In Dementia Reconsidered, Tom Kitwood theorized that there are 5 great needs of those with dementia. A cluster of needs, very close connected, overlapping and connected with an all encompassing need for love.
These needs can be filled with the use of Spiritual Care. Although some of the interventions may be “religious” in nature the true goal is to reach the residents true spirit and give sense of each of the 5 needs even for brief periods of time. By using the 5 petals we can build a program to enrich the spirit of those with dementia:
Attachment:
One on One visits are great but have you thought about bringing one to four residents together? This could be done in the chapel, a small visiting room or even one of the resident’s room. It should be done at the same day, time & place as often as possible. The same residents should attend. Choose resident with like beliefs and general ability. Pray simple prayers, read familiar bible verses, sing familiar hymns. It may be boring to you but even repeating the same prayers, readings and hymns can make the residents feel more attached to the group. Keep it short, 15 -20 min. watch for distracted behavior to let you know your time is up. Seeing the same faces, hearing the same names will build connection. They may never be able to remember each other’s name but the feeling on “attachment” will be there
Inclusion:
Of course we take our residents to church services. But are we taking those with dementia to the services they know or are we taking them
to fill the chapel? Take them to the services and pray prayers that are meaningful to them. There is a great capacity in those with dementia
to respond to rituals and symbols even in the later stages. This is where knowing their past history is so important. Use their familiar
hymns and prayers. In his book “My Journey into Alzheimer’s Disease” Reverend Robert Davis stated that he had used the more modern version of the Bible for many years and as his disease progressed he found it harder and harder to understand. He went back to his King James Version from his youth and found it much more comforting. We need to recognize that the changes in the church services may be confusing and uncomfortable for our residents.
Occupation:
Dementia does not preclude a person’s ability to participate in life around them. We must find their strengths and encourage them to use
them. Give them a chance to lead a prayer or a hymn. Let them assist in the services handing (Spiritual Well Being and Dementia – Continued from page 5) out the books or programs. Let them bring up the offerings.
Identity:
Identity is probably the hardest Petal to help our residents to achieve because dementia is ever changing who they are. We can help them by: Visiting and providing services as close to the same time and day as possible.
Singing the same hymns over and over (even if it makes us a little crazy). Praying the same prayer over and over. Listening to the same stories or reminding them of the stories they told us when they can no longer remember them. Again, knowing who they were spiritually AND religiously. For example: I had a resident who was devoutly Catholic, as her disease progress she began to refuse communion. She always took it from the Eucharistic Ministers but now refused. Until the Priest offered it. She may not have recognized him as a person but recognized his collar and vestments.
Another resident began refusing communion and by talking to her family they mentioned that no matter how they were financially during their life their parents always made sure to give something to the church. So, when the Priest came with communion we made sure she had a dollar bill. She would give it to the Priest and then accept Communion. (That dollar bill was passed back a forth for years). The power of the spirit and ones beliefs can be so profound that it can affect many different parts of one’s life. There was a resident who would refuse to eat unless he was physically assisted and encouraged and would become agitated with the help. Talking to his family they mentioned he always said grace before eating. We started saying grace at his table before the meal and when we finished he picked up his fork and started eating. Eventually he even led the prayer sometimes. As stated before these interventions didn’t work every time, but when they did it was a beautiful moment.
Comfort:
This is the easiest Petal to help our residents to achieve but the most fleeting. As those who provide Spiritual Wellness & Activities it is our
DNA to provide comfort using all the techniques previously mentioned? However Jolene Brackey said it best in her book “Creating Moments of Joy”
“Memory is made up of moments. We are not able to create a perfectly wonderful day with someone who has dementia, but it is absolutely attainable to create a perfectly wonderful moment. Five minutes later they won’t remember what you did or said, but the feeling you left them with will linger”
Final Thought:
When all else fails remember Psalm 19:1-4 “The heavens declare the glory of God; the skies proclaim the work of his hands. Day after day they pour forth speech: night after night they display knowledge. There is no speech or language where their voice is not heard. Their voice goes out into all the earth, their words to the ends of the world.”
