Giving Confidence to Seniors with Dementia

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By Roy Herndon Smith Many older people live alone and do not have a close family member or friend living nearby who can help them if they become ill and unable to do all the tasks necessary to maintain their lives at home. They or a family member will sometimes employ a geriatric care manager. A geriatric care manager can perform a range of needed tasks, such as helping with paying bills; planning for medical care and ensuring that a client goes to doctor's appointments; working with doctors, nurses and social workers at hospitals and rehabilitation centers to ensure that a client receives the best possible medical care; arranging for and supervising home care aides; and working with a client to maintain his or her quality of life. For example, a professional colleague referred me to Ms. D, who lives alone. She had been a professor until she was diagnosed with Alzheimer's disease. The first time I met her, she told me that she had been having increasing trouble remembering how to pay her bills. Sometimes she got disoriented on the subway, even when going to a familiar place, and panicked when she realized she did not know where she was. She needed help logging on to check her email. She did not remember how to tell the time from a digital clock. She did not know how to retrieve messages from her answering machine. She was overwhelmed, uncertain and close to despair. Since that first meeting, I have met with her in her home for two hours a week. As I help her go through her mail, pay bills, check her email and do other tasks, I repeatedly confirm what she can do. She is a witty conversationalist. She has become active in the senior center and is going to be teaching a writing class there. She maintains close friendships. By the second or third meeting, she had become more confident. She has stopped getting lost or panicked on the subway. She continues to have difficulties with other tasks, but, as I help her with them, her lack of ability rarely overwhelms her. She is enjoying her time at the senior center and conversations with friends. This case illustrates a principle in working with someone suffering with dementia: Help with the specific tasks with which she is having difficulty, but repeatedly and consistently confirm her remaining abilities and help her find others who will appreciate what she knows and can do. Roy Herndon Smith, Ph.D., is with Community Geriatric Care (, a subsidiary of Foremost Home Care.

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