The Importance of Human-Centered Therapies in Dementia Care
New therapies allow patient connections on a whole new level
by Sasha Inobe

Education and experience are always a professional advantage.

That extra insight, confidence and know-how are even more valuable when it comes to caring for people with dementia and helping both patient and family members maintain a quality of life. Skilled caregivers, versed in new therapies and methods of care, are changing the face of professional homecare for the positive.

Implementing professional caregiving from the time of diagnosis can be an enormous help in maintaining the life and cultural values of a person with dementia. Experience, support and training are three elements that allow service providers to deliver levels of care with a human-centered and value-based approach.

Treating the Whole Person

One of the professional’s advantages is seeing the patient for who they are—not for who they once were. Through training, professionals grasp an understanding of the importance of relating to an individual on a personal level rather than a conditional one. By relating on a personal level, a caregiver is able to develop a plan of care that makes the most of an individual’s skills and capabilities throughout the progression of the disease. With the cooperation of both patient and family members, today’s well-trained care provider can establish routines, activities and relationships that go a long way toward minimizing the challenging behaviors associated with dementia—agitation, anxiety, aggression and apathy—while keeping the patient safe and calm.

People with dementia had a life before this condition set in. Recognizing individual likes and dislikes, personal history, and particular skills and interests, as well as physical conditions and emotional sensitivities help to create a connection that is practical and compassionate. Family members are frequently and understandably limited by long-held views of the person, that are potentially complicated by fear, resentment, anticipatory grief and self-doubt.

Where a family caregiver may see loss and decline, the professional caregiver seeks out and enhances current capabilities—understanding that physical discomfort may manifest as anger, withdrawal or anxiety—and seeks out the root cause of discomfort. As communication skills dissipate for the person with dementia, knowledge of how the disease progresses, and its behavioral symptoms, helps identify and avoid potential triggers that may tarnish well-being.

Training focused upon the person’s holistic well-being is a caregiving standard pioneered in part by The Green House Project, whose person-centered initiatives emphasize creating purpose as part of a plan of care that reflects the individual’s values, cultural background, interests, personal history, physical abilities and care choices. As communication abilities decline, this knowledge comes increasingly into play as avenues of engagement and protection against stress or agitation.

Engaging the Brain

While there is currently no cure for dementia, slowing its progression through various lifestyle habits and engagement methods shows increasing promise. Trained interventionists administer certain activities and other stimuli, as well as facilitate certain lifestyle choices to help people maintain their autonomy and quality of life.

Grounded in scientific studies, the Cognitive Therapeutics Method from Home Care Assistance incorporates a variety of lifestyle interventions to promote the overall well-being for individuals already experiencing cognitive impairment.

Geared to strengthening the brain’s five domains—executive function, attention, language, visual-spatial perception and memory skills—the program also targets these areas to help inhibit negative behaviors associated with increased reliance on others, such as frustration, withdrawal and aggression. The program also provides caregiver insight as to the individual’s perception of physical objects to help prevent falls and injuries.

Going With the Flow

One of the most important skills provided by an experienced dementia caregiver is the ability to be fully in the moment with the patient. Interacting with a kind voice, compassionate gaze and guiding touch reinforces a sense of trust between caregiver and patient.

Being present sets the foundation for caregivers to learn more about playful dementia therapies such as improv theatre techniques. An improv technique that calls for spontaneous and unscripted role-playing is considered to be one of the best ways to communicate with individuals who have dementia. The key to this is saying, “Yes, and …” Rather than challenge someone’s reality, improv encourages jumping right into where the patient is and supporting the illusion. Be present within their present.

The benefits of these interactions are improved patient self-confidence, creativity and focus, as well as a renewed, positive sense of playfulness. Studies also show that endorphins released during a pleasant experience have a salutary effect on a person with dementia, even after the experience is forgotten.

Connecting Creatively

Skilled art therapy activities suitable for adults are increasingly a part of dementia caregiver education, due to an increasing body of research supporting art’s transformative effects on those suffering from the disease. A 2016 study by Swedish researchers found that people with Alzheimer’s have a preserved capability to paint and that painting can be used as “an appreciated and beneficial activity” for people with Alzheimer’s. The International Journal of Geriatric Psychiatry also found that art therapy can potentially “improve cognitive function, ability of daily living and behavioral and psychological symptoms of elders with dementia.”

The Hearthstone Institute for Memory Care and Training conducted research demonstrating that artistic experiences can significantly reduce dementia’s negative behavioral symptoms. Artistic experiences and expressions are also shown to help maintain cognitive functioning and optimize remaining capacities. Art can also improve verbal expression, attention span and engagement, and help people with dementia experience a greater sense of self. Hearthstone has used these insights to develop its ARTZ: Arts and Culture Experience coursework to enable professional caregivers to create and implement a rich art experience for people with dementia that includes hands-on expression through painting and crafts.

Looking Back

Reminiscence Therapy (RT) taps into an ability to recall past events, even when short-term memory is failing. Caregivers implementing RT discuss past events and experiences with the person with dementia, alone or with family members present, usually with the aid of tangible prompts such as photographs, objects from past travels and music from younger days.

These conversations help to boost the patient’s mood and stimulate wider conversation. Anecdotal evidence suggests that stimulating long-term memory can also improve short-term memory and increase the self-worth and engagement of someone with dementia.

As much as possible, bringing in an educated and experienced professional caregiver provides people with dementia a greater opportunity for quality of life. With up-to-date training in human-centered therapies, helpful engagement techniques and an unbiased view on the health and well-being of the patient, professional options perpetuate the highest levels of homecare.