Nine Things for Adult Children to Remember This Thanksgiving
Recently, we asked The Baptist Home’s Campus Administrators for their advice and insights for families coming into the Holiday Season. We expected a few practical takeaways for making home safer and maybe a few fun stories of family life at The Baptist Home. We definitely got that! What we also came away with was a healthy dose of perspective about what’s truly important.
Nine Things for Adult Children to Remember This Thanksgiving
1. Visit. When you can’t visit, call. Never underestimate the value of consistent communication.
2. Think in terms of partnership. Nobody likes to be told what to do. Invite mom and dad to tell you how you can help, but do not take over.
3. Practice patience and perspective. Everyone finds this difficult, everyone. (Parents, adult children, grandchildren.) When you and your loved ones are in disagreement or are downright argumentative, remember that these challenges are painful for everyone. Practice patience and mercy with one another.
4. Simplify your expectations. Seek to enjoy each other’s company above all else. If the meal preparation is just too much, go out for dinner. If things don’t go exactly like they ought to, who cares? At least you have this time together.
5. Take the time to be proactive. The costs of being proactive may be a few difficult conversations or some extra time working on the estate plan. The costs of being reactive are far greater.
6. Get proactive about physical safety. Have stair or rugs become a fall hazard? How easy is it to get into the shower, to reach canned goods in the pantry?
7. Get proactive about health hazards. Does mom have a system for taking her medications properly and at the right time? Are there expired, unsafe foods in the refrigerator?
8. Get proactive when you notice signs of forgetfulness. Again, look into food and medicines. Also, are household chores and/or hygiene being neglected?
9. Take every opportunity to tell great memories and create new ones. Better yet, set up a camera/smart phone to record these special times of remembering.
Remember: This is difficult for everyone. Everyone, including you, is going to experience frustration and defensiveness. Pray for patience, grace. Pray that the Love of Jesus would permeate your time together and fill the hearts of everyone involved. This may seem a bit heavy for an encouraging Thanksgiving message, but the Holidays are when memories are made … remember the great ones and make a few more!
From the President’s Desk: Honoring Wisdom
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From the President’s Desk: Honoring Wisdom
by Dr. Rodney Harrison
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Music Therapy and Dementia
Research continues to show that music can play an important role in connecting with those suffering from dementia. The Baptist Home continues to use music as a form of therapy and connection with residents. To learn more check out the resources below:
Music: Bridging the Memory Gap An article in The Baptist Home newsletter about the use of music therapy at The Baptist Home.
A Musical Mission To Improve The Lives Of Elders With Dementia
Naomi Feil Uses Validation and Music to Connect with Gladys Wilson
Movie Trailer for Alive Inside – A Documentary about Music and Dementia
Expert Advice
Below is advice from Baptist Home residents and staff to potential residents on: “What to look for in a facility?”
Staff:
- Observe the attitude of the staff and how they interact with residents and their families. This is especially noticeable during mealtimes.
- Look for a list of planned activities: Are there enough options? Are the options appealing?
Residents:
- Are the residents happy and content? Are their spiritual needs met?
- Ask the visiting family members how they feel about their loved-one’s new home.
- Do the residents have their own, private living space?
- Do not be afraid to visit with residents about their feelings and experiences.
- Look for a place where you are treated as an individual, not as a number or a private in the army.
Facilities:
- A pretty facility does not matter if its staff does not love the residents.
- When you move be prepared to make this your new home.
- Is there a Chaplain on staff? Is it a Christian facility?
- Be sensitive to smell, cleanliness, noise level and the atmosphere in general. Is there a sense of peace or of chaos?
- Look for a record of state inspection deficiencies to discover how they have been addressed. (These should be available to the public.) Go to www.medicare.gov for additional information.
- Remember; appearance does reflect on type of care and you cannot necessarily gauge quality based on price.
- Ask to see the kitchen.
Visiting:
- Make an unannounced visit at an odd time. (Evening, Weekend, etc.)
- A quality life-care facility should have open-door visiting hours; you should feel you are being welcomed into a home when you visit.
