Often, when I begin a consulting or training relationship with a care partner for an individual living with dementia – whether that care partner is a family member or a paid professional – I confront an essential misunderstanding in what it is we hope to accomplish. This happens when people call upon my services with the belief that I am going to teach them some tricks that will make their loved one living with dementia behave as they want them to.
It doesn’t work like that. It never works like that. Whether it manifests in memory loss, poor judgment, or sensory degradation, the core cause of dementia is change that comes from the slow destruction of the brain on a cellular level; not from internal electrical or chemical “processing errors” that can be altered with psychotropic drugs.
Still, there is this deep-seated belief that we can apply medication, some form of persuasion, or some technique of deception that will cause the person with dementia to see the light, stop their nonsense, and return to the manageable person they used to be. I repeat, it does not work that way because their brain is dying; literally and irreversibly!
The foundational step in dementia care training is to help the care partner understand that their person is not trying to give them a hard time; they are having a hard time. What they are experiencing is more harrowing, frightening, and lonely than we can possibly imagine. And we must understand that it is entirely outside their control.
So, we cannot use persuasion, bargaining, trickery, or any other logical process to make them change their behavior. Rather, we must understand, to the best extent we can, why they are behaving the way they are, then alter our own behavior to avoid the words or actions that make matters worse.
This isn’t easy. Understanding what is happening to their thinking processes is a deep study that we probably can never master, though we can move toward mastery. It reminds me of the mystical song by Donovan (am I dating myself?): “First there is a mountain, then there is no mountain, then there is!” We embark on this learning journey with the belief that we can arrive at a destination where we know how to make our loved one behave. Then we realize this destination does not exist.
But we continue on, and suddenly, as in the song, a mountain does appear! We learn that there is a way to achieve less troublesome behavior from our loved one, but it is not the destination we thought it would be. The path to this different mountain is through changing ourselves.
We learn compassion, we learn to change our expectations, we learn to focus on their abilities rather than disabilities, we learn to validate rather than contradict, and we learn to apply empathy rather than logic.
Most important of all, we learn that our loved one indeed can still change and learn, but they do so through feeling, not thinking. When we learn to selflessly bring joy, hope, and pleasure to their dark world, they will respond.
Melody Beattie, who is arguably America’s foremost expert on codependent relationships, says, “The only person you can change now or ever is yourself. The only person that it is your business to control is yourself.”
This statement is never more valid than when it applies to the relationship between a care partner and their loved one with dementia. It is not an easy journey, but the results are worth it because we both deserve the best.
Until next time remember: “We all deserve the Best”
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