The Whitworths of Arizona, bringing science to you in everyday language.

Sunday, June 19, 2016

Using Improve with Dementia, Part 2

Last week the blog was about using improv with hallucinations and delusions. This week, it is about other helpful ways we can adapt improve guidelines for use with caregiving. If you didn't read last week's blog go back and do it now...or at least watch the video.

Accept offers and gifts. When an improv actor offers another one an imaginary gift, the second actor takes it and runs with it, adding information and action. Take what your loved one offers, be it a hallucination, memory (real or false) or a comment (pleasing or not) and find some value in it. Show appreciation, talk about feelings, ask for more information.

Develop options. People with dementia respond with knee-jerk actions because their brains don't give them a choice. Caregivers can consider responses and choose the best one. Like improv actors they can go from "I don't like what just happened," to "What can I do with what just happened? How can I make it work for us?" This takes knowing what doesn't work as well as what does. With that, they can reject explaining, defending and arguing as ineffective and choose a more positive action like joining their LO's reality and moving the action away from negative feelings.

Don't force an agenda. Improv actors may start out with an agenda, but they work to make it acceptable to their audience. Caregivers often have an agenda too. Some things that make an agenda more acceptable are small steps and suggestions that are more of an invitation. "Do you need to use the bathroom?" Then, "While we are here, how about a shower?" Take time, and if they don't respond well, pull back and create another invitation. Leaving the room often helps. Then return with a different invitation, "The bathroom's toasty warm. Let's do that shower, OK?"

Commit 100%. Improv actors have to be willing to commit to BEING their character. For that moment, they ARE whoever they portray and they speak as their character would speak. Caregivers must do this too. When you accept a role in their LO's drama, you must play the part with conviction. For example, if the LO accuses you of infidelity, think of how you would feel if it were really true and you really did want to be forgiven. Speak with that conviction. After all, you want to be believed so that the negative feelings will go away.

Touch is powerful. You don't always need words to set a scene. You probably touch your LO a lot, just getting work done. You touch while helping with dressing, bedtime, and bathroom duties, eating, sitting, etc. That's not the same as meaningful touching, like hugging, holding hands or a pat on the back as your pass. These touches show you care, that you really want to be in this relationship.

Accept change. Improv acting requires that an actor can respond to changes quickly and move on. So does dementia caregiving. Dementia is progressive and will continually change your LO. Demanding that things stay the same will only bring stress and frustration. This can be especially difficult in early stages when your LO often looks and acts the same as in the past. But the quicker you can accept change, the less stress there will be.

Collaborate. Improv acting is usually done with a couple of actors, sometimes more. It only works if everyone works together. Caregiving is like this too. Surround yourself with other "actors." Don't try to do this alone. Join a caregiver support group. Have a "phone buddy," someone you can phone and vent with, etc. Get someone to help a few hours a week at least. I know, you hear this a lot. But have you done it? Are you still trying to do it all?

Give yourself permission to fail. When improv actors make mistakes, they laugh and move on. Everyone fails. No one is perfect. Trying to be the perfect caregiver is a setup for failure and stress. Give yourself permission to fail. See it as a gift of learning, a "learning experience." I tried that. It didn't work. How else can I do this? Then forgive yourself and move on.

For information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Helen and James Whitworth are not doctors. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a physician's advice.

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