Art therapy provides an invaluable contribution to the care of people with dementia, whose language skills have been impaired, by allowing them to express their feelings and increase self-esteem through the language of art. Art therapy may be undertaken through drawings and colourings; through creating collages of magazine images; or through objects of coloured or textured figures and shapes. Engaging in art allows friends and family to connect with their loved one who has dementia, in a non-threatening and failure free way, when the ability to communicate in the traditional manner has been lost.
With art therapy, it is important to remember that it is not a matter of giving the person with Dementia some paint and paper or scissors and glue and leaving the room. People with dementia will benefit more from the art as an activity or in therapy with encouragement and prompting. As the dementia progresses, you will find that you will need to be more creative in your approach to find ways to encourage interest and participation in art, however the results can be very rewarding once a connection is made.
It is important to remember, that an activity that was unsuccessful one day, may be successful the next and vice versa. Persistence is key.
Music is a valuable communication tool for reminiscing and can be used as a form of therapy or just for the pure enjoyment of listening. Music therapy is used by many professionals to maintain health and promote well-being in people of any age or ability, and it does not require a long attention span making it suitable for people with Dementia.
Everyone has memories connected to a favorite song or songs. Some memories might transport us back to childhood, some may take us to a different time or place and some will just brighten our day, relax and stimulate us.
Even in later stages of Dementia, the person can still enjoy familiar songs and certain music can often trigger memories and emotions. People in later stages of Dementia often remember the lyrics of songs that they may not have heard for years. A person with Dementia who is unable to communicate and stumbles to find the right words might sing along to a familiar old song without hesitation. People who in the past, played a musical instrument, may still be able to play. It doesn’t matter how well, so long as they are enjoying the moment.
People with dementia will benefit more from music as an activity or in therapy with encouragement and prompting. As the dementia progresses, you will find that you will need to be more creative in your approach to find ways to encourage interest and participation in music, however the results can be very rewarding once a connection is made. For example, if your loved one likes to sing, you may need to start singing the song with them or use a trigger such as a song that they particularly liked to sing in the past. If they played a musical instrument, you may simply need to play alongside them or to be more creative in your approach to encourage them to play, you may need to sit in front of a video or DVD of them playing.
It is important to remember, that an activity that was unsuccessful one day, may be successful the next and vice versa.
Animals are a very important part in the lives of many of us and are a source of companionship and support. Pet therapy can have a remarkable impact on the quality of life for people living with dementia. Interaction with animals can drastically reduce feelings of loneliness, especially in people who have had pets all their lives. Pet therapy can also provide motivational, recreational, and socialisation benefits and help to decrease behavioral problems in people with dementia.
|Child Representation/Doll Therapy|
When it comes to emotional needs, people with Dementia are no different than the rest of us. We all need to feel needed and useful; be given the opportunity to care; have our self-esteem boosted; love and be loved and express our emotions freely. Often, for people with dementia, these emotional needs are unfulfilled and when these needs are not met, they have a tendency to revert back to a time when significant people, places, objects or situations fulfilled their emotional needs.
Doll therapy can help to fulfill emotional needs and improve the overall well-being of people with dementia. Many people with moderate to advanced dementia will take to dolls as they may see them as their own children back in a time when they were nurturing and caring for their children.
Seeing firsthand the effects of doll therapy for people who have progressed past the early stages of dementia can be quite remarkable. The benefits of doll therapy may be:
- Speaking directly to a doll stimulates cognition and enables words to flow more easily promoting correct sentence structure.
- The ability to care provides an enjoyable and stimulating activity that utilises past learned skills.
- Dolls help to stimulate memories and provide an opportunity to reminisce.
- Dolls provide opportunities for nurturing, boosting self-esteem, and to feel needed and useful.
- Dolls reduce agitation, anxiety, feelings of loss and insecurity.
- Dolls may help reduce the need for psychotropic medication for behaviour modification.
Doll therapy can be controversial between those caring for people with dementia including nursing homes where they live, carers and professionals. Those in support of doll therapy have likely had positive experiences of the symbolic meaning that a doll has provided to the person with dementia and the sense of purpose and fulfillment it gives to them. Those with opposing views may think that dolls are childish, demeaning, and infantilising, formed upon their own logical and rational interpretations of how, they themselves would feel if they were the person with dementia caring for a doll.
