Dementia is the greatest shame of modern medicine; not because there have been no significant advances in treatment, but because—from restraints, to locked units, to antipsychotics, to ECT—we have lost our recognition of the humanity of those living with the diagnosis.
I think it’s time to challenge a bit of the language being used to advocate for people living with dementia. The negative effects of stigmatizing language are huge, and our language choices are often the places where such stigma starts or ends.
Music and Memory is a great tool for engagement for people living with dementia (and everyone), within the context of a deeper transformational approach to support and care. It is not a magic bullet, and we need to stop expecting to find a magic bullet. There is no substitute for relationships, meaningful engagement in all aspects of life, and shifting our systems to support different ways of living and caring.
Reducing anti-psychotic use in nursing homes not only requires education to hands-on team members about the well-being approach and how to operationalize it; it also requires a strong commitment from the formal leaders of the home, particularly the Administrator, Director of Nursing, Medical Director, and Consultant Pharmacist.
In my evolving understanding of how best to support people living with dementia, I came to realize several years ago that it was never really about antipsychotic drugs—it was about well-being. And more recently, I have come to realize that it wasn’t really about well-being either—it’s about humanity and human rights.
When a person faces a diagnosis of dementia, she and her loved ones are thrown into these two most complex worlds like never before. Our predominant view of dementia puts those caring people in a system that is stacked against them
Proponents of transforming elder care focus on the words we use, and often suggest new language choices for much of our terminology.
There are two common operational practices that make it difficult for organizations to visualize a pathway to unlocking doors (and many other activities as well): all-or-none thinking and surplus safety. I explore each of these in the conclusion to my series “Hidden Restraints.”