Get In Tune with Dementia
The National Institutes of Health (NIH) defines dementia as the loss of cognitive functioning — thinking, remembering, and reasoning to such an extent that it interferes with a person’s daily life and activities. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person’s functioning, to the most severe stage, when the person must depend completely on others for basic activities of daily living. It affects millions of people, and while more prevalent as people age, it is not a normal part of aging. It is caused by damage to brain cells, which in turn interferes with the ability of brain cells to communicate with each other affecting an individual’s thinking, behavior, and feelings.
My background in Sensory Processing gained from my pediatric days taught me not to forgo looking at dementia with a sensory lens, often there are changes with sensory processing that arise along with the other symptoms. From a sensory perspective, the brain will seek out what it needs, but not always appropriately. One aspect of the Sensory Integration approach is finding ways to provide the individual with what their brain/body is seeking, while at the same time training them to seek this input in an appropriate and safe manner. Developing a keen awareness of patterns in behavior is important in determining if these behaviors are of a sensory processing nature or simply a method to garner attention behaviorally. Being in tune with the various senses of the body including vestibular and proprioception (which I refer to as the grounding sense) are important in helping individuals to better modulate their sensory system.
Finding the reason for a behavior can promote increased safety and quality of life for the individual. Knowledge of how the sensory system works along with observation of how an individual interacts can provide valuable feedback about a given behavior, and by asking simple questions we can better understand and provide appropriate recommendations based off the information about how a person is processing sensory input.
For example: Are they having a tough time sitting still? Do they pace? Are they clumsy? Do they crave touch? Do they avoid touch, textures, or busy/noisy places? Do they hum? Do they bang their hands on hard surfaces?
I could spend all day talking about various tools and interventions utilizing a sensory processing approach, but the tool I wish to spotlight is music.
Music and Dementia
Music has the ability to break through cognitive barriers, where memories are locked away and thought to be forgotten and evoke feelings of comfort and happiness from an earlier time or event in the life of an individual.
Music and memories have a special connection with Dementia. Often, when all else fails, music prevails! It’s a beautiful thing to witness when someone who can no longer walk or engage in the most basic activity, listens to a song, and instantly lights up and starts singing, often verbatim the lyrics of a beloved song. For a moment in time, gone is that person who sits and stares into space, and we are privileged to catch a glimpse of the true person hidden behind a locked door that is called Dementia. Music is powerful and is invaluable to our therapy toolbox! It can help increase attention, improve cadence in walking, calm anxiety, and it can even brighten up even the worst of moods!
I’ve acquired quite the eclectic playlist over the years in working with seniors: hymns, Mozart, jazz, classic country, 1940s war songs, swing, Elvis and even some Beatles, but no matter what style of music, the common thread is that they were each a key that unlocked a door of hidden, once forgotten memories that lead to happiness!
“Oh, simple thing, where have you gone? I’m getting old and I need something to rely on…so tell me when you’re gonna let me in, I’m getting tired and I need somewhere to begin…and if you have a minute, why don’t we go? Talk about it somewhere only we know, this could be the end of everything. So why don’t we go? Somewhere only we know?” –Keane
I was listening to the lyrics of the song above one day, and the beauty of the words brought tears to eyes, as I was reminded of the sweet memories of time spent with my grandfather, who was diagnosed with early onset Alzheimer’s when I was a young girl. I can still recall his contagious smile, his quiet sense of humor, and his love for roasted peanuts. I also remember knowing a moment in time when something shifted abruptly. Gone was his smile to be replaced with eyes that reflected confusion rather than recognition. Suddenly I was not allowed to see him as often, I was told he was sick and needed rest, but I know now this was said to protect not just him but me from the things I was too young to understand. Dementia is not for the faint of heart. The song, “Somewhere Only We Know” may mean something different to others, but for me, it is a haunting reminder of what life is like for those living with dementia. I believe that if they could express what it’s like, it would sound quite like the lyrics above.
If I could give any advice on their behalf, it would be this: slow down, embrace the moment, find joy in the simple things together. Be present with them, listen to them, even if it doesn’t make sense, and smile often. Doing so gives them purpose and helps them feel needed. Isn’t that what we all long for?
Hope is the byproduct of compassion and quality care. By giving just the right amount of challenge to meet each individual where they are, we give them the chance to live a life of joy and purpose even in the later stages of the disease. We set them up for success by familiarizing ourselves with resources and utilizing tools such as the Tx:Team Living Well with Dementia program, which is designed to provide therapists with the necessary tools needed in determining the stage the individual is performing at and further aid in providing staff/caregivers the best methods for intervention and communication with the individual at their level.
In the end, those with dementia will not remember that they have it, but they will remember how we made them feel in the moment. So, smile, have fun, and in the words of Bing Crosby, “Accentuate the positive, eliminate the negative, and don’t mess with Mr. In-Between.”
Rebecca, “Christon” Cardell, MHS, OTR/L received her Bachelor of Science in Occupational Therapy in 2004 and her Master of Health Science Degree in 2005 from the Medical College of Georgia. Christon has experience working in both the pediatric and geriatric settings. Since her early years as an OT student, Christon has been interested in pursuing more knowledge in the area of Sensory Integration and Processing. She is so excited to see that this area is starting to become more widely used as a treatment approach not only with pediatrics but in the adult population as well. Christon is a certified provider of “The Listening Program” and has been utilizing this therapeutic technique in some of her treatment plans with great success. She has been a champion for the Tx:Team Living Well with Dementia Program.