- Do not be afraid to ask questions.
- Sit down with your family and listen to each other to get their feelings.
Finding a Light in the Darkness: One Family’s Struggle with Dementia
The Baptist Home
by Becky Barton
Like most children, we want the very best for our parents. We want them to live independently, able to live healthy, happy lives for as long as possible. But what happens when a parent is no longer able to care for themselves, and suddenly, the child finds themselves in the position of caregiver? What happens when it becomes a question of their safety for a parent to remain in their own home? I recently had the opportunity to sit down and visit with the daughter of one of our residents who was faced with these very questions just a few years ago. Here is her story.
Tell us a little about your mother’s background and when you began to notice her declining health.
My mom was born in Kentucky. Her dad was a farmer, and her mom was a nurse. She grew up working very hard. She went to college, met my dad, and later married. He was a minister, so she was a minister’s wife for 40-plus years. That was her life.
When my dad passed away four years ago, my brother and I had to step in to help her. My dad had been paying all of the bills, so we came in and thought we could teach her how to manage the checkbook. We went grocery shopping, to Walmart and tried to help her pay the bills. It did not take long to figure out that she was just not able to. She also was not capable of taking her medications properly. Because she could not remember what day it was, she was taking more medicine than she was supposed to and was running out sooner. We tried having someone come to the home to help her with meals because she could not remember how to cook and was not eating very well. But then there was another complication. She started having hallucinations and began losing track of reality. She no longer wanted to let the lady hired to help her into the house. She became more afraid and eventually did not want to stay in her house. One day she said to me, “Can I just come stay the weekend with you?” And I said, “Well, sure Mom. You can come to stay the weekend with me.”
She came and spent the weekend with us, and the weekend came and went. We were having a good time and everything was going pretty well, except she did not want to go home. It was during the next three weeks that we discovered she had a lot more problems than we realized. She was very disoriented. She did not know where she was, where to go to the restroom, how to dress herself, or even when to eat. She needed constant supervision.
Faced with the knowledge you would not be able to care for your mother at home, what did you do?
This was a very difficult spot we found ourselves in because I was working. My husband also needed to work. And so, we didn’t know what we were going to do. We discussed our options which included one of us giving up a career.
My pastor is Ron Mackey who also works for The Baptist Home. He helped me get in touch with Sherri Snider, administrator at The Baptist Home-Arcadia Valley, and found out she could assess my mom. The assessment would help us find out what her needs were and what they could do to help us.
My husband, Dan, and I brought my mom to visit with Sherri in her office. She conversationally interviewed Mom, asking questions to evaluate her memory and cognitive ability. “How many children did you have?” “Where did you grow up?” “What year is it?” “Who is the president?” “What did you have for lunch?” Just very basic questions, but she could not remember. Some days she could, some days she couldn’t. After her mother’s assessment, Sherri felt that an assisted living arrangement would be the best placement for her.
Moving a parent out of their home into a long-term care facility can be very difficult. What steps did you take to make the transition as easy for your mother as possible?
We went back to her house and brought as many personal things as we could to make her room feel like home. When she moved to assisted living, she had two rooms and a bathroom. We brought in her pictures and her furniture and tried to make it home for her. Even when she stayed with us, she had difficulty recognizing what was her home and what was not. The transition in that way was a little difficult, but I think she recognized the things in the room. This helped her and helped me to feel more comfortable.
The first night I spent at The Home. There was a place downstairs with a very nice room where I could stay. The next day it was hard to leave her. It is so hard to have a parent come to a home. You know in your mind that this is what she needs, yet it is so hard emotionally. You feel like you’re doing something to her, but you are doing something FOR her.
Have you been pleased with the care your mother has been receiving at The Baptist Home?
My mom has been at The Home for almost three years now. She has gone from assisted living to the medical wing where she gets the most care. Over the last three years, she has continued to decline with her dementia and needs more care, which she is getting. Even though it was really difficult in the beginning, especially the separation, it has gotten much easier. I have seen her relax. I have seen the relationships that she has developed with the people and their relationship with her. They all call her by name. They interact with her like she is a friend, not just a resident.
