Lesson of the Day: Never Underestimate the Power of Enthusiasm!

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Ginny is really been a show stopper at the facility! She is like the welcoming committee, party planner and "go-to person' who can be counted on for giving encouragement to those who are struggling. Thing is, she is quite confused, and half of what she says makes no sense at all.

It really doesn't make a difference, though, because her enthusiasm is contagious!!

One thing does make sense today....Ginny goes first thing this morning to the Administrator with a story and a plan...

"I wheeled past this amazing room yesterday!" she tells our leader. "I didn't know it existed! It was full of sun and there were some books in there!"

Ginny goes on to describe the sun room, which contains two bookshelves, about 2/3 of which are stacked with donated books, a sofa, a table and dining chair, an easy chair, and a large bird cage. It houses LeeRoy, the African Gray Parrot, who 

can whistle like a sailor, growl like a dog, say "fresh air!" and "whatever!"  Only on his terms, of course!

She tells the Administrator that she wants to "develop the library!"

Wonderful!

Ginny was the school librarian in the middle school of this town for most of her life. I ask around, and no one remembers her in this role because she's been retired more than 25 years! Goodness sakes, she's 90!

I get wind of the request when Ginny rolls into the gym for therapeutic exercise about 10:30am this morning. She's ready tell the world that she plans to be the librarian here.

"I don't want to be paid! I want to volunteer." She makes me smile!

My mind goes into "how to make it happen" mode. Due to her cognitive deficits, we will have to modify a few things. I stroll alongside her as she wheels down to "show me" the library.

"Let's do a needs analysis, Ginny! We'll figure out what you need in order to get this rolling," I tell her.

"Well (pause), we need a card envelope in each book, a check out card, and I need to catalog the books."

In my mind, I am thinking, "No, no, no....Modification #1...." I will keep it positive but work to sway her line of thinking. Remember, she is old school.  Literally.

"Ginny, it's a great idea to catalog the books we have. What would you think about streamlining the borrowing process to a checkout log so you don't have to handle all those cards?"

"Well..." I can see she can't make the jump without my assistance.

I describe how it will look. "We'll have a binder in which each resident will sign out their book on a special sheet. There will be a column for who is checking out the book, their room #, title of the book, date they check it out, and the date it needs to be returned."

I ask her expertise about how long it should be checked out. "Two weeks," is her confident answer. I have her buy-in on the checkout log.

OK. One thing accomplished. We develop a checkout log on the computer in no time and print it out. While I am at it, I print out the list of Dewey Decimal classes from Wikipedia just to make her day.

You should see Ginny smile.  I have her punch holes and put it in a binder I have picked up just for her.

Enthusiasm is contagious. I begin to get excited for her, too!

A few times I have to redirect her. She goes into,  "Now, we really need to order some books for the middle school age, and I'd like to get some for the early elementary."

I remind her, "Ginny, this library is for older kids, ages 75 to 100!"

"Oh, like me!" she says.

"Yes."

And I count the number of times I remind her in an hour....five.

We brainstorm and make some great plans. Ginny wants to have a "book drive" to collect donations from employees and current residents. Great idea!

We will create cool bookmarks, and we'll ask the receptionist to laminate them. I'll bring in my hundred colors of embroidery floss and she can work on fine motor coordination by punching a hole and making a tassle for each one. Great idea!

We will start a book cart, and she will be the welcoming committee, deliverer of news and books in the building, and overall person of encouragement for those around her. Great idea!

Hopefully by then, we will have her fully ambulatory again.

The process has begun. We are assisting Ginny with integrating her life into long term care. We are giving her a reason to get up in the morning, an avenue to share her passion, and the ability for her to touch the lives of everyone else with her enthusiasm.

Ginny will not shrivel up and die. She will live gracefully, joyfully and just plain "fully" until she graduates from this life.

Never underestimate

the power of enthusiasm!

Breakthroughs

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Remember my first post about the "new place?" There was a lady with dementia who repeated over and over and over....

