Beruflich Dokumente
Kultur Dokumente
Communicating with
People Who Have Dementia
Finding and Using Their Strengths
by
www.healthpropress.com
This book is a revised edition of the previously titled Can Do Activities for Adults with Alzheimer’s Disease:
Strength-Based Communication and Programming (Eisner, 2001).
Purchasers of Engaging and Communicating with People Who Have Dementia: Finding and Using Their
Strengths are granted permission to print or photocopy the blank forms and guides in the text and/or
to print the forms and guides from the HPP Web site for the purpose of training and program
implementation. Printouts and photocopies may only be made from an original book. Unauthorized use
beyond this privilege is prosecutable under federal law. You will see the copyright protection notice at the
bottom of each photocopiable and/or downloadable page. In the case of clinical applications, none of the
materials in Engaging and Communicating with People Who Have Dementia may be reproduced to generate
revenue for any program or individual. This restriction is not meant to apply to reimbursement of usual
and customary charges that may be allowable when performed with other reimbursable evaluation and
management services.
British Library Cataloguing in Publication data are available from the British Library.
When words and memories fade, love remains.
_________________
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207
vii
About the Author
and Contributors
Eileen Eisner, M.Ed., CCC-SLP, is a speech-language pathologist with
more than 30 years of experience. She specializes in communication disor-
ders related to Alzheimer’s disease, as well as language-learning disorders in
school-age children. Eisner is the author of Merging Language Intervention with
Classroom Practices: A Guide for the Speech-Language Pathologist (1998), and Can
Do Activities for Adults with Alzheimer’s Disease: Strength-Based Communication
and Programming (2001). She served as the Director of Speech and Language
Services of Westfield, NJ. Eisner has presented papers at both the state and
national meetings of the American Speech-Language-Hearing Association as
well as the Alzheimer’s Association. A seasoned consultant, Eisner has written
professional articles on practical intervention strategies for adults who have
neurodegenerative dementias and also provides staff training sessions on the
strategies.
_________________
ix
x About the Author and Contributors
Speech Therapy, Green has developed a new and effective approach to therapy
using technology and other unique resources to empower individuals, families,
and professionals with state-of-the-art treatment. She coaches professionals,
students, clients, and caregivers at the local, state, and national levels on in-
tegrating computers and technology into SLP treatment. She is the author of
The Ultimate Guide to Assistive Technology in Special Education: Resources for Edu-
cation, Intervention, and Rehabilitation (2011), and Technology for Communication
and Cognitive Treatment: The Clinician’s Guide (2007). Green also offers an in-
formative free e-newsletter to more than 7,000 professionals and families that
highlights strategies using technology to help maximize progress toward goals.
Acknowledgments
I wish to acknowledge the significant contribution made to this book by S usan
Harris, CEO of the Oscar and Ella Wilf Campus for Senior Living in Som-
erset, New Jersey. Susan graciously shared her expertise and time. I also want
to acknowledge Char Christensen, activities director for First Community
Village in Columbus, Ohio; Dakim, Inc., of Santa Monica, California; and
Michelle S. Bourgeois, Ph.D., of The Ohio State University Speech & Hear-
ing Clinic, for their efforts in providing many of the chapter photographs.
xi
Preface
As an intuitive speech-language pathologist, I learn by doing. Each client and
professional consultation provides me with opportunities to create practical
programs and techniques for older adults with cognitive impairment. It is in
this manner that I present my views of therapeutic, strength-based interven-
tions for adults with Alzheimer’s disease. The goal of all therapeutic interven-
tion is to engage a person with dementia in life experiences for as long as pos-
sible. This book offers practical intervention practices that nurture the spirit
and enhance the quality of life for individuals dealing with chronic cognitive
and memory losses. It is my mission to share with family members, caregivers,
and geriatric practitioners the activities and environmental modifications that
promote meaningful and joyful interactions for adults with dementia.
People with Alzheimer’s and other progressive dementias experience op-
portunities for social and emotional interactions throughout the duration of
the disease. In most instances the ability to communicate diminishes before
an individual loses the ability to feel. Adults in the later stages of dementia
still have feelings. Lacking vocabulary, they communicate emotions by crying,
yelling, touching, looking, and smiling. These expressions are windows of op-
portunity for elder care professionals and family members to connect with an
individual. Geriatric professionals and caregivers require strategies and tools
to discover these unique windows of opportunity for each person. Individual-
ized and strength-based programming offers practitioners the necessary tools
to develop appropriate and enjoyable activities for people with dementia to
nurture the spirit and maintain quality of life for as long as possible and is a
positive approach to therapeutic intervention. These activities do more than
take up time. They are meaningful and life-enhancing experiences because
they are based on the person’s remaining strengths, abilities, and preferences.
Geriatric care practitioners, including recreational therapists, social work-
ers, psychologists, speech-language pathologists, physical therapists, occu-
pational therapists, dance therapists, music therapists, and nurses, know why
people with dementias need recreational activities. However, knowing how to
select specific activities for an individual creates challenges. Are all recreational
activities appropriate for every individual? Should all individuals participate in
music, dance, and crafts activities? The answer, of course, is no. Individualized,
strength-based activities emphasize a person’s previous interests and talents as
well as current capabilities.
xiii
xiv Preface
My mother has been having memory issues for a number of years. Her neurolo-
gist has been telling her it is “mild dementia.” Her cognitive impairment and
memory loss have worsened and I recently met the neurologist without her. He
told me that she has Alzheimer’s. He felt we should not yet tell my mother, as
that diagnosis has been her greatest fear and it would be too devastating. He
felt we could not tell my father unless we told my mother. I am uncomfortable
keeping this terrible secret. Is it better to tell a loved one of the prognosis they
fear, or is it more ethical to let them live in hopes that they have escaped it?
The fact that Alzheimer’s is your mom’s greatest fear validates just how essential
those faculties are to the quality of her life; it’s possible she views the onset of
Alzheimer’s to be a version of living death. This being the case, the dilemma
must be viewed in the context of dying. If your mother had terminal cancer,
would you hide that news from her? I assume you would not. You would want
her to have the opportunity to initiate final, meaningful conversations with the
people she values most. You would want her to have a chance to cogently look
back at the life she has already lived. (Klosterman, 2012, To Tell or Not to Tell
[June 24])
_________________
Issues of quality of life arise throughout life. It seems, however, that only at
certain times are quality-of-life issues magnified. One of these times is as peo-
ple age and change due to various health reasons. Unfortunately, too little
attention has been given to quality-of-life issues as they affect older adults
with Alzheimer’s disease. The approach outlined in this book contributes to
the efforts to raise awareness about maintaining quality of life throughout the
progression of dementia. As stated in the Preface, the purpose of this book is
to provide positive options to a pessimistic situation. The practical framework
and activities offered throughout are aimed at enriching the lives of adults
with Alzheimer’s disease. The individualized strength-based approach pro-
vides family members and practitioners with a useful resource for identifying
activities that a person with dementia can do successfully. Most important,
the activities are individualized (based on individual interests and strengths),
which can enhance feelings of personal fulfillment and satisfaction as well as a
sense of productivity.
Participating in a singing group (auditory-musical/interpersonal
strengths)