How has The Baptist Home been able to minister to both her and her mother’s needs?
Here, my mom gets spiritual help. She gets the nourishment she needs for her soul. She gets what she needs from other people loving her. And, she gets her physical needs met. This is just the best place for us, especially with my mom being a devout Christian all of her life. When she is unable to articulate a complete sentence, she can still sing all of the words to a hymn. At The Baptist Home, she has the opportunity to sing hymns frequently because they are constantly having church services and gospel groups in to sing. She sings along, and it brings her to life.
I remember one Sunday morning in particular. I had been struggling because my mom had been very sick, and it seemed as if her dementia was taking control. I wondered if this was all she had left or if this was a temporary thing. God let me know that He has her spirit, and she is still her on the inside. She is still His child. She is still able to love and sing hymns and communicate in a way that her words don’t always say. At The Baptist Home, Validation Therapy has helped her, and me, to communicate and keep that part of her alive. If she is living forty years ago, and I happen to be her sister instead of her daughter, we do not correct her. We just go with it and allow her to be. It’s not a “you’re wrong” response which just shuts people down. She is allowed to be happy and alive, as much as she can be for as long as she can be.
What would you say to a family who has a parent or another loved one who is struggling with guilt, anxiety, or fear, not knowing what to do?
I would say that even though I was afraid to let go of my mom because I did not know if anybody could love her as I could love her, there are people who can love her or him, whoever they are. My mom has found a family here. Yes, you can love her or him as a child, brother, or sister, differently, but the people here can love them, too. I could have given my mom some help if I had given up my career and stayed home, but I do not think that would have been the best thing for her. Here she is around other people who are similar to her and with people who know how to take care of her. I can come now and visit as her daughter, and we can have special mother-daughter time. If I were her caregiver, 24/7, that would be hard… hard. I know bringing my mom here was the best decision for us.
Respecting Presence
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Naomi Feil developed effective methods for communicating with people who have “Alzheimer’s-Type Dementia.” She identified four stages. The third and fourth stages require certain approaches which can create meaningful interactions with confused persons.
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Persons in the third stage engage in repetitive motion. They may pace or wander as if they had endless energy. They may repeat certain words or sounds over and over again. They may make movements with the hands in a rhythmic fashion.
Since people in the third stage have lost speech and the ability to think logically, verbal techniques rarely work. Non-verbal methods such as appropriate touch, genuine eye contact, matching facial expressions to emotion, and linking behavior to universal human needs (to be loved, to be acknowledged, to be useful) help to restore, if only for a moment, the quality of life.
Mirroring the sufferer’s movements can spark immediate, direct eye contact. Copy the person’s body movements, breathing, hand and feet movements, and facial expressions. Follow the person’s lead and dance to his or her rhythms. However, be careful not to use mirroring in a mocking way. As with all people stricken with dementia, our purpose is to build trust and lower anxiety. Do not use mirroring if there is any sign of resistance or agitation.
A caregiver once encountered a lady who wandered the hallways of The Baptist Home. As she pushed her walker, eyes looking straight forward, she made annoying wooing sounds of a train whistle louder and louder. The caregiver walked with her matching the same gate and sound. Eventually, she stopped, made eye contact and said softly, “If you’ll stop, I’ll stop.” By matching her body movements, the caregiver was able to gain the attention of the confused person. Eventually, the caregiver worked with the repetitive mover to replace the annoying train whistle sound with the less disturbing rubbing of the hands.
Much of the same occurs for those in stage four, vegetation. Speech is lost, as well as the ability to think logically. Again, non-verbal techniques; such as, touch, genuine eye contact, matching facial emotions and linking behavior to universal human needs is the most effective. Stage four people often do not acknowledge old friends or recognize family. Breathing is shallow and soft, the sufferer barely moves on his or her own initiative. He or she may lay in bed in a fetal position, eyes shut with an expressionless face.
