’t Tough
When relating to a person with Alzheimer’s there are many guidelines to follow. Below are five of the most basic ones:
Don’t Tell Them They’re Wrong About Something:
To let the person, save face it’s best not to contradict or correct them if they say something wrong. There’s no good reason to do that. If they’re alert enough, they’ll realize they made a mistake and feel bad about it. Even if they don’t understand their error, correcting them may embarrass or be otherwise unpleasant for them.
Don’t Argue with the Person:
It’s never a good idea to argue with a person who has dementia. First of all, you can’t win. And second, it will probably upset them or even make them angry. The best thing to do is simply change the subject – preferably to something pleasant that will immediately catch their attention. That way they’ll likely forget all about the disagreement
Don’t Ask if They Remember Something:
When talking with a person who has Alzheimer’s it’s so tempting to ask them if they remember some person or event. “What did you have for lunch?” “What did you do this morning?” “Do you remember that we had candy bars when I visited last week?” “This is David. Do you remember him?” Of course, they don’t remember. Otherwise they wouldn’t have a diagnosis of dementia. It could embarrass or frustrate them if they don’t remember. It’s better to say, “I remember that we had a cup of tea and a giggle the last time I was here. It was wonderful.”
Don’t Remind the Person that a Loved One Is Dead:
 It’s not uncommon for people with dementia to believe their deceased spouse, parent or other loved one is still alive. They may be confused or feel hurt that the person doesn’t come to visit. If you inform them that the person is dead, they might not believe it and become angry with you. If they do believe you, they’ll probably be very upset by the news. What’s more, they’re likely to soon forget what you said and go back to believing their loved one is still alive. An exception to this guideline is if they ask you if the person is gone. Then it’s wise to give them an honest answer, even if they will soon forget it, and then go on to some other topic.
Don’t Bring Up Other Topics That May Upset Them:
There’s no reason to bring up topics you know may upset people. If you don’t see eye-to eye on politics, for example, don’t even bring it up. It may just kindle an argument, which goes against the second guideline above. You won’t prevail, and it’s just likely to cause them anger and/or frustration.
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