Take time out to observe around you, everything that you see, without judgment. Especially in the realm of caregiving, it is too easy to make judgments about a loved one is communicating, if we are only using our own perspective. We must needs have an empathetic view, asking ourselves, what is my loved one trying to communicate with words, behavior, silence facial expressions, bodily movements, mannerisms, tone of voice. If I am too caught up in “tasking,” that is to say, attempting to complete a caregiver task, without paying attention to presence, then I can all too easily miss the cues. And, so rather than meeting a human being, namely, my mother, where she’s as, it is as if the only role I am playing in that moment is one of functionality.
This is a conscious process, identifying the underlying concern of the loved one, behind the speech or behavior. It becomes more challenging to navigate as cognitive decline continues to progress. Moreover, cognitive baseline is not always stable, depending upon various factors such as situational agitation, UTI’s or other infections that cause speech confusion and possibly delirium. So, this empathetic stance, tuning into the world of the loved one, and honing one’s relational skills is essential as the inevitable diminishment of cognitive capacity seems to occur over time.
Yet, in my own experience, it has been a struggle to follow through on my own words, as stated above. I need to heed my own words and be more empathetic. The question is how? I think that the answer lies in the approach toward my mother that I take upon myself as a family caregiver. A quiet, gentle approach, respecting the human being in front of me, created in the image of G-d.
What does this look like in actuality. Perhaps, at times a firm yet gentle approach. Seeking not to incur any agitation on my mother’s part. Having a lot of patience, especially when giving medications, when she can exhibit obstinacy. The goal is to honor her independence by letting her take her own medications, by putting them in her own mouth one by one.
taking a breathe, pausing and reflecting on brief momentary situation that will pass. Giving my mother space and time as well as myself (self care). Even if she is agitated, looking past this, knowing that this is not her self. Honoring when she is more calm, clear and recollected as her best self, more in alignment with her godly image.
And, for myself, thinking before responding; not requiring myself to say anything at all. Silence is often the best policy. This can be especially helpful in regard to perseveration, when a question or phrase might be repeated over an over. Another technique in that case to use is redirection away from the thought. As well as somatics, holding a hand, gentle touch on shoulder, reassurance if it is a “distressing thought.”
These are all aspects of the caregiver’s approach that I am learning for myself, through research, experience, and learning from others. A caregiver’s education is essential to continue serving in a role that usually is taken upon oneself without any prior experience or knowledge about how to cope with various situations relative to an elderly person with vascular dementia.
Breathing Room 