Appropriate touching often kindles memories from long ago. The early, emotionally tinged memories are permanently stored in the brain and are sometimes stimulated by gentle touching. By touching different parts of the face and shoulders, memories arise of significant relationships. A gentle petting of the top of the head may evoke pleasant father-like memories or a tender touch of the cheek may cause lovely maternal thoughts. Signs of meaningful interactions are when the vegetative person awakens, turns his or her face towards the caregiver, eye contact is made, and the face of the sufferer is relaxed and warmly animated. Avoid touching if there is any sign of resistance or unpleasantness.
The use of soft music is beneficial in all the stages of resolution previously mentioned. Familiar songs learned in early childhood become permanently imprinted on the brain. Often these songs become associated with loving relationships and strong emotions. They can elicit pleasant responses and experiences of those in the final stages of dementia.
We must be careful to always acknowledge the person in a confused stage. That is, when we are in his or her presence we should never talk about them as if they were not there. We never know what people are able to perceive while in this state of mind. His or her soul may be alert and alive, but in a wearied body that can no longer communicate effectively.
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Music: Bridging the Memory Gap
Chillicothe Campus
by Becky Barton
Close your eyes for just a moment and think back to the first time you heard music. How old were you? What was your favorite song? How did that song make you feel? Music has an amazing ability to transport us to a specific time and place, to evoke emotions attached to a memory almost instantly. It is as if music has left footprints in our mind that can be retraced to memories once thought long forgotten.
The Baptist Home staff at Chillicothe recently had the opportunity to attend a seminar about how music can be used therapeutically for people who suffer from memory loss. Guest speaker Dan Cohen, the executive director and founder of Music and Memory, shared how his organization has been helping hundreds of elderly, nursing home residents who suffer from Alzheimer’s and other forms of dementia reconnect with the use of personalized music. The results shared by Mr. Cohen were so compelling that Administrator Lynn Jackson and Assistant Administrator Ruthie Meyers were convinced they wanted to offer the same treatment to our residents.
“Music has more ability to activate more parts of the brain than any other stimulus.” – Oliver Sacks, M.D.
Ruthie began sharing with resident families during care plan meetings about the use of personalized music therapy to treat dementia and within a couple of weeks she received new headphones and an iPod (portable listening device) already loaded with music from a nephew who wanted his aunt, Ann Joy Herman, to have her own personalized playlist. Oftentimes, Ann Joy was uncommunicative and would rarely talk. When she received her iPod and began listening to her favorite music, the results Ruthie and others witnessed were almost immediate. Staff reported she would listen to her music for hours and became vocal when the iPod was taken away saying, “Where are you taking that!” When Ann Joy declined to the point she needed hospice care, the Home purchased an external speaker and played her iPod next to her bed so she could listen to her music through her last days.
Ruthie admitted that when she first heard about this form of music therapy she was a bit cynical. “You know after you’ve been in this industry for twenty-plus years and you hear about a ‘new’ thing to try, sometimes it just falls by the wayside. However, Dan Cohen, who has been studying this form of therapy for many years, has had amazing results which have been documented in a film called Alive Inside. The movie chronicles how music has changed the lives of many people who suffer from varying forms of dementia, memory loss and even bipolar disorder. After hearing Mr. Cohen speak and seeing the dramatic improvement of residents like Henry in the film, well, I can’t argue with those results.”
When a resident is identified as someone who might benefit from personalized music therapy, Ruthie works closely with the family and the resident, if possible, to choose his or her favorite music. “The experts tell us to choose music they would have enjoyed between the ages of 11-25,” Ruthie said. “There is something about having the music play directly in your ears that allows you to feel the music and remember a song that has a memory attached, thereby helping to reestablish identity. The claim is that the music can actually stimulate neurological pathways in the brain in a way that nothing else can.”
Another resident currently using music therapy is Rev. Jim Grubbs. His wife, Una, has been primarily responsible for ensuring that he listens to his music regularly. “When the iPod batteries run low, Una comes to find me right away to recharge it,” Ruthie said. While Jim’s response to the music has been subtle, he is noticeably moving his fingers along with the music. “We can tell the music is reaching him,” Ruthie said. Rev. Grubbs’ playlist includes some Elvis, big band tunes, scripture readings and even recordings of his granddaughters playing the violin.
