May 17, 2005


Dementia a progressive brain dysfunction, leads to a gradually increasing restriction of daily activities. The most well-known type of dementia is Alzheimer's disease. Dementia not only affects patients, but also those surrounding them, as most patients require care in the long-term.

Tips for dealing with dementia sufferers

The basis of the relationship is the absolute and unconditional esteem for the patient, the love for him/her, the struggle for the acceptance of this person with his/her illness. This emotionally dedicated esteem has to be constantly renewed even in crisis situations and does not go without saying. Acceptance of the patient and the situation also means setting limits, taking responsibility and leadership, providing orientation. It is, however, necessary to react to their behaviour in an adult manner and not to embarrass the patient.

You will not succeed without empathy in gaining access to the inner frame of perception and behaviour, in understanding the emotions and feelings of the patient. If the efforts to understand wane, there is a risk that people with dementia become objects of nursing and disappear as a person. There are limits here as well: we cannot understand everything and there is not a convenient theory for every anomaly of behaviour. One must try to accept this as well, to accept what cannot be understood.

Sincerity and truthfulness substantiate sensitive understanding and esteem. One has to be completely genuine provided this does not harm or hurt the patient. Pretending to have more esteem than one really feels undermines relationships. One reacts false using friendly facades, ambiguity, artificial role play, emotionally shallow encounters. People with dementia notice this and reject or retreat - caring for people with dementia means to make your own self available, the whole range of your ability for affection.

It is important to understand the inner world of the care receivers, to foresee their plans, to supplement and to enable again and again a small feeling of success. Behave like a tennis coach who plays the ball to a pupil in a way that he can return it.

Create a reliable daily routine with small rituals (from washing hands, saying prayers, preparing food, cleaning and singing to a little dancing before bedtime). Activate the patient in the framework of this routine without too little or too much demand. Existing capabilities should be used if possible because self-esteem relies on their use. Discreetly link into former habits, weave in memories, give the patient things to hold which represent parts of his/her life (christening candle, child's hat, wedding veil). Remember that the focus is always on the experience and not on the result. Feeling good preserves the feeling of being a person.

As the disease progresses, the body very much becomes the focus. Physical closeness, touching hands, gestures and eye contact, firm grip of the other with your own body, showing your own feelings creates a warm sense of security, closeness and comfort.

Try to communicate attentive calmness: allow unusual behaviour, reduce your rejection of bizarre behaviour and take care that your relative does not endanger himself. Resist the impulse to intervene and ask yourself from time to time what is the meaning of a particular type of behaviour and what 'pleasure' is behind it.

Obtain relief for yourself. People are not made to constantly carry such loads on their own. Take care of your own body, your relationships and interests and get outside help in time. The sooner you accept help, the longer you can be a partner to the person with dementia.