It is Day 4 of Dementia Awareness Week in the UK, although I am almost a day ahead of them, and so my blogs are being read ahead of time there! However, this topic seems pertinent to write about again for this particular week. it is, of course, is on whether we should focus on behaviour management or, improving staff education, and the question I constantly ask myself, is this:
Do the staff need better education about dementia in general, and in particular about how to communicate with people with language or other impairments, or do the staff simply need to ‘control’ the challenging behaviours that mostly come about as a result of poor care, feeling locked up, bored, disempowered or lonely and upset about living in aged care?
For me, my poem on wandering, of which I have written many versions, says it all! If simple walking can be labelled wandering (like walking is a bad thing?) and managed with drugs or being restrained, then the whole system may well have it wrong. So, instead of writing a whole blog on this topic again, I am going to add the latest poem I have written on wandering.
Most of the other challenging behaviours could be written about in the form of poetry, and I feel sure, with different education, most of these ‘behaviours of concern’ would simply disappear.
Before a diagnosis of dementia, if I went walking, even if I was ‘wandering’ through a shopping centred for pleasure, it was still referred to as walking. Wandering along the beach with the sand between my toes, was still considered walking. When I go walking, even if I get lost, I am not a wanderer… I am a person.
Sometimes people like to go for walks, even people with dementia. Sometimes people get lost, even people without dementia. Sometimes people walk because they are looking for something, even people with dementia. Sometimes people go walking because they are bored, even people with dementia.
Sometimes people go walking because they might be trying to ‘escape’, or ‘manage’ the boredom of living in an aged care facility. They might be feeling like they are in prison… locked up even though they are not criminals…
Sometimes people walk for exercise, even people with dementia.
Before aged care, people were involved in habitual walking almost all the time… Walking to the kitchen to get a cup of tea, walking to the bathroom, walking to the shed, walking to the clothesline, walking to the shops… Living in aged care does not mean people with dementia wish to stop walking.
Oddly, before a diagnosis of dementia, doctors tell us to get or keep fit, and that walking is one of the best exercises for us… Even more peculiar, is when we have dementia this must stop, and walking is then referred to as wandering, a challenging behaviour that needs managing.
People with dementia are still ‘real’ people, living their lives just as they did before acquiring the label of dementia. People with dementia are not wanderers, screamers, poor feeders, wetters, aggressives, or demented sufferers.
People with dementia still wish to live well, but get very little or no support from others for well-being, or for improving our quality of life, including for walking. Walking is good for us, and fun, it is not a challenging behaviour.
Copyright 2015 Kate Swaffer