Persons with Alzheimer’s disease and other dementia often experience feelings of loss, isolation and loneliness, sadness, confusion, worry and anxiety, frustration, fear, paranoia, anger, and embarrassment. They can become easily overwhelmed by these feelings. And then what happens next? The answer to that question is all too familiar to many readers of this book: behaviors that are challenging for care partners to respond to, including anger and agitation or struggles with personal care, and a feeling of frustration and failure for the care partner.
When you learn and practice the Best Friends approach, you begin to learn how to provide care with “knack,” that art of doing difficult things with ease. With empathy, strategic use of the Life Story, good communication, and other techniques described in this book, you can turn failure into success. Enormous challenges will continue to exist or emerge, but the Best Friends approach almost always makes things better.
One of Rebecca Riley’s greatest fears was that others would not treat her as a “real person.” Following are examples of how the Best Friends approach reinforced positive emotions and helped Rebecca feel valued, part of her family, and connected to the world around her. Your goal as a Best Friend is to find the ways that will produce these results in the person in your life. Then you, too, will understand how the Best Friends approach has helped Rebecca and so many others live a dignified life.
THE BEST FRIENDS APPROACH CAN TURN FEELINGS OF WORRY AND ANXIETY INTO FEELINGS OF CONTENTMENT
- Rebecca found listening to music and playing still-familiar songs on the piano soothing.
- Rebecca marveled at the beautiful sunsets at Crystal Lake.
- Rebecca delighted in simple activities such as watching birds and butterflies.
- Rebecca felt comforted when read aloud to.
THE BEST FRIENDS APPROACH CAN TURN FEELINGS OF FRUSTRATION INTO FEELINGS OF SERENITY AND PEACEFULNESS
- Rebecca loved knitting in front of a fireplace.
- Rebecca felt calm socializing in small groups instead of big parties.
- Rebecca found long walks peaceful.
- Rebecca enjoyed working in the yard at a slow pace.
THE BEST FRIENDS APPROACH CAN TURN FEELINGS OF CONFUSION INTO FEELINGS OF ORIENTATION
- Rebecca enjoyed old hobbies such as swimming, hiking, and boating when surrounded by family and friends.
- Rebecca responded well when others slowed down in conversations.
- Rebecca appreciated when day center staff gave her cues to relive important life events.
- Rebecca felt the most oriented in her long-term care community when surrounded by familiar family mementos.
THE BEST FRIENDS APPROACH CAN TURN FEELINGS OF LOSS INTO FEELINGS OF FULFILLMENT
- Rebecca gained a sense of worth from teaching a class for young adults at church for the first year after her diagnosis.
- Rebecca was pleased when her children thanked her for being such a great mom.
- Rebecca was proud of maintaining her family role as grandmother to her grandchildren.
- Rebecca felt rewarded when helping others, especially at the day center.
THE BEST FRIENDS APPROACH CAN TURN FEELINGS OF SADNESS INTO FEELINGS OF CHEERFULNESS
- Rebecca could be a “free spirit,” having fun at the Crystal Lake cabin.
- Rebecca reminisced gleefully when her younger sister recalled funny childhood stories.
- Rebecca smiled when friends talked with her about her nursing career and her family, discussing the children by name.
- Rebecca felt cheered up when Jo teased about the time she tried to hike in the Grand Canyon with a cast on her leg.
THE BEST FRIENDS APPROACH CAN TURN FEELINGS OF EMBARRASSMENT INTO FEELINGS OF CONFIDENCE
- Rebecca liked it when Jo helped her prepare simple meals.
- Rebecca did not get embarrassed by small gaffes because her friends were so understanding.
- Rebecca felt competent and useful when exposed to day center programs that matched her remaining skills.
- Rebecca felt more equal when Jo told a joke at his own expense.
THE BEST FRIENDS APPROACH CAN TURN FEELINGS OF PARANOIA INTO FEELINGS OF TRUST
- Rebecca felt more involved in family finances when Jo had her sign the checks he filled out to pay bills.
- Rebecca liked that Jo used “we” instead of “I” when talking about their family.
- Rebecca appreciated making decisions, even simple ones, or being asked her opinion.
- Rebecca felt that friends were their friends, instead of Jo’s friends, when Jo asked her to contribute to the annual Christmas letter.
THE BEST FRIENDS APPROACH CAN TURN FEELINGS OF FEAR INTO FEELINGS OF SECURITY
- Rebecca felt more secure when friends and families acknowledged her illness.
- Rebecca appreciated that she was never left alone in public.
- Rebecca felt reassured by friendly hugs.
- Rebecca loved feeling “protected” by her dog, Corky.
THE BEST FRIENDS APPROACH CAN TURN FEELINGS OF ANGER INTO FEELINGS OF CALM
- Rebecca released pent-up energy when walking the dog.
- Rebecca felt adequate when volunteers at the day center let her hang up her own coat.
- Rebecca found that vigorous exercise diffused anger.
- Rebecca felt distracted from her agitation by the simple act of holding hands, cuddling, or being loved.
THE BEST FRIENDS APPROACH CAN TURN FEELINGS OF ISOLATION AND LONELINESS INTO FEELINGS OF CONNECTEDNESS
- Rebecca felt important and competent when Jo made her feel part of his ministry.
- Rebecca felt friendship and support from a couples group.
- Rebecca received unconditional love from her dog, Corky.
- Rebecca felt heard when friends let her talk about the experience of Alzheimer’s.
- Rebecca felt connected to God when she worshipped in her church.
The Best Friends approach transformed Rebecca by helping her operate at her best, despite her younger-onset Alzheimer’s disease diagnosis. Good communication, social engagement, and friendship helped her to be happy and feel safe, secure, and valued.
The Best Friends approach also transformed her husband, Jo, helping him overcome the despair that can overwhelm families and allowing him to be his own Best Friend. According to his holiday letters during his wife’s journey with Alzheimer’s, Jo still managed to spend time with Rebecca at their cabin at Crystal Lake, be active in his church, enroll in a class, travel (after she moved to assisted living), spend time with family, and have some fun. He did this while still being fully engaged as Rebecca’s care partner.
Think of the Best Friends approach as a road map. It is not only a way to get the person from “here” to “there,” but it is also a way to bring all those who provide care from “here” to “there.” This approach can shift negative behavior to positive behavior for everyone. It makes the journey of the disease more of a shared experience between the person and his or her care partner.
Family and professional care partners with knack are confident people who deliver confident care, prevent problems before they occur, and enjoy spending time with the person in their care. When care partners are not well informed, argue and correct the person with dementia, do not utilize resources, and do not take care of themselves, the darkness and despair that can come with dementia will win out.
As we conclude, we want to introduce you to one last family member who has embraced the transformative power of the Best Friends approach:
Howard Woods amazed his friends and family with his daily care of his wife, Emma, who had late-stage Alzheimer’s disease. He told friends that they had not really had the best marriage, often having disagreements. Yet he said that through his time with her, caring about her, and doing things for her that he could never imagine doing for anyone, he had fallen in love with her all over again.
Remember, the medical condition of Alzheimer’s disease and other dementia will not change, but your approach as care partners can. By following the Best Friends approach, you will help reduce challenging behaviors and create a joyful, safe, secure, rich, and dignified life for the person and for yourself.
There is great value in being totally present for another human being. There is great value in getting the most out of every moment, every day. There is great value in good communication. There is great value in honoring an individual’s Life Story. There is great value in giving care to another.
Because any of us can be touched by Alzheimer’s disease or dementia and can have times of challenge and great need, the ultimate message the authors wish to convey is this: we should treat everyone important to us as a Best Friend.