Showing posts with label eyesight. Show all posts
Showing posts with label eyesight. Show all posts

Tuesday, 10 July 2012

A sensory journey

In everyday life we can often take being able to see, hear, smell, taste and touch for granted. Senses give context to the mundane, stir our emotions, affect our body language and have the power to make the ordinary, extraordinary.

Many of us will spend much of our disposable income on making our homes and our lives as appealing for our senses as possible, so it is obvious that applying that same focus to the environments and lives of people with dementia can make a huge difference to the quality and richness they find in each day.

Bland, sterile, faceless environments do not benefit people with dementia. From contrasting colours to calming music or voices, aromas that stir fond memories, favourite foods, and compassionate reassurance to alleviate anger or remove fear, the opportunities to enliven the senses to bring positive therapeutic benefits are extensive, and yet they are often not fully explored.

In some care homes sensory rooms have become very popular, not least because staff who were perhaps sceptical previously see the clear benefits on their residents' moods, emotions and wellbeing. These rooms can have a wonderfully calming effect on people who are experiencing agitation due to their dementia, and are as valuable as other standalone therapies like music (that I wrote about here) art, gardening or exercise.

Soft, possibly coloured lighting, tactile fabrics, comfy chairs, delicate aromas, relaxing sounds and, crucially, the opportunity to put the person with dementia in charge of what they do by making the room safe for them to move around and try different sensations, is a very enriching activity, particularly when enjoyed with loved ones, offering the chance for renewed family interaction and exploration.

I have visited care homes where they have interpreted the idea of sensory areas in many different ways, for example through having daylight rooms, beach rooms (complete with sand and gentle wave sounds), and sensory gardens with waterfalls and pathways that have been planted up with tactile plants and scented flowers. Conversely I have also walked down many corridors that offer no stimulation, with rooms leading off of them that are virtually identical, and people sat blankly staring into the distance while others are agitated or wandering around a seemingly never ending space that offers them nothing for their wellbeing. The difference in these atmospheres is what separates person-centred care from conveyor-belt care.

For our part, we tried to make my dad’s room a place of sensory delight. For dad, a particularly successful therapy was that of touch. Having been an active farmer all his life, his hands were desperate to be busy again, and without something to hold he was at a loss with that to do with them. Life-like miniature versions of farm animals were dad’s salvation; their soft faux-fur was perfect to stroke, and he could hold one under each arm to cuddle.

This approach was successful because not only did it solve the idle hands problem that dad was experiencing, it solved it by tapping into the touch sensation to calm and relax him. As in all things dementia related, personalisation is the key to therapeutic interventions, and this becomes even more important when the person with dementia has limited or completely non-existent use of one of more of their senses.

Dementia can create huge isolation by its very nature of putting the person with it into their own world that none of us can truly be a part of, but when someone cannot see or hear what is happening to them, who the people are around them and why they are being offered or given particular care, the world is an altogether more frightening place.

A lot of dementia training focuses on explanation and demonstration, not taking into account what happens if the person with dementia cannot benefit from that. If someone cannot see that a carer is trying to feed them, or cannot hear what the meal is and that it is now time to eat, they are likely to panic. If you were blindfolded, given ear plugs and then had someone jabbing at you with a spoon you would probably panic too. Therefore assessing someone’s sensory abilities, whether that be through checking their hearing, eyesight, ability to respond to taste (sometimes tastes need to be stronger as taste buds become duller) and smell (my father could not remember how to blow his nose for the last few years of his life, meaning that he had a permanently blocked nose and sneezed daily) is extremely important so that when it comes to touch, this is appropriate, expected and welcomed.

Touch is what ultimately brings true compassion, and can, when part of person-centred care, compensate for the deterioration of any of the other senses. Touch reminds us of how we are nurtured from birth, and for someone with dementia, those memories of being protected and loved are very empowering. Dementia is a hard road to travel, but making it a more sensory journey nurtures the person, and if there is one thing we would all like to be able to do for a loved one with dementia it would be to make life just that little bit easier for them.

Until next time...

