Dementia during the Holidays: Emerald

Brain Change Model

This is the continuation of our series about connecting with a loved one, living with dementia, during the holiday and winter season.

In the previous article about Diamonds, we discussed someone exhibiting the first signs of dementia. About half the time, the person and/or their loved ones, may not know they are living with the disease. During the Emerald stage, the signs become more obvious.

The path is different for everyone

The previous article defined dementia. It is important to remember that although there is a general disease progression, the path will be different for everyone, primarily for two reasons:

  1. There are different types of dementia. A dementia is defined by at least two parts of the brain with larger accumulations of insoluble tau protein tangles and amyloid plaques protein molecules. The brain is subdivided into many parts, specializing in different functions. If some parts are more compromised than others, this will impede upon a person’s daily existence in a unique way.
  2. We are all different. Our personalities and life histories will play their role. Repressed desires or family conflicts may reappear as the person loses the ability to filter their words, put their feelings in context, and control their actions.

 Seeing the glass half full, engage with your Emerald

  • The person living with dementia will still feel capable and independent, and usually has a very limited awareness of any change in their ability to complete most tasks. Allow them to participate as much as possible in their routine daily activities. Remember to do with instead of for them.
  • There will be times when your loved one appears much more lucid. They will remember and then forget. Look for changes in their cognitive reasoning skills and ability to perceive others’ feelings. Anticipate faulty logical trains of thought and help steer them towards better decision making, by including them in the process. If they appear inconsiderate of your feelings, it is not their fault, but cause of the disease. This is especially common in frontotemporal dementia types. Do not take offense.
  • Their ability to understand language is changing. Begin to introduce other visual and touch cues while speaking. Change the way you speak but remember not to be condescending. If you speak to them as a child, they will pick up on this and your relationship will worsen. We recommend speaking slowing and repeating the same words in your sentences to convey singular thoughts.
  • They will repeat themselves. Although this can become exhaustive to the listener, try to avoid stating the obvious, that they already said the same thing before. They will not be able to help it or remember not to say it again. Insisting on logic in these situations will only further tire the caregiver and recipient.
  • Notes, along with other visual and touch cues, will help them complete a daily routine. The more consistent the routine, the better muscle memory will guide them through their day.
  • Do not insist on awareness of the correct time, place, and situation. Meet them wherever they are and make the best of that moment. If they are packing for a childhood vacation, pack the suitcase, and use this as a time to talk about their favorite childhood memories. You can often spin these situations into others that allow you to bond with your loved one.
  • Beware of strong emotional reactions. These are often based on fears, desires, or unmet needs. Your loved one will become increasingly incapable of verbally expressing themselves, so find refuge in other senses, such as smell, taste, and sounds. These can serve as emotional outlets in times of frustration.
  • They will look to you to fill their day with meaning. They are either on the go and cannot unwind, or the opposite, not being able to begin their day without you. The more you emphasize a routine, the better they will feel. Show gentle guidance and assist, remembering to include them in the process.

You will need a team

If you have not started building your team, now is the time. Your loved one is beginning to depend on you for their daily routine. If you are the only one, as their dependence grows to include physical needs, you will also be the natural provider.

Remember, someone living with dementia does not have needs that are met at your convenience. Increasingly they circadian clock will not match yours. They may lose ability to perceive your own frustrations and sleep deprivation. They will begin to not parse words or practice tact in conversation. If you are the only caregiver, under a lot of stress, this quickly leads to a deterioration of your relationship, and subsequently the health of both the caregiver and recipient will suffer.

Assessments at no cost

NursePartners has decades of experience constructing care teams to support older adults. If you reference this article, we will provide your loved one a wellness assessment at no cost. Call us today at 610-323-9800.

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