Use the biography to learn as much as you can about what it was about the times your loved one keeps re-living that are most meaningful. Again focus on feelings not the facts. Their need to revisit those eras may come from a desire to re-experience times that evoke positive feelings associated with a sense of accomplishment, being needed, capable and contributing.

Find ways to let them take the lead, ask their advice, praise their efforts and engage them in activities and reminiscing that bring those positive past experiences right into the present. Sometimes the reflection is about wanting to define their legacy, which is a developmental stage and a natural part of the aging process. Persons with Alzheimer’s/dementia have the same need, especially in the early stages of the disease, to define what their life “has been about” or what they might be remembered for. 

Sometimes retreating to the past can stem from a desire to resolve past conflict or hurt. Ask them to tell you more, and listen for clues as to what they may be missing most so you can work to provide it. Writing letters, asking them to share with you what they wished they would’ve said or done can help when there is a need for closure.

Seek first to understand the why behind your loved one’s proclivity for the past, and then you can identify ways to push it forward into the present.

Preferences are important. Think about having a cheeseburger for example. I can’t remember ever seeing any two people eat a hamburger the same way. No mustard, no pickles, no raw onions. Add mayonnaise, ketchup, tomatoes, lettuce, cheese, crisp bacon and sautéed mushrooms. Chances are, I lost a few of you somewhere along the way with that hamburger order. If I served a hamburger to everyone the way I liked it, not everyone would eat it, and some wouldn’t even taste it. Imagine being at a barbeque where all you were served at every meal were things you didn’t like, prepared in ways you didn’t think tasted good. To top it off, someone else may have even dressed you in an outfit you find tight, too hot and made form itchy material. Now, how much fun are you having?

Persons with Alzheimer’s/dementia may not be as able to articulate their own needs anymore and, as a result of being in situations that aren’t to their liking, they may act out or fail to extract the maximum benefit. If they are dressed in uncomfortable clothing, for example, that may be one reason they keep shedding their shoes or pants. If their food is served in a way that doesn’t taste good to your loved one, that could explain part of the weight loss and decrease in appetite.

Look for what works and continue to try different ideas that are not bound by “the way it’s supposed to be done” necessarily, but are created anew each time based upon what your loved one can and wants to do in the moment. Use that to guide them into accomplishing the task or enjoying the activity at hand.

Who says “playing cards” requires rules and a certain method of play? Sorting by suit, putting in numeric order and even holding the cards while snacking on veggies and homemade dip can be enough to re-create the positive parts of card play from the past. Focus on what your loved one can do and build the adapted version of reminiscing, a favorite hobby, or activity of daily living around those abilities, minimizing the deficits. Look in Chapter 29 of When Caring Takes Courage for several hundred Alzheimer’s adapted activity ideas to help you create “failure free” fun.

Success lies in looking for and recognizing the positives. This approach is all about translating old favorites, familiar pastimes, long held routines and past preferences into activities that engage your loved one and create the best possible day. The more you know about them, the more you’ll have to work with when it comes to brainstorming new ways to bring the “old days” forward.

 

Excerpted with permission from When Caring Takes Courage, A Compassionate and Interactive Guide for Alzheimer’s and Dementia Caregivers, copyright 2014.


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Mara Botonis

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