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Dementia and experimentation

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Yes I realise this sounds a bit like the title of a horror movie (and in the past few hundred years people with Dementia were misunderstood, undiagnosed, and treated cruelly under a regime of ‘care’). So the idea of experimenting is a little fraught.

But now (2017) the institutionalised care of people, like Anthony, who suffer from dementia, is kinder. So the ‘experimentation’ I refer to in the title of this post is my own.

Let me explain:

I was recently made aware that Anthony was exhibiting antagonistic behaviour toward carers, particularly in the late afternoon when they were trying to put him to bed. It was a terrible shock to discover this so yesterday I decided to go to the nursing home later than usual. I already knew, via hearsay, that it had now become necessary to put Anthony to bed earlier rather than later and that 4pm was the ideal time. If it were left any later, he would become more rigid and resistant to the hoist, the handling, due to the confusion of his sundowning (a late afternoon phenomenon that exacerbates the confusion of Dementia).

Once I realised this, I decided to adjust my visits from early to late so that I could calm Anthony before and after the bed-time ritual. Yesterday, I did this for the first time: I was there in Anthony’s room before the carers came in to put him to bed; I told him I would be back very soon to give him his evening meal, and vacated the room for about 15 minutes. When I returned, Anthony was comfortably in bed, happy to see me again and even happier for me to feed him his meal.

And, when I left him, he was smiling. So I guess this will be my new routine from now on. I have resisted the idea of a routine until now but I think it’s probably time I paid attention to the rather obvious findings of this experiment.

A. Anthony is more prone to exhibiting antagonistic behaviour later in the day;

B. Anthony is more confused in the late afternoon;

C. Anthony may settle into sleep better if I give him a good-night kiss, even if it’s only 5pm.

So it’s useful to know that later-in-the-day visits are more comforting to Ants than morning/noon visits. This way I can be around before and after the bed-time routine and, hopefully, diffuse Anthony’s distress, fear, and confusion.

Me: Ants, the nurses are going to put you to bed and then I’ll come back to give you your meal, okay?

Anthony: Okay, but it’s a bit unorthodox, Jules.

Perhaps I am the one being experimented on – ha!


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