“Music connects people with who they have been and who they are in their lives.” – Dan Cohen, founder of Music and Memory
The Baptist Home has been using music to minister to residents for over 100 years, but the idea of creating a personalized list of favorite music for each resident is new. We are excited to see how this form of therapy will benefit our residents and their families. “Our goal, Ruthie said, “is to have enough iPods available to provide this ministry to every resident who needs it.”
When asked how people who were interested could help, Ruthie said, “We need gently used or new iPods and people willing to volunteer an hour or two to help download the music. Teenagers are welcome!” If you would like more information on how you can help with this new and exciting ministry, please contact Ruthie Meyers at 660-646-6219 or rmeyers@thebaptisthome.org. Additional information on this form of therapy can be found at www.musicandmemory.org and www.aliveinside.us.
Q&A: IRAs and Taxes
IRAs, 401(k)s, and 403(b)s are all excellent tools for preparing for or enjoying a financially worry-free retirement. However, there are some income tax issues with these arrangements that may affect you or your family in the future. If you want to make the most of your retirement savings, The Baptist Home Planned Giving program can help. We’ve prepared this article to help you learn more about how to reduce taxes, benefit you and your family, and support kingdom causes and The Baptist Home.
Question:What are the tax implications of Individual Retirement Accounts?
Answer: You are eligible to establish an IRA account even if you are participating in a company retirement plan. You may be able to deduct your contributions to the IRA. Earnings accumulated in the account will not be taxed until you withdraw them – usually at a later time when your tax rate is lower. It should be noted that Roth IRA’s withdrawals are not taxable during life or at death.
Question: What are the tax considerations of a Lump Sum Distribution versus Direct Deposit to an IRA?
Answer: If lump sum distribution from a qualified plan is an option for you, be aware of the tax withholding requirement. When requesting a lump sum distribution, 20% will be withheld for taxes. You will have 60 days from the date of distribution to make a tax-free rollover into an IRA account. The 20% withholding tax will be refunded, but this method allows the government to have interest-free use of your money. You may wish to consider a direct deposit of qualified plan to an IRA. You can avoid the 20% withholding tax by having distributions placed directly into a qualified IRA account. It is suggested that you establish a separate IRA for this purpose rather than combining your distribution with money you already have in an IRA.
Question: How are IRA distributions taxed?
Answer: Most often, IRA withdrawals are taxed as ordinary income. If you are less than 59½ years old, there will be a 10% penalty tax in addition to the regular tax. After you reach age 72, distributions are required based upon your life expectancy. If you are married, it can be based on the life expectancy of you and your spouse. Your IRA withdrawals will continue to be taxed as ordinary income. (ROTH IRAs do not require withdrawals until after the death of the owner.)
Question: What is IRD and why is it important?
Answer: The term Income in Respect of a Decedent refers to ordinary income items which are included in a deceased person’s estate, but have not been included on his/her final income tax return. IRD items usually pass to the estate unexpectedly, with the unforeseen tax liabilities seldom being included in the estate planning process. Common examples of IRDs are IRAs and qualified pension plan distributions, deferred gain on commercial annuities, and interest accrued on U.S. Savings Bonds (Series EE & HH). Many people do not realize that at the death of the owner of an IRA and/or the surviving spouse, funds remaining in the account become taxable income to the heirs of the account or estate.
Question: How can an estate owner avoid this IRD tax problem?
Answer: A donor may designate a qualified charity like The Baptist Home as beneficiary of an IRD asset at the donor’s death. Because of The Baptist Home’s tax-exempt status, the income tax on this asset will be avoided. IRD assets can also be left to a charitable remainder trust. It should be noted that to avoid the income tax the asset must pass to charity or charitable trust at the death of the donor. A lifetime transfer may result in the income being taxed to the donor at the time of the gift to charity.
Question: Is it possible to benefit children and heirs and still reduce IRD taxes?