"What do I do?   What do I do?   What do I do?"

well....it's time to deal with it.

I overhear a conversation by the nurses talking about how Nadine's adaptive clothing needs to be replaced, so I figure that is my cue to step in. "I can help you with that, guys."

They are so busy, they are happy to turn it over. I let Nadine's family know I can address not only the clothing issue, but I would like to determine her cognitive level and identify some activities appropriate to her current cognitive level that  that may help reduce her behaviors.


Adaptive Clothing
So, first, adaptive clothing - what the heck is that?  Clothing that is modified to take care of a person's special needs. Here are simple examples:  cutting a seam on a pair of jeans to make room for a leg cast. Putting velcro closures instead of buttons if someone is unable to manipulate buttons any longer.


Nadine needs all her clothing to open/close behind her back. She has a problem that is common to more older adults with dementia than one would think. She puts her hands in her brief (aka diaper) and occasionally gets her hands and fingernails really dirty.


Sorry!! But it's reality.


You take care of that nasty little problem with clothing that secures down the back. I go online and print a few options off for Nadine's daughters. I will discuss this with them when they visit next.

Next step is the hard part.

How do I connect with Nadine? How do I actively engage her and keep her attention?

Nadine has a designated parking spot at the nurses' station. From there, she partakes in a constant line of questioning, over and over,

"What do I do?

"What?"(she can't hear well)...

"What?"

(and again...) "What do I do?"

and when the nurse answers,

"What?"

I meet her where she is most comfortable, at the nurses' s station. I slowly put a tray over the frame of her merry walker. Merry walkers are used for people who are dangerous to walk solo, but who need the support of holding on to something or a seat when they feel like resting. It's for people who are stable going from sitting to standing or standing to sitting, but not someone who needs help standing up. Got it? Let me know if it doesn't make sense!

I must start with a very simple task. I bring a package of sugar and sweetner packets with me. My mission is to get her to separate the pink from the white. That's all.

 The pink from the white.

I put a handful on her tray.

"Nadine, pick out the pink."

Rule #1 with dementia patients, esp. hard of hearing ones: SHORT SENTENCES

I demonstrate.

She doesn't register my slow demonstrations until about 15 minutes in. She occasionally watches what is happening around the nurses' station. I continue to clearly articulate short verbal cues while I lift the pink packets and slowly lift them into a container that I hold straight in front of her. She follows my calculated movements.

...and I see it click.... after 15 minutes!

"The pink?" she says.

"Yes!"

I demonstrate again and put the packet in her hand.

She holds it a while, then puts it in the container.

VICTORY!

I continue to move slowly, and for the next 5-7 minutes, she puts three pink packets in the container. Then, a turning point. She picks up a packet and holds it to her face.

"Sweet N Low," she reads,

and she proceeds to discipher the small print on the packet!

I tuck that away for the next treatment two days later. I print out Robert Frost's lovely poem, The Road Not Taken.

The Road Not Taken

TWO roads diverged in a yellow wood, And sorry I could not travel both And be one traveler, long I stood And looked down one as far as I could To where it bent in the undergrowth;         Then took the other, as just as fair, And having perhaps the better claim, Because it was grassy and wanted wear; Though as for that the passing there Had worn them really about the same,         And both that morning equally lay In leaves no step had trodden black. Oh, I kept the first for another day! Yet knowing how way leads on to way, I doubted if I should ever come back.         I shall be telling this with a sigh Somewhere ages and ages hence: Two roads diverged in a wood, and I— I took the one less traveled by, And that has made all the difference.

I hand it to Nadine. She picks up the paper, and starts to read.

NOT JUST READ! RECITE!

She has obviously recited poetry in the distant past. WOW.

A nurse walks in and sits down shocked. She starts to cry. Nadine keeps reading Frost. I print off Elizabeth Barrett Browning. EE Cummings. Amy Lowell. Louisa May Alcott. Others.

She continues to read....recite...and read some more.

Breakthrough.