Beth x







You can follow me on Twitter: @bethyb1886

Thursday, 28 June 2012

Little touches that make a BIG difference

One of the features of living with dementia is the constant battle over what the mind can help the body to do. As the disease progresses ability to do simple personal tasks, or even awareness that they need doing, can gradually decline, making assistance with things that were previously taken for granted much more important.

We all like to look and feel our best, and that certainly doesn’t alter when someone has dementia, even if they cannot articulate it. Their tolerance of having assistance may fluctuate however, as witnessed on the many occasions I battled to file my dad’s nails whilst he valiantly tried to prevent the emery board from doing its work.

Throughout every stage of my father’s dementia we strived to keep him looking smart and feeling as comfortable as possible. He was always a proud man, long before dementia ever came into his life, and it is almost as if his pride was transferred to us when he could no longer maintain the standards he had set himself.

Whilst it may sound quite simple, paying attention to the little touches that make life more pleasant is surprisingly time consuming. Apart from the shopping for clothes and bed-linen (dad had his own pure cotton sheets, since all three of his care homes used the cheapest, nastiest poly-cotton bed-linen that resulted in him sweating at night), I became an expert in keeping him clean shaven (if the carers had not had time), maintaining short nails (essential to limit his scratching) and regularly set up in the hairdressing room to perform my duties as a barber.

When someone is living with dementia, their perceptions of their appearance can alter quite dramatically. Mirrors are renowned to cause problems, usually because what the person is seeing does not reflect what they are thinking or expecting, and in my dad’s case when he caught his reflection in a bathroom mirror shortly after I had cut his hair one day, he exclaimed that he was, in fact, now bald! (He wasn’t).

Outside specialists came in to all three of dad’s care homes to offer chiropody and eye tests, but when dad developed severe problems with his teeth (long-standing issues existed anyway, but with his dementia keeping them clean was a massive problem), we had to run the gauntlet of dental services. Suffice to say that if doctors do not receive adequate training in dementia, many dentists receive even less, and the few that we saw clearly struggled to cope with a patient who could not understand instructions. However, numerous appointments later and dad’s rotting teeth had all been removed, which may sound very drastic, but poor dental health is known to cause problems throughout the body and is a massive infection risk.

Introducing a full set of dentures to someone without the ability to comprehend what on earth is being put into their mouth, and therefore being completely unable to co-operate with this alien invasion, proved very unsuccessful. Spending many years without a tooth in his head did not bother dad one bit though. His gums toughened up, his oral health was greatly improved, and his appetite remained one of the best, if not THE best, in the whole of the nursing home.

For dad, another major problem was his skin. Keeping him cool, particularly when he had no ability whatsoever to move himself, was a constant round of opening and closing windows, using fans, adding and removing layers of clothing, and hoping that the care home could finally get their antiquated heating system to offer gentle, constant warmth rather than blasts of hot and cold. Sweating meant itching, and with no ability to tell us when he felt warm or cold, everyone needed to be very mindful of his body temperature.

Bloodied scratches became a regular feature on dad’s skin, despite those short nails and us trying glove treatment, and indeed at one point a GP even declared that dad had scabies (he didn’t, but the hassle this diagnosis caused not just to the home but to us as his family in our homes – which effectively had to be pulled apart and everything washed – is the stuff of legend). Initially we trusted in the products prescribed by doctors to treat dad’s skin, but when it got worse, it was plainly obvious that all the chemicals and synthetic ingredients were making his skin, and his mood as a result, ten-times worse.

Investment in natural skincare products made a huge difference to dad’s life, and when the carers had the time to shower him regularly and apply body creams and lotions, his skin was calm and moisturised and his agitation disappeared immediately. To anyone else watching his distress, you would have been tempted just to pop a pill into him to calm him down, but a little thinking around the problem and a perfectly logical solution was found.

Our experience was always that such small, yet common sense steps had an amazing effect on dad’s quality of life. He was always the smartest resident in the home, but more than that, his personal care also brought him calmness and comfort that he could not possibly ask for but that he really needed. The things that many of us do regularly for ourselves can easily slip when someone has dementia, but just like the ladies in the home having their nails done or make-up applied, a little bit of pampering can become a fantastic therapy, as well as giving people with dementia dignity and pleasure, and there can be nothing more worthwhile than that.

Until next time...

Beth x







You can follow me on Twitter: @bethyb1886