I picked an Alzheimer Residential facility in Portland, Oregon, from the internet, because they were close to home and looked like an "up-scale" facility. When I met with the Assistant Director of the last-stage Alzheimer unit known as "Expressions," I came with an industrious proposal in hand. After reviewing my ideas, she politely suggested that I focus on using Reminiscent Therapy with the unit's 15 residents.
She explained, "This is the end of the road for these folks. While their short-term memory is gone, they've retained their long-term memories. Allowing them to reminisce about their pasts would be the most therapeutic approach." I realized I knew nothing of last-stage dementia, so I conceded. The residents were all end-stage Alzheimer or Parkinson patients, who were between the ages of 80-100 years old, the average age being in the 90's.
Patients I spent time with ranged from bedridden, catatonic and non-verbal to mobile and cognitively impaired, on a spectrum. Implementing Reminiscent Therapy was as straightforward as interviewing the residents, armed with information about their age, diagnosis, and family histories. My objectives were clear: to encourage the residents to talk about past events, to improve word finding, attention and concentration, to increase communication among residents and staff, and to share thoughts and feelings.
I individually interviewed fifteen residents, spending between an hour to three hours collecting history, including: occupational, family, marital, military, and social. I also implemented Group Reminiscence Therapy in three sessions, for a period of 60-70 minutes, with the entire resident base (all mobile residents). This encouraged them to comment on one another's common past experiences. What did I learn from this experience?
This is where it becomes difficult to express all I learned in my short time at "Expressions." I thought, like any good social scientist, that I would objectively observe, collect and record the various dementia symptoms, and clinically apply a simple group cognitive therapy. The reality, however, was quite different. I found there was no way to objectively use a therapeutic arsenal of techniques on these people. No, these were fathers and mothers, grandpas and grandmas. These were people with rich lives and stories to tell with hard-won wisdom and wit. These were people like the tough school teacher who was convinced I was her daughter; who took me quietly by the hand as she let the tears slip down her face, and admitted, "Nobody comes to see me anymore except for you." People like the German gentleman who, after being in Hitler's army as a youth, escaped before being sent to a Russian concentration camp, and came to America where he converted to Christianity. As he draped his gangly arm around my shoulder, he spoke to me in his thick German accent in a fatherly voice, admonishing,"It's the hard times that make you into somebody." People like the oldest resident of the unit, a Centenarian, whose advice to me about life was: "Just keep busy, kid, and you'll keep outta trouble." And when asked how she was doing, quipped cryptically, "I've got one foot in the grave, and the other on a banana peel!"
Each of them, suffering from the debilitating effects of late stage dementia, all had this quality in common: they all had a particular, and sometimes peculiar beauty about them. Through the mask of their aging bodies, I could still see a glittering soul there, like a buried jewel, which was still vibrant and alive. During individual interviews, I watched sparks in their eyes as they reminisced about their childhoods, adult adventures, and deceased spouses.
These people had LIVED: they had parachuted out of planes, ridden in plane cockpits, traveled internationally, been successful business people, been teachers and homemakers. They had raised oodles of kids, and grand kids. The most extraordinary thing about them was this indomitable human spirit I was witness to. At the median age of 90, they were still mostly positive, and had a keen sense of humor. They still could smile and laugh at their own frailty. What did they teach me, you ask?
It is said that Alzheimer's is called "The Long Goodbye," as the median life expectancy from diagnosis to death is 8 years. These people proved to me it is not the amount of time we have left, but what we do with it that counts. Above the objective theoretics of psychology, they taught me that we create our own happiness (the German soldier told me that), and we can choose to be happy regardless of our failing bodies and brains. They reminded me it is the amazingly resilient human spirit that is most important. They reminded me that kindness, patience and respect are important qualities. They reminded me how to be childlike and to trust. Mostly, they reminded me how to love unconditionally. Because of all they taught me, I believe I received at least as much as they did from the time we spent together; time I'll always cherish.
She explained, "This is the end of the road for these folks. While their short-term memory is gone, they've retained their long-term memories. Allowing them to reminisce about their pasts would be the most therapeutic approach." I realized I knew nothing of last-stage dementia, so I conceded. The residents were all end-stage Alzheimer or Parkinson patients, who were between the ages of 80-100 years old, the average age being in the 90's.
Patients I spent time with ranged from bedridden, catatonic and non-verbal to mobile and cognitively impaired, on a spectrum. Implementing Reminiscent Therapy was as straightforward as interviewing the residents, armed with information about their age, diagnosis, and family histories. My objectives were clear: to encourage the residents to talk about past events, to improve word finding, attention and concentration, to increase communication among residents and staff, and to share thoughts and feelings.
I individually interviewed fifteen residents, spending between an hour to three hours collecting history, including: occupational, family, marital, military, and social. I also implemented Group Reminiscence Therapy in three sessions, for a period of 60-70 minutes, with the entire resident base (all mobile residents). This encouraged them to comment on one another's common past experiences. What did I learn from this experience?
This is where it becomes difficult to express all I learned in my short time at "Expressions." I thought, like any good social scientist, that I would objectively observe, collect and record the various dementia symptoms, and clinically apply a simple group cognitive therapy. The reality, however, was quite different. I found there was no way to objectively use a therapeutic arsenal of techniques on these people. No, these were fathers and mothers, grandpas and grandmas. These were people with rich lives and stories to tell with hard-won wisdom and wit. These were people like the tough school teacher who was convinced I was her daughter; who took me quietly by the hand as she let the tears slip down her face, and admitted, "Nobody comes to see me anymore except for you." People like the German gentleman who, after being in Hitler's army as a youth, escaped before being sent to a Russian concentration camp, and came to America where he converted to Christianity. As he draped his gangly arm around my shoulder, he spoke to me in his thick German accent in a fatherly voice, admonishing,"It's the hard times that make you into somebody." People like the oldest resident of the unit, a Centenarian, whose advice to me about life was: "Just keep busy, kid, and you'll keep outta trouble." And when asked how she was doing, quipped cryptically, "I've got one foot in the grave, and the other on a banana peel!"
Each of them, suffering from the debilitating effects of late stage dementia, all had this quality in common: they all had a particular, and sometimes peculiar beauty about them. Through the mask of their aging bodies, I could still see a glittering soul there, like a buried jewel, which was still vibrant and alive. During individual interviews, I watched sparks in their eyes as they reminisced about their childhoods, adult adventures, and deceased spouses.
These people had LIVED: they had parachuted out of planes, ridden in plane cockpits, traveled internationally, been successful business people, been teachers and homemakers. They had raised oodles of kids, and grand kids. The most extraordinary thing about them was this indomitable human spirit I was witness to. At the median age of 90, they were still mostly positive, and had a keen sense of humor. They still could smile and laugh at their own frailty. What did they teach me, you ask?
It is said that Alzheimer's is called "The Long Goodbye," as the median life expectancy from diagnosis to death is 8 years. These people proved to me it is not the amount of time we have left, but what we do with it that counts. Above the objective theoretics of psychology, they taught me that we create our own happiness (the German soldier told me that), and we can choose to be happy regardless of our failing bodies and brains. They reminded me it is the amazingly resilient human spirit that is most important. They reminded me that kindness, patience and respect are important qualities. They reminded me how to be childlike and to trust. Mostly, they reminded me how to love unconditionally. Because of all they taught me, I believe I received at least as much as they did from the time we spent together; time I'll always cherish.
No comments:
Post a Comment