People with dementia may have difficulties in adjusting to new environments due to memory loss and decline in judgement. In the following case, Liang Shu (a person with dementia) has been living with his daughter. Their home is under renovation. The daughter thus arranged for Liang Shu to use the Residential Respite Service for Elders and stay at a residential home temporarily. Liang Shu has requested to go home frequently during his stay there. How would you handle this situation?
Liang Shu is anxious and depressed because he cannot adjust to the new environment.
Liang Shu requests to leave the residential home frequently. He also makes a scene at the end of each visit by his daughter.
The staff at the residential home pay more attention to Liang Shu to prevent him from leaving by himself, making him even more anxious.
Liang Shu's daughter pays fewer visits to him as she is afraid of the scene that he would make at the end of each visit.
Liang Shu has been living with his only daughter for many years. He is an introverted person and seldom joins social gatherings. He has no intention to develop friendships with others during his short stay. All of these factors contribute to his boredom and anxiety.
The physical condition of Liang Shu has been very stable. It is not a major reason for his anxiety and depressed mood.
Liang Shu's dementia has progressed to the moderate-to-late stage. As a result, he has difficulty adjusting to the new environment. His anxiety level also goes up when he forgets why he is staying at the residential facility.
Liang Shu does not have any close friends in the residential facility. He gets nervous when others invite him for games and activities. On the other hand, he worries that he may be abandoned by his daughter. This causes great stress for Liang Shu during his stay.
| Liang Shu: |
Why is she so late?
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| Daughter: |
Dad!
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| Liang Shu: |
Sweetheart, where have you been? Let's go now!
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| Daughter: |
Sure. You must have missed me.
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| Liang Shu: |
You know how much I missed you!
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| Daughter: |
Wait, Dad. I have left some money with this home. I have to go and get it, or they will take it. Can you come with me just for a minute?
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| Liang Shu: |
Oh, sure. But be quick. Let's go.
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| Daughter: |
Everyone must be praising you then!
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| Liang Shu: |
Well, they always say I look good all the time. I'm getting sick of it.
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| Daughter: |
That's so cool! Why don't you show me your room? I heard they posted your photo on the door. Your photo must be great!
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| Liang Shu: |
Sure. See, I look great, right?
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| Daughter: |
Wow! You look so smart!
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| Liang Shu: |
Ha ha!
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| Daughter: |
That's so cool! Why don't you show me your room? I heard they posted your photo on the door. Your photo must be great!
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| Liang Shu: |
Sure. See, I look great, right?
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| Daughter: |
Wow! You look so smart!
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| Liang Shu: |
Ha ha!
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| Daughter: |
Wow! Dad, your room is so big!
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| Liang Shu: |
Yes, very big.
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| Daughter: |
Dad, you have been here for over two weeks. I'm glad you're doing great.
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| Liang Shu: |
You know, all I need to do here is eat and sleep.
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| Daughter: |
But, the nurse told me that you're doing great in the calculation groups and reminiscence groups as well.
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| Liang Shu: |
Of course. Who do you think I am? Those are too easy for me.
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| Daughter: |
I should bring your albums with me next time. You can show them your photos and tell them your great stories.
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| Liang Shu: |
Tell them my eye-opening stories!
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| Daughter: |
Fantastic!
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| Daughter: |
The staff here are really kind. See how nicely they packed your clothes up after doing the laundry for you. Let me hang them up for you.
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| Liang Shu: |
Hey, you don't have to hang the pullover. Just fold it up and put it inside the drawer.
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| Daughter: |
Oh, sure! Let me fold it up and put it here.
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| Liang Shu: |
That's it.
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You can design preventive measures by combining your knowledge and skills in communication, behaviour management, environmental modification, and activity design to fulfil the needs of the person. For example:
Aim: To prevent Liang Shu from feeling bored.
Aim: To show care and support to Liang Shu during his stay.
Aim: To increase Liang Shu's sense of achievement.
Aim: To increase a sense of belonging in Liang Shu.
Aim: To remind Liang Shu about the meaning of his stay.
Aim: To help Liang Shu adjust to the new environment.
There are numerous ways to satisfy the needs of a family member with dementia. You may take into consideration his or her characteristics to reduce resistance and increase effectiveness.
