• Ellen Belk
  • Redirecting the Alzheimer's Patient in Exit-Seeking Behavior
Redirecting the Alzheimer's Patient in Exit-Seeking Behavior
Written by
Ellen Belk
May 2012
Written by
Ellen Belk
May 2012
In my current professional role, my business travel has taken me through 11 states: From Texas to Florida, through South Carolina, Kentucky and Pennsylvania with a stop in Maryland and several other states in between. I’ve logged thousands of miles as I cross the country providing support to the assisted living communities in my division (former job).
My primary responsibility is to train staff and give them the reinforcement and tools necessary to care for our residents with memory impairment. Training staff is imperative and I relish that role. However, above and beyond everything else, the absolute highlight of my current professional role is the time I spend with the residents. I have the great pleasure and honor of advocating for over 400 seniors with a diagnosis of Alzheimer’s or other dementias.
The territory is vast and I spend more time in some regions than others, but I’m proud to announce to the staff I train, that I know the names and back-stories of handfuls of residents in each of the 24 buildings I support. And, if I can learn about those folks I may not see for several months I encourage staff to know 100 things about every single resident that they serve.
Someone once said, “If you meet one person with Alzheimer’s disease, you’ve met one person with Alzheimer’s disease.”
Although the disease affects millions and the benchmarks can be similar in many or most; the way those benchmarks appear and manifest vary greatly in each individual. Since I meet so many, I have a bigger picture reality. However, one of the things I find consistent is that the more we specialize the programs, engagements and activity to meet the specific needs of each individual, the more successful we are and the more successful the memory-impaired person is too.
One tried and true method I have is to “keep em’ busy.”
This is especially useful for residents who are still quite mobile and exit-seeking. Asking a person to “help” or asking for their “opinion” is a non-medicinal elixir.
Regardless of whether their ‘help’ is exactly perfect or whether their ‘opinion’ makes exact sense, isn’t the issue. The ‘normalcy’ of asking them for their help or opinion, regardless of the outcome is a powerful affirmation to someone whose world is devolving into lost memories and confusion.
Many months ago, while in Kentucky, Bob was having a rough day. He’d had a restless night and slept through breakfast. When he emerged from his room past 10am, the staff provided him with his standard request of a bowl of cereal and a glass of juice. One of the caregivers was cleaning up the kitchen space from the breakfast service and Bob ate in silence at his place at the table.
I’ve known Bob for nearly three years and have formed a bond with him that I treasure. I’ve met his daughter, know that he served in the Air Force and was an avid boater and photographer. Bob was very active. On this day, after he was done eating he rose from the table and made the proclamation that it was time for him to “go home.” And, his slight agitation made it quite clear he didn’t mean he was heading back to his room. Without hesitation I responded, “Well, thanks for stopping by” I said as I reached out to shake his hand.
Bob gave a tiny smile and responded while extending his hand, “You’re welcome.” The caregiver stopped briefly as she took in our exchange. Yep, I was living in the moment with my friend Bob. “Hey,” I continued “before you go, do you have time to help me with something?”
“I don’t know,” Bob responded with a hint of skepticism.
“Well, I’ve got to fill the salt and pepper shakers and I could really use your help, if you’ve got some time.”
“Oh, okay” Bob smiled.
We walked back into the kitchen together and Bob took his seat at the head of the table. I gathered up all the half-filled salt and pepper shakers and placed them in front of Bob. “Bob, we’re going to fill these shakers with salt and pepper.”
“Okay” he responded.
“If you could take the tops off the shakers, I’ll go get the salt and pepper.”
Bob glanced down at the shakers in front of him then back up at me. I quickly pivoted and broke down my instructions once again.
I sat down next to Bob and I took the top off one of the salt shakers. “See? These silver caps screw off. Can you unscrew the rest of the caps?”
“Sure,” my friend responded.
I turned my back and hustled to the cabinet to retrieve the large canisters of salt and pepper that we would use to refill. And, in that moment Bob had just enough time to unload all the salt from a couple of the shakers onto the dining table.
I sat back down next to Bob at the table. At this point, the first caregiver stopped cleaning and paid close attention to my response as another caregiver entered the kitchen area too.
“Hey good job, Bob, thanks for emptying out the salt.”
“You’re welcome.”
A dual snicker arose from the caregivers in the corner.
Sure, Bob created a little mess. But, I’d asked for his help. He was now focused on this task. He wasn’t agitated or seeking a way out the door. So, it mattered not, how he completed the task. The bigger picture is that he was helping me and that was super.
We sat together and funneled the salt and pepper into the appropriate shakers. He helped me screw the caps back on and I placed the shakers back in their center-table positions. Bob even corrected me when I accidentally put two salts together.
Asking for their help is purposeful and valuable to someone with memory impairment. Allowing that ‘help’ to unfold without concern for ‘exactness’ is a huge part of the successful equation. Creating ‘chores’ for folks who need something to do is a trick I use frequently. And, it hasn’t failed me yet.
In Virginia, Thelma vacuums while Bill helps empty the garbage. Betty and Kitty love arranging flowers and folding towels. In Texas, Jim helps water and tends to the community garden while several ladies fold the cloth napkins used at meal time. In Kentucky, Richard also empties the garbage and Ginny clears dishes from the tables after each meal. In Tennessee, Mike pushes the wheelchairs of the ladies who need assistance. And Claire is responsible for the clean up after each art project, in Georgia.
Purposeful chores are a valuable engagement for someone with memory impairment. Allowing the ‘help’ to unfold in whatever manner it comes, is a valuable lesson of acceptance to the care provider.

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