Sometimes it can be easier to move into their reality, than them move into ours.
It can be a very difficult task trying to understand the feelings of patients who are suffering from dementia or stroke. As it can be oftentimes confusing, exasperating, and exhausting. For this reason, it is crucial to examine and revise the way we treat and communicate with stroke/dementia patients. By trying to examine decision making and reasoning from their perspective, we are able to gain more insight into potentially triggering questions/movements and behaviors that as a carer, we might not be aware are causing the survivor distress. A key change that could improve the carer/ stroke survivor relationship, is carers asking clients more lifestyle/routine questions and listening to the survivors in order to understand the survivors’ motives, and methodology behind perceived disruptive behaviors
As each person in the world sees and does things differently it is important to gain understanding of why a disruptive behavior is occurring (1). As for yelling, swearing, and pushing there is likely to be reasoning behind it. Therefore
it is important for carers and family to ask questions such as why did you do that that way? what is upsetting you? how we could get this job done without causing this negative emotion. To gain a better understanding from the patient’s perspective, rather than impose our personal way of doing things and completing tasks, which might not be compatible with a stroke survivor.
A further way to assist stroke survivor is helping build up a stroke survivors’ sense of self-worth. This is a task that the family can assist with. And is a significant factor as it can give the survivor the confidence to improve on their post stroke recovery journey (1). Furthermore, it is also crucial to assist stroke patients with their choices around their care, their life, their food, and their decision making. As well as viewing all these factors from their view, and their reality. I’ve seen some family members try and influence the survivors’ decisions. They have the right to change their mind from one day to the next be it their Favorite food or the clothes they like.
This is exemplified in the personal essay, about post stroke recovery by Angus Booth.
A few key insights into the life of a stroke survivor with cognitive impairment.
Firstly, it is crucial that you as a carer/family member take them seriously and show them their concerns still have value in a world that often discards people after they’ve survived a stroke. This can be done by showing them you will spend the time to seek out the actual underlying issue and find a solution with methods which they can replicate later their own.
It is crucial that stroke survivors’ fears, concerns and anxieties are taken seriously as they are real and valid, even if a carer overlooks something, which can cause the survivor major emotional turmoil. By treating them like a valued human, a trust can be formed. This can alleviate some of the tension which might if let out of control ..put further pressure on an already strained bond between survivor and carer. I have seen this first-hand recently in a facility. Where a man got woken up and started becoming stressed. A group of carers came in to wake him up and tried to put on jovial uplifting voices. The man deep in slumber got taken by surprise and went into fright and fight mode. I managed to bring him back to a calmer state by listening and getting to the root cause. A lot of reassurance addressing his concerns … and he was back to his very cheeky self. This may take a bit of time ..but it’s worth it. After that’s achieved there is a certain amount of reasoning with the survivor that can be achieved, and a stronger carer/survivor bond can be build, and trust in each other can develop.
Article creators: Angus Booth and Kassia Murphy
1)Sense of Self among Persons with Advanced Dementia – Alzheimer’s Disease – NCBI Bookshelf (nih.gov)