Saturday, June 21, 2008

Habilitation Therapy: The Answer to Caregivers' Frustrations

Habilitation Therapy: The Answer to Caregivers' Frustrations
Doesn't habilitation therapy sound like something new and
innovative? It isn't. However, once you learn about it
and implement it, then caregivng, as you know it, will be a
thing of the past.

Before I explain habilitation therapy, let me give credit
where it's due. I knew nothing about habilitation therapy.
I was an activities worker who "developed" a method of
communicating with my residents through trial and error.
What I did worked for me. Recently, I learned that even
though I practiced habilitation with my residents, I was
only applying a method that an incredible lady pioneered
three decades ago. I give total credit to Joanne Koenig
Coste, who cared for her husband for three years after he
suffered a stroke and developed vascular dementia. She was
the first, and thanks to her, she will not be the last.

Okay, you ask, what is habilitation therapy, and how can it
help me? In a nutshell, habilitation therapy is the
practice of focusing on the skills a person with
Alzheimer's or other related dementias has at the moment,
and not the skills that have been lost. Habilitation is
different from rehabilitation because rehabilitation is
therapy that helps people with physical disabilities to
function again. Habilitation, however, enables people to
maximize what remains and emphasizes their emotions. Only
emotions can survive the ravages of Alzheimer's Disease.

According to Koenig Coste, "The person with Alzheimer's
disease -- like anyone with memory loss -- may soon forget
what you say, but he will never forget how you made him
feel."

Habilitation therapy can be successful if the caregiver:

Makes the home environment work

Realizes that communication continues to be possible

Focuses on remaining skills

Lives in their loved one's world

Keeps their lives productive by ensuring social and at-home
activities

Undesirable behaviors are often blamed on a lot of things,
and some caregivers have told me that they wonder if their
loved one "acts out" on purpose. The simple truth is that
Alzheimer's alters perception. Something as seemingly
insignificant as a shadow can be terrifying to someone with
Alzheimer's. Because their perception is altered, a shadow
is often perceived as a stranger in the house. In that
instance, the way to avoid shadows would be to make sure
the surroundings are brightly lit. Avoiding floor lamps is
a way to reduce shadows and avoid possible falls.

Communication is more than words. You've heard that
actions speak louder than words; so do facial expressions,
posture and tone of voice. What you project through your
tone of voice and your posture comes through loud and clear
to a person with impaired memory. It is entirely possible
that it is you who sets the tone for the day. If your
attitude is positive and your loved one is still agitated
then listening to the emotions behind the words is often
more important than what they are saying. If they keep
asking, "Where am I?", they don't want to know where they
are, they want to know that they are safe. Reassure by
letting them know that they are safe with you, and that you
will take care of them.

No matter how much ability they lose, there is going to be
something they can still do. Maybe your mom can't wash the
clothes anymore, but put some unfolded towels or some
mis-matched socks next to her and she will instinctively
begin folding and matching. You've given her value, and
she knows she still has a purpose. Best of all, you don't
have to remind her that she can no longer do the laundry.
What about dad? What did he do? He might not be able to
work on cars, but he can sort nuts and bolts. The point is
to focus on what they can do without reminding then of what
they can't do.

I know that all these things are important, but living in
their world is the most important to me. When someone who
has lost the ability to reason, it is pointless to try and
reason with them. They can't be in your reality; you must
meet them in theirs. It's the only way to preserve their
dignity. Don't tell them their mom is dead when they ask
for her; that's not her reality anymore. You can say,
"She's not with us right now; she will be gone for a couple
of hours." You have validated her concern and left her
dignity intact.

Activity is important. People with Alzheimer's and other
dementias need to feel needed. They need to feel
successful and have failure of any kind eliminated. They
need to feel that they are still a part of society in a way
that is safe for them. Music is an activity and so is
reminiscing. A tea party with one or two familiar friends
is a wonderful way for them to socialize.

There is a lot more to habilitation, but these are the
basics -- the foundation on which every other aspect of
habilitation is built. Consider this Basic Habilitation
101. I encourage everyone who reads this to learn more.


----------------------------------------------------
Brenda Dapkus, Co-founder of Alzheimer's Family Help in
Asheville, NC. We provide solutions to behaviors common to
Alzheimer's and dementia.
http://www.alzheimersfamilyhelp.com
For more tips visit us at the above link.

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