Answer: Yes, there are solutions to the IRD tax problem that reduce taxes and provide benefits to heirs. In order for the tax on IRD to be avoided, the charitable gift must be properly structured. We recommend consulting a professional advisor to be certain your gift is handled properly.
This article has been written to assist you in achieving your long-term retirement goals and avoiding unnecessary tax liabilities through charitable giving. Naming The Baptist Home as the beneficiary of an IRA or other IRD asset can result in tax savings for your heirs, and the funding needed to sustain our mission for many years to come. It is also a simple way to make a charitable gift at your death.
If you have questions about the tax consequences of your IRA or other assets, The Baptist Home Planned Giving staff would like to assist.
The Baptist Home – No Place Like It
Some have said The Baptist Home is the best kept secret in Missouri. Although it is never our intention to hide this light under a bushel basket, I think the expression is just the way people convey their appreciation for this ministry. It is a great ministry and God gets the credit for everything this ministry is and does. I am very grateful to Him for His guidance, His wisdom and His provisions for The Baptist Home.
When I share The Baptist Home story with others, they are amazed how we do this without government support. I know of no other faith based nonprofit, secular nonprofit, or for-profit business that is able to do this for the general population without heavy subsidies from the government, primarily through Medicaid and secondarily through Medicare.
Oh sure, there are a few upper scale facilities providing care for those who can pay; and that’s okay. And a few more, that severely limit the amount of charity care to make their operations sustainable; and that’s good that some charity is given. A few top feeders discharge residents as soon as they deplete their funds. However, The Baptist Home provides over two million dollars a year for fifty percent of its residents in its long term care facilities on its three campuses without government support. And yet, no resident worries about discharge because of her or his inability to pay the cost of care. I don’t think there is anything like it in the nation.
Sounds boastful, doesn’t it? Well I can assure you God gets the credit. I’ve seen so many ways in which God moved and provided for this ministry. The Baptist Home’s beginnings were tough and difficult. Then, the Great Depression was upon us, and The Baptist Home was sold on the Iron County courthouse steps like so many businesses were in the 1930s. A local businessman of the Episcopal faith purchased the Home and gave it over to a reorganized Baptist board of trustees. Past wise leadership sacrificed and invested funds to ensure the continued operation and growth of The Baptist Home. Individual and church donors were and continue to be faithful.
And, here I sit 101 years after its founding grateful to God for His guidance, His wisdom and His provisions for The Baptist Home. Heavenly Father, we love You and thank You for meeting our daily needs. May we be good stewards of Your provisions and always mindful of Your will for our lives and for this ministry. May others come to know of Your love and grace demonstrated by Your Son who died for us and gave us eternal life.
Things My Kids Need to Know
Things My Kids Need To Know
A review of the essential information every parent needs to communicate to his/her adult children so the children can fulfill the biblical mandate to “Honor you father and mother.” Each participant will receive an “Important Information Workbook.” (TBH also offers a similar program for the adult children entitled “The Things I Need To Know About My Parents”)
Do You Need Good Estate Planning Information?
Do you have estate planning decision to make and need up-to-date information? We have a place for you to find what you need. It is the new estate planning and planned giving website for The Baptist Home and The Baptist Home Foundation. You will be amazed at the amount of content that is available on wills, trusts and other estate planning tools. The purpose of this article is to familiarize you with what is available on our website and how you can access the information. Our desire is to provide the most accurate and up-to-date information to the friends and supporters of The Baptist Home. It should be noted that on some pages you can increase the size of the text by clicking the Text Size button.
You begin by going to The Baptist Home website at www.thebaptisthome.org and then click Support. You move down that page to the bottom left green section and click the arrow beside Planned Giving. From here there are several directions you can go. You can click Gift Options and go to types of assets that can be used in a planned charitable gift. The What to Give tab includes Stocks and Bonds, Land or Real Estate and Retirement Plan assets as well as cash. There is an explanation of each type of asset and the tax rules. You can also review How to Give which includes numerous options including Bequests, Charitable Gift Annuities, Charitable Remainder Trusts, the Give It Twice Trust and much more. There is information on each of the giving options. There are donor stories on many different planning issues included on the website. There are also e-brochures that can be requested on almost every topic covered.
