Thursday, March 13, 2014
A few years ago, we went to visit my father the day after Thanksgiving. When we walked into the living room of his AFH, he was sitting at the end of the sofa with a blanket over his legs, looking alert. I sat down beside him and said hello while rubbing his arm, and my husband leaned over him and put out his hand for Dad to shake it. Dad looked at him, took his hand, and then didn’t let go after the initial shake.
He kept holding on to my husband’s hand, not painfully, but definitely firmly. My husband stood there for several minutes, talking to my dad, allowing his hand to be held until finally Dad’s grip loosened a little and he was able to pull away and sit down. At the time, I thought it was a reoccurrence of something Dad used to do a lot with his aide and friend, Del. They used to have a strength contest of sorts, with Dad squeezing Del’s hand while Del laughed and squeezed back. After having attended Teepa Snow’s workshop, I now realize that something else may have been going on.
Our hands essentially have two main functions or abilities: fine motor skills, with the thumb and first finger like grasping items and manipulating pens; and strength, with the last three fingers and heel of the hand allowing us to apply pressure and open jars. People with dementia lose the fine motor skills portions of their hands relatively quickly, yet they retain the strength portions. What is more, it feels good to them to use that strength portion; they tend to grip tightly what they can – hands, arms, chairs – and not want to let go because it is soothing. I was amazed to hear this, and thought immediately back to that day with Dad.
I learned so much about the physical effects of dementia, just in that six hour workshop. Another thing I didn’t know about dementia is that it affects the sufferer’s sight, not in terms of clarity of vision, although age has probably already affected that, but in terms of range of vision. Someone with dementia goes from having normal peripheral vision, to a narrowed field of vision the equivalent of wearing a diving mask. It then narrows even further to the equivalent of goggles, so that they can no longer see anyone approaching them from the side.
They can only see what is directly in front of them; if they are looking down, they can see their plate, for example, and if they are looking up, what is in front of them seizes to exist. This is one of the reasons why talking to someone with dementia while they eat is not a good idea; they will look up to see you and forget about their plate altogether. Or trip over something on the floor while paying attention to the person in front of them. This is also why dementia sufferers become frightened or aggressive when a caregiver approaches from the side to change them or feed them – they just can’t see it.
These are only a few of the many, many changes caused by dementia, changes we as caregivers need to know as much about as possible. Just think how many incidents of aggression, episodes of intense emotion, and occurrences of ‘bad’ behavior could be avoided if we all understood exactly why our loved one was reacting the way they are. Dementia is a mystery, following it’s clues and understanding it’s hints is our main job as caregivers.