Whether it’s helping someone with Alzheimer’s feel a little less anxious about taking a bath; renewing their interest in a hobby such as singing or gardening; or using Therapeutic Reasoning to calm them down when they get agitated— I love hearing from caregivers about their success stories. Sharing these successes—big or small, hard-earned, surprising, or just plain unexpected—is not only motivating for other caregivers, but can also lend helpful insight. In the particular case of a care aide named ‘Hallie’, success was found via two key strategies: uncovering the meaning behind a challenging dementia-related behaviour, and the use of a toilet-bowl cleaner.

ACTION PLANS THAT RESOLVE PROBLEMS

Hallie was caring for a client, named ‘Molly’, who lived at home and not only had dementia but also aphasia, a condition causing speech impairment. Unable to speak a full sentence clearly, one day Molly started yelling out the word “urine!” Automatically Hallie thought Molly needed to use the toilet, so she decided to try ‘Plan A’, inviting her to go to the washroom. Yet despite these efforts, Molly continued yelling. Hallie then attempted ‘Plan B’ in checking to see if Molly was sitting on or wearing any wet clothes that were causing her discomfort, but no wet clothes were in sight.

At this point, Hallie could have decided to simply ignore the yells, since no urgent personal care matters were at play. Instead she chose differently and continued her quest to try and understand the meaning behind Molly’s distress. Putting her detective hat on, she decided to put ‘Plan C’ into action and began asking Molly a series of questions, one at a time. By doing so, Hallie uncovered that Molly was upset because she felt there was a smell of urine coming from her washroom. Having been a busy homemaker, Molly had always taken pride in keeping her home neat and clean, and, though she now had dementia, this hadn’t changed. Hallie now knew exactly what the next plan of action was and started cleaning Molly’s toilet bowl. As soon as this was done, Molly stopped yelling and was pleased that she now had a fresh-smelling washroom.

VALUABLE INSIGHTS

Hallie and Molly’s success story points to a number of valuable insights—the importance of “if at first you don’t succeed, try, try again”; the effectiveness of discovering the meaning behind the behaviour; as well as the simple but powerful truth that a person, despite having dementia, is still a person, with their own wants, needs, personality and backstory. Hallie succeeded because she understood that people need to be understood. She recognized that the solution to Molly’s problem was about more than a sparkling toilet bowl or a clean house or a fresh scent, it was about being acknowledged, validated, and heard.