People in the early stages of dementia may also have the ability to think in this same logical and rational way, however as the dementia progresses beyond the early stages, the person’s way of thinking changes dramatically. They will lose their memory and their ability to think logically and rationally. They will also lose their social inhibitions, and as a result of this decline, their beliefs and values as they used to be, will no longer be important. They will have no memories of the past and no expectations of the future. They will live only in the moment. Although we do noâ??t like to think of our loved ones as children, as the disease progresses, people in the middle to late stages of dementia inevitably regress to a childlike (not childish) manner as a result of the deterioration of the brain and decline in cognition.
Our senses connect us with the world around us. Can you imagine what your world would be like without them? A person living with dementia can still obtain enjoyment from pleasant sensations just as they can be disgusted by unpleasant ones. For people with dementia, failing senses can often add to the confusion that he or she may already be feeling, and for this reason, sensory stimulation can play an important role in overall emotional well-being, especially in the later stages of the dementia.
Sensory stimulation plays an important role in aiding communication as well as helping to reduce agitation, sleep disturbances and unmet needs. The benefits of sensory stimulation can be seen by increased socialisation, concentration and alertness as well as improved self perception.
It is important to create an environment with balanced stimulation. The balance needs to be sufficient to alleviate boredom, but not too busy or noisy that the person becomes agitated as a result of over stimulation. Generally, too many people and a lot of noise, activity and visual stimulation is too much stimulation for the person with dementia.
The early stages of Dementia are often only apparent in hindsight as the onset of Dementia can be gradual and easily attributed to old age or stress. It is not uncommon to be unable to identify exactly when it began.
You may notice the person displaying unusual behavior such as:
- Becoming apathetic.
- Losing the ability or desire to take part in hobbies or activities, or unwilling to participate in new things.
- Inability to adjust to change.
- Forgetfulness at work, such as regularly forgetting appointments or deadlines.
- Becoming more forgetful of details of recent events.
- Making poor decisions and diminished judgment. People with Dementia will often do or say totally inappropriate things.
- Becoming slow to understand complex tasks and difficulty with everyday tasks and activities such as cooking and driving.
- Blaming others for â??stealingâ?? or â??losingâ?? things they themselves have misplaced or lost.
- Becoming more self-centred and less concerned with others and their feelings.
- Repeating themselves or losing the thread of their conversation.
- Difficulty remembering simple words. People with Dementia often substitute inappropriate words without realising, making them difficult to understand.
- Sudden mood swings with no apparent causes.
- Changes in personality and increased irritability.
- Difficulty handling money.
- Problems remembering familiar places, such as where they live or what year it is.
As the person progresses to the moderate stage, their problems become more apparent and disabling and they will require someone to oversee and provide assistance to them. You may notice that they are:
- More forgetful of recent events and common activities such as leaving saucepans boiling on the stove or the gas on. Their memory of the distant past is better, but some details may be forgotten or confused.
- Very repetitive.
- Confused as to time and place.
- Forgetful of the names of family and friends, or confusing one family member for another.
- Wandering around the streets, maybe at night and sometimes becoming lost if away from familiar surroundings.
- Behaving inappropriately by doing things like going outside in their nightwear or taking their clothes off in public.
- Seeing or hearing things that are not there.
- Neglecting hygiene and not eating.
- Becoming angry or distress as a result of frustration.
During the later stages of Dementia the person will require a high degree of care and support with daily living. They will lose the ability to perform basic tasks without assistance, such as feeding and toileting themselves, and they will not respond to their surroundings or to familiar people. You may notice that they:
- Are losing their ability to understand and to verbally communicate. Their speech becomes jumbled.
- Do not remember – even for a few minutes. For example, they will forget that they have just had a meal or gone to the toilet.
- Do not recognize friends and family.
- Do not recognize common objects.
- Become incontinent.
- Need help with everyday tasks such as eating, washing, showering, dressing and using the toilet.
- Become disturbed at night.
- Become restless. For example, they may be looking for their Mum or Dad who have passed away or wanting to go home.
- Become agressive, particularly if they are feeling threatened or confined.
- Find it difficult to walk and may eventually become confined to a wheelchair.
- Have uncontrolled movements.
- Will become bedridden in the palliative stages.