Avoiding Depression with Dementia (part 2)

December 20, 2010

In the first part of this blog, I covered what depression is and the common symptoms in dementia patients.  There are two basic categories of treatment for this condition, behavioral and medical treatment.  In part 2, I’ll cover behavioral treatment  — and I’m talking about the behavior of the caregiver, not the dementia patient.

How do you interact with the patient?  Speaking from personal experience, I tried to correct everything one of my relatives with dementia would say that was incorrect, to bring him or her into reality.  This is exactly the WRONG approach.  Patients with dementia cannot be made to rejoin reality and constantly correcting them only contributes to depression.  The worst case I’ve ever heard involved a friend’s mother.  A home health nurse came to her house every day and every day, my friend’s very elderly mother would say, “I had breakfast with my mama this morning,” with a big smile on her face.  The nurse would correct her every time, saying, “Ma’am, your mother has been dead for many years.”  Predictably, tears and grief followed.  For this woman, her mother died anew every day.

This is an extreme example of what not to do.  However, when we constantly correct the dementia patient, we are reinforcing his view of his own inadequacies.  In most cases, correction isn’t necessary or kind.  The alternative is to love the patient where he is, to validate the abilities he still has, to help him find abilities he may not have had before his diagnosis.

Such was the case with my father-in-law, a very skillful man who could fix just about anything.  As dementia became more and more apparent, he realized he was losing his abilities to perform many tasks, having been so capable previously.  Enter depression.  He stopped smiling and grew frustrated and angry with his own inept attempts to accomplish tasks.  At the point at which he could no longer hammer a nail or put lights on the bushes outside, he began going to Caring Days, a local dementia daycare center.  There he learned to paint, having never painted anything more artistic than a wall or a fence before this time.  We have nearly 100 of his water color paintings and they have been exhibited all over the country, including recently in Beverly Hills at the David W. Streets Gallery just off Rodeo Drive.  After he began painting, he regained his smile and took tremendous pride in his artistic ability.

Good daycare can be invaluable in avoiding depression.  It gives the patient a purpose for getting up in the morning and mentally stimulating activity all day, in addition to giving valuable respite to the caregiver.  If you don’t have access to good dementia daycare (and I’ll cover what “good” means in another blog), try to recreate this at home as much as you can.  Help the patient find something they can do, which may or may not be something they did before their diagnosis.  Crafts, charity projects, art, music — all these are valuable tools in the fight against depression.  Especially when doing crafts or art, remember that a perfect end product isn’t the goal.  The goal is to provide cognitively stimulating activity and to make the patient feel good about themselves.  Criticism should not enter into the equation.  Also, use craft and art supplies suitable for adults, not children.

Give the patient something to do that they believe contributes to the family or the community.  For instance, one woman loved to fold and unfold clothing.  Her daughter gave her a large laundry basket of old clothes to fold.  It kept her mother busy for a long while and made her mother feel like she had contributed to the family.  Caring Days puts together care baskets for West Alabama AIDs Outreach and the patients feel like they are contributing to the community.  Everyone wants to be a contributing member of society.  Help your dementia patient be a contributor.

Keep things fun!  Humor, silliness, and fun are all valuable tools for your loved one to avoid depression (and by the way, they are valuable tools for you as the caregiver to avoid depression, too!)  Sing, dance, be silly.  Have fun!

Have you found other methods for avoiding depression in your loved one with dementia or with yourself as a caregiver?  Please share!


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3 Responses to “Avoiding Depression with Dementia (part 2)”

  1. Great blog! Keep it up. I will definitely come back again.

  2. Christian says:

    My mother also has dementia, sometimes we will give her clothes that she loves to fold and unfold. Once, she pulled her back and I taught her to walk like a penguin. She is able to live happily with her dementia because of the little things in her life

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