One of the cruelest effects of Alzheimer’s Disease and some other forms of dementia is the inability to express wants and needs.
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“The way Alzheimer’s progresses, it starts off affecting the brain’s hippocampus region, which is involved in short-term memory and language processing,” explains Barbara Worthington, a certified dementia care specialist based in Oregon, with nursing and health education degrees from Johns Hopkins University.
Worthington said that as verbal capacity diminishes, dialogue between patients and caregivers can become a frustrating guessing game.
In an effort to alleviate the anxiety of patients and the people caring for them, Worthington, 37, created Caregiver Cards in 2006 — a series of illustrated and descriptive “visual prompts” that caregivers can present to individuals who experience language loss due to dementia.
The 155 hand-drawn illustrations are printed on double-sided, glossy cardstock. They feature six categories:
– Daily Living (ex: snack, wash hands, clothes on/off)
– Instrumental Activities of Daily Living (eg: laundry, money, seat belt)
– Activities (ex: bingo, walk, art)
– Commands and Prompts (ex: good morning, good night, come to the table)
– Emotions and Feelings (ex: thirsty, hungry, calm)
– Events, People and Places (ex: Christmas, family, nurse, restaurant, store, doctor’s office)
With the verbal, your brain has to be ready to listen and absorb everything.
Visual communication, on the other hand, “sticks a heck of a lot better.”
The simple black-and-white illustrations are accompanied by a short text description, such as “happy,” “come inside,” or “feel safe.”
“Instead of saying to them, ‘Why are you mad?’ which could further frustrate them because you’re now throwing more verbal words at them they’re not able to process, you could get their attention, point to the card, and ask, ‘Too hot? Too cold?'” Worthington said.
She recalled working with an aggravated Alzheimer’s patient who had reverted to her native language, Portuguese. When staff couldn’t speak with her or understand why she was gesturing towards her face, Worthington approached her with her cue cards.
“I’m flipping through, playing detective. I pointed to the ‘hearing aids’ card, and she said in English, ‘Yes, hearing aids,’ wrote it down on a piece of paper in English, and then she mellowed out,” Worthington said. “She went right back into speaking Portuguese.”
Worthington’s 14 years as a caregiver for people with Alzheimer’s includes assisting her grandfather, who was diagnosed with the disease when she was in college. Her grandmother also suffered from dementia related to an encephalitis virus that affected her brain.
While designing Caregiver Cards, Worthington consulted the memory care community as well as speech therapists to see how she could simplify her illustrations.
The card representing “family” shows stick figures under a rooftop; “doctor’s office” is depicted by an examination table in a room with blood-pressure gauges and other medical devices on the wall.
Worthington would pencil-sketch the drawings after her children were asleep, trace the lines with a black Sharpie, then scan the images. “I would take it into Photoshop to touch it up, and then just select the Sharpie lines and shadow them with extra darkness or offset grey,” she said, noting that she designed the pictures with high contrast in mind to help with loss of visual acuity.
Last year, Caregiver Cards won two concept product competitions.
Worthington said she has received shipping requests from Sweden, Canada and Britain.
The product retails for $34.69, with free shipping in the U.S. and can be purchased at www.caregivercards.biz.
Matt Kwong is a writer based in Atlanta, Georgia and Toronto, Canada
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