I came across this article written by the Canadian reminiscence expert Gwendolyn Geest who I admire, who has kindly agreed to my reproducing it here. I think the understanding and wisdom contained herein is exceptional – yet even though the interview and analysis are so straightforward and you might say, obvious, even, I have come across the kind of knowledge holes that are described in this article, again and again.
First and foremost, care home residents are people – husbands, wives, fathers, mothers, brothers, sisters, uncles, aunts, and friends. They are all richly endowed with memories of life and experiences – sometimes the only things of real value that they bring with them into a care home. In forgetting this, we fail to recognise them as human.
Ms Geest writes:
"Peter was 13 when he had his first dog, 18 years old when he
worked in the lumber camps, and 20 when he married. Peter, now 74, is pacing up
and down the hallways of Tick Tock Manor where he is a resident. Peter always
paces on this day, because today is Peter' s bath day.
Things are done right on schedule at Tick Tock Manor. The
caregivers never forget Peter' s bath day. Even more amazing is that, although
Peter has dementia, he never forgets the bath day either.
This morning is different however. Peter is clutching a
small book close to his chest. When the caregiver approaches him to offer to
assist Peter with his bath, he becomes agitated and walks off quickly in the
other direction. Any further mention of bathing sets Peter off in an angry
When I approach Peter and ask if he would like to share what
is in his book, Peter continues walking off in the opposite direction. He then
pauses to think, gives me an indignant look, places his hand on his hip, and
replies, "Sure, why not?"
Peter and I sit side by side in the lounge situated next to
the bathing area. And Peter proceeds to share the family photos in his small
album. It becomes evident that many of Peter' s photos have been taken of a
black Labrador dog in a garden.
"Who is this Peter?" I ask. "That' s Sparky, my dog," replies Peter, with a big
smile on his face. Peter is happy to share that he and his dog, Sparky, have
spent many happy years together. He also adds that he misses Sparky very much.
In one of the photos, Peter is in the backyard with Sparky, where Sparky is
receiving a bath.
"What' s going on in this picture Peter?" I ask. "Oh, Sparky is having his summer bath," says
Peter. "I can' t do the bath in the house, because Sparky races around
after, shaking off all the water. Sparky loves being clean." Peter shows
pride on his face.
I see this as an opportunity to distract Peter away from his
own bathing situation. "Peter, I see that you and Sparky are having a lot of
fun together. And Sparky likes to be nice and fresh and clean. That' s great.
Let me help you to be nice and clean as well. And when Sparky comes for a
visit, you will be fresh. How does that sound?"
"I don' t know about that. Do you think my wife can
bring Sparky for a visit?" "Sure she can Peter, anytime, and you and Sparky can have
a good visit. Let me first help you with your bath. Let' s go." "Oh, alright," says Peter. He takes my hand and we
walk together to the bathing area.
The small book is left behind on the table, the book
containing memories of who is Peter, the book that holds the photos of Peter' s
best friend, Sparky.
The interview with Peter' s caregiver follows:
1. What seems to be the main obstacles in giving Peter his
bath? Just about everything. Peter doesn' t like taking his clothes
off. He doesn' t like having his hair washed, and he doesn' t like getting wet.
Then when the bath is finished, Peter wants to put the same clothes right back
on. He gets really angry with us if we try to persuade him.
2. What have you tried so far? We no longer wash Peter' s hair on bath day. Rather, his hair
is shampooed in the salon where the hair cuts are done. Also, the girls on the
last shift lay out fresh clothing for Peter in the morning, so the clothes
Peter insists on putting on following the bath are clean.
3. How is this working? Good, Peter is far less agitated.
4. I understand Peter has a dog, Sparky. Does Peter ever
talk about his dog? To be honest, I didn' t know that Peter even had a dog. That
is really good information for us. Maybe we can ask the family to bring the dog
in for a visit.
5. That' s a great idea, Peter would love that. Also, does
Peter ever speak of the days he worked in the lumber camps? Yes, now that you mention it, Peter loves to reminisce about
those days. He' s told me he feels lucky that he didn' t lose a finger when he
was working in the lumber camps. And he says, "Those were the best days of
6. Do you think talking about "the best days of Peter' s
life" might help on bath day? That' s a good idea. We can sure try.
7. Can you offer suggestions for other caregivers having
similar difficulties? The most helpful thing I have discovered is to never argue
with the person with dementia, or to try to get them to do something they don' t
want to do. Rather, I allow the person time, and perhaps try again twenty
8. Do Peter' s family visit often? Do you think they might
have some suggestions about the bathing time? His wife visits every day. That' s a good idea; I will
discuss with her some suggestions for Peter' s bathing time.
9. Does the family visit make any difference to Peter' s
behavior? During the time she is here, Peter is happy. However, when
she leaves, Peter starts pacing again. I think he' s lonely.
10. Overall, what is your perception of the present
situation? I' ve learned to never rush Peter, and not to argue with him.
No means no. When Peter gets agitated, and feels that we are trying to rush
him, he will say, "don' t guess; wait till my mind tells me." This is
Peter' s way of letting us know he is still in charge.
Bathing time can be one of the most challenging times for
the caregiver, and one of the most frightening times for the person with
dementia. Think of all the steps we ourselves need to take when preparing for a
Firstly, we need to gather all of our supplies and draw the
water. Then we must undress, and for Peter, that means taking off his clothes
in front of another person. All of us strongly dislike feeling a chill. Persons
with dementia especially do not do well with being cold.
The next step is to actually get into the water, which can
be very frightening for persons with dementia. Their perception may be that
they are drowning. And when the bathing is done, we must get out of the nice,
warm water, towel dry, and then all of the fuss of finding our clean clothes
and putting them on.
Peter is down to the very basics. He lives in the moment.
Talking about his dog, Sparky makes him happy. Reminiscing about the days of
working in the lumber camps makes Peter happy. Peter is not interested in
bathing. He doesn' t see any reason for taking a bath. In fact, any discussion
over three minutes is too long to even discuss the bath. The caregiver needs to
change the subject and discuss what makes Peter happy.
Family caregivers have brought their loved one to the
nursing home, and trust that the professional caregivers will provide care and
understanding. Professional caregivers trust that the family will share
information with them about their loved one. And the person with dementia
trusts that they will receive care and understanding.