Dementia Care

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12 Australian Journal of Dementia Care December 2016/January 2017 Vol 5 No 6
started my geriatrics
placement in a hospital. The
internal struggle that I was
feeling as I grappled with my
Bobba’s decline gave me a
new perspective on the
patients I met that term.
Patient labels transitioned
from ‘the demented old lady
with delirium secondary to
constipation’ to ‘the retired
teacher and grandmother of
seven with …’. I discovered a
newfound depth of empathy
and focus on patient-centred
care. This gave me a greater
understanding of the
underlying disease processes
of the patients as my passion
for their well-being led me to
deeper investigations of their
conditions.
The lessons I have learnt
from communicating with my
Bobba, especially in her
moments of stress and
confusion, have enabled me to
connect to the geriatric patients
with greater patience, tolerance
and appreciation. I found that I
was able to use the techniques I
had learnt from soothing my
Bobba to calm distressed,
agitated and scared patients.
The timing of my geriatrics
placement was no coincidence,
but a treasured journey that
transformed the blanket of grief,
loss and regret that plaguedmy
mind into one of acceptance,
gratitude and understanding. It
was emotionally draining being
confronted every day at
placement with the exact
challenges that I was trying to
distance myself from in my
personal life. Nonetheless,
witnessing so many people in
the same circumstance as my
Bobba andmy family also
brought solace and comfort.
One moment I will never
forget was walking into the
room of a very disorientated
woman; she was 63 years old
and had early onset
Alzheimer’s disease. She lay in
bed with her 40-year-old
daughter, who was cuddling
her, stroking her hair and
soothing her with kind words:
“Don’t worry mum, I’m here,
everything’s going to be
alright”.
I left hospital that day and
went straight to my Bobba’s
home. Although I could sense
that she didn’t know exactly
who I was that day, I could feel
her love for me and as we sat
together cuddled up on the
couch I found pleasure in the
complex simplicity of love and
togetherness that persists, and
perhaps even strengthens, in
the face of adversity.
Just like the 40-year-old
daughter, I remember my own
mother soothing my Bobba by
likening her confusion to a car
ride, telling her that she can
simply shut off and relax,
knowing with confidence that
she was being looked after;
that although she was in the
passenger seat, she could trust
in the fact that the driver had
meticulously planned the
journey ahead with love and
care.
When my mother was
suffering herself, overwhelmed
by hopelessness and pain, I
remember my auntie, my
mother’s younger sister, telling
her that it was better to laugh,
to simply shut off, relax and
enjoy the ride herself. As my
auntie so aptly put it, we have
to laugh, for if we don’t laugh,
then we’ll just cry.
And so we chose to ignore
the ugliness of the disease and
to find joy in the benevolent
absurdity of my Bobba’s
behaviour. We laughed in the
lift of crowded people when
my Bobba interrupted the
silence singing Baa baa black
sheep. We laughed when my
Bobba plaited my friends’ hair
together as they sat on the
couch. We laughed when my
Bobba walked up to the
stranger engrossed in her
book, sat down beside her and
engaged in conversation as if
they were lifelong friends. We
laughed so much with my
Bobba until we laughed so
much that we cried. And I
thought of all those times we
ran around as small children,
my Bobba warning us “too
much laughter ends in
crying”. Yet now we had
reversed this, we had turned
our crying into laughter. And
we were so much happier.
Alzheimer’s disease teaches
us to savour every minute spent
with those we love. It sensitises
us to those extraordinary
moments of pure joy. It clears
out the complexity of the recent
past and future to make way for
the serenity of the present. And
it peels away the shell of the
mind only to reveal the
perfection of the soul – what a
beautiful force to be around.
Gabrielle Cher is a fifth-year
medical student at the University of
NSW. She is passionate about a
holistic approach towards medicine
and sees medicine as an avenue for
social change. Contact her at:
Guide explains level of care consumers should expect
A new consumer guide is now available that sets out the level of care
that people with dementia and their carers and families should
expect from health and aged care professionals.
Diagnosis, treatment and care for people with dementia was
launched in November as a consumer companion guide to
Australia’s Clinical practice guidelines and principles of care for
people with dementia, released earlier this year.
This consumer version of the guidelines is designed to support
consumers to be fully informed when being investigated or treated
for possible or diagnosed dementia. The information is relevant to
anyone who has signs and symptoms of dementia, has been
diagnosed with dementia or is close to or caring for someone who
may, or does have, dementia.
This Consumer companion guide was developed by people living
with dementia, carers, researchers and clinicians from the National
Health and Medical Research Council’s (NHMRC) Cognitive Decline
Partnership Centre (CDPC).
Dr Kate Laver, NHMRC-ARC Dementia Research Development
Fellow at the Department of Rehabilitation, Aged and Extended Care
Faculty of Medicine, Nursing and Health Sciences at Flinders
University, is the lead coordinator and was also involved in
developing the Clinical practice guidelines.
“The objective of this project was to … ensure that the information in
the Clinical practice guidelines is more accessible to those who need
it most, regardless of their varied levels of health literacy,” Dr Laver said.
The guide is not intended to be a comprehensive summary of all
aspects of dementia care. Rather, it outlines what information health
and aged care professionals should provide, what kind of care and
treatment to expect, questions that can be used by consumers to
support discussions with these professionals, as well as sources of
further information. It covers dignity in care, ensuring a timely
diagnosis, advance care planning, accessing community services,
living well with dementia, rehabilitation services, supporting carers,
strategies to manage symptoms and end-of-life care.
The Consumer companion guide and the Clinical practice
guidelines are both available for free download from the
CDPC website at:
resources/dementia-guidelines.php.
Clarice’s family treasure her
presence, her warmth and her
unconditional love