There is a great deal of information on Estate Planning. You can reach the information by clicking Create Your Plan. You can then click Learn About Wills which takes you to a wide variety of topics. There is information on Wills, Living Trusts, Joint Tenancy, Planning for Children and other relevant issues. There are videos available on most topics with case examples to help make the information more understandable.
Under the Plan Your Will tab, click on Plan Now and you will enter the on-line planner. This on-line planner can lead you through preparations before you visit your estate planning attorney. It will be necessary to set up a user ID and password and log in to use the on-line planner. The process of logging on will make the information you enter completely confidential. You can allow access to the planning information to your attorney. The more prepared you are for your attorney visit, the more likely it will expedite the process and possibly lower the costs of your planning.
Another important tool on the Planned Giving website, under the Gift Option or Create Your Plan, is the Planned Gifts Calculator. You can do your calculations for a Charitable Gift Annuity, Deferred Gift Annuity and a Charitable Remainder Unitrust.
You can also sign up for our Gift Legacy eNewsletter which is sent out weekly via e-mail. The newsletter has helpful planning information and important up-to-date information on tax law changes and other issues that might affect your planning. There is also an Advisor’s Gift Law e-newsletter available on a weekly basis. You can sign up for both eNewsletters on our website.
The Estate Planning office of The Baptist Home is available to answer questions and provide more information about estate planning and planned giving.
Prepare Before Communicating with the Confused
Communicating with someone who is confused can be frustrating. And yet, somehow caregivers need to listen and speak in a way that builds trust and lowers anxiety. Anxiety only heightens uncooperative, difficult behavior and impedes communication. The goal is to provide as much quality of life as possible for the confused person by lowering the distress that can accompany difficult moments.
Therefore, it is important to prepare for the relationship with a confused person. Naomi Feil in her book, The Validation Breakthrough, speaks of the value of ‘centering.’ Caregivers must be in the right frame of mind in order to handle the complicated thoughts, feelings and behaviors that may come to the surface. ‘Centering’ begins when the caregiver acknowledges his or her own feelings. It is important to find a way to express them so they are not imposed on the relationship.
The exercise of certain relaxation techniques by the caregiver is helpful. For example, the practice of deep, slow breathing calms the internal being. The imagery of slowly breathing in new fresh air and expelling old stale air (thoughts and feelings) can be therapeutic for the caregiver. Positive self-talk can sweep away worrisome and needless thoughts before and during an exchange. This intentional effort will prepare the caregiver for empathetic listening and unconditional acceptance.
Joy Goodwin, who introduced Validation Therapy to The Baptist Home in the 1980’s, gave this good advice. “Relax; the confused or disoriented do not have to live in our reality. It’s okay to allow them to have their own reality as long as they are not in physical danger or a danger to others.” Insisting that the confused person live in the caregiver’s reality does not work. Reality Therapy attempts to correct the confused with verbal and written cues. However, this is often found to increase agitation and is generally not beneficial for effective communication.
The caregiver may miss an opportunity of understanding the underlying thoughts and feelings by becoming too obsessed with making sure the facts are correct. The confused person is probably speaking in symbolic language and not interested in facts anyway. He or she may be subconsciously creating fantasy to express deeply felt needs. Correction interrupts this process and will more than likely be met with stubborn resistance and increased hostility, agitation and withdrawal.
Spouses and adult children of the confused may find this approach difficult since life lived in the family unit and workplace often involves correction. However, the caregiver’s feelings of anger, fear, embarrassment and guilt must be put aside. Accepting the confused person’s condition frees the caregiver to find effective ways to have a meaningful conversation. This builds greater understanding by allowing deeply felt needs to be expressed in a safe and nonjudgmental way.
This approach builds trust; however, it is also essential not to patronize, lie or play along with the mistaken reality. On one level the confused person may realize you are toying with them. This does not make for a good relationship or meaningful experience. Next time I will address some important ways to build trust without patronizing.
