Dementia “Ramps’, Part 2:
Thanks for all your comments on last week’s post. It occurs to me that some might consider my post to be a bit contradictory. After all, I am frequently stating that people with dementia can continue to learn and grow, and yet my latest remarks advocate accepting that such people have irreversibly changed in their thinking processes, just as a person with paraplegia will likely never walk again.
Can we reconcile this? In a word, yes. A person with paraplegia, through development of his arms and use of specialized equipment, can continue to find ways propel himself, even compete in marathon races. A person who loses her sight may develop increased acuity of her senses of hearing and touch to compensate for the loss.
A decade ago, Tom Kitwood postulated that people with dementia in supportive care environments could undergo a process of “rementing”–creating new nerve connections and pathways. Many of us doctor-types didn’t take him seriously, but new studies of stroke survivors show that the brain is, indeed, adaptable and capable of new growth.
Therefore, to maximize the potential for people with dementia, we must “let go and re-engage”. First we must let go of our desire to make people think exactly the way they used to, or the way we do. Then we must find ways re-engage them on other levels, to bring out their ability to find new solutions to day-to-day challenges. This can best be accomplished on their terms, not ours.
This is a give-and-take process. It is highly individualized and requires careful attention, creativity and re-invention as a person’s life, health and needs evolve. It doesn’t fit well with our society’s desire to just find a magic pill that will make everything go back to normal. It’s a lot like the Eden Alternative.