|Published May 31, 2007.|
I have frequently heard caregivers recommend Lauren Kessler's book Dancing with Rose: Finding Life in the Land of Alzheimer's. I finally made the time to read her account of working in the memory care wing of a skilled nursing facility.
Trained as a university professor, Kessler decided to work a minimum-wage job as a certified nurse assistant (or resident assistant as she calls it). She chose to do this as a way to pay homage to her mother who spent her last few years living with dementia.
Kessler shares her experience learning how to care for the physical, emotional and social needs of the residents of Maplewood, most of whom have moderate memory problems.
On the one hand, Kessler presents the bare facts of helping residents eat, dress, transfer and toilet. On the other hand, she explores the possibility that she can communicate and connect with the people who are transformed by dementia. She learns how to accept living with them in the moment. Instead of mourning what they have lost, she celebrates what remains and finds the joy, the whimsy, the love available in the moment.
For example, she initially found one of the residents, Hayes, difficult to be with because he constantly asked her, "What's next?" Then she learned two things about him that helped her reframe his behavior in a positive light.
First, Kessler learned that he was a stoic and uncommunicative person prior to his diagnosis, and his adult daughter found his talkativeness a great blessing. Second, she learned that he worked for years as an engineer, which probably encouraged him to see life in terms of mechanical tasks that must be performed efficiently. Kessler instead started to guide Hayes step-by-step through daily tasks, which decreased his level of anxiety.
For each resident, Kessler worked to understand their past lives, their primary stance towards the world, their major insecurities, and their value system so that she could help validate their way of being in the world. For example, a retired university administrator conceptualized the nursing home as an administration building or a retreat center. Kessler validated these views rather than distressing Marianne by challenging them.
I found Kessler's book a great example for how to accept people at face value and how to live more fully in the moment. Yes, these are valuable lessons for learning how to better relate to people with dementia. But on further reflection, acceptance and embracing the moment are powerful tools for relating with all people.
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