My grandmother was never in a nursing home. No, I take that back. Into her seventies, she did private duty nursing for elderly people. And before that, she worked in nursing homes. I wonder why she made her children promise never to put her in one? So I took care of her in her own home, where she had lived since the Eisenhower administration.
Still, as a caregiver, I was profoundly influenced by GENTLECARE® system of dementia care, though it was developed for institutional use. Actually, I didn’t even finish reading the book, but it changed my attitude toward my grandmother. I was first a student of my grandmother – that’s the most important part. But the philosophy of “prosthetic life care” guided the study of my grandmother.
What is a prosthesis? A prosthesis is an artificial body part, such as an artificial leg or artificial teeth. It replaces or restores missing function. Using a prosthesis isn’t a sign of defeat; it’s a declaration that you’re not defeated yet.
In college, I knew a girl who had half her leg removed because of cancer. So she got fitted with a prosthetic leg. She didn’t become a different person. She didn’t lose the right to self-respect. Quite the opposite. She was eighteen, she had places to go, things to do, and she needed two legs to do them. Except for downhill skiing. She did that with one leg.
Prosthetic care simply treats Alzheimer’s patients with respect and tries to compensate for what is missing. It’s perhaps a radical thought to some people, but a person is a person even if they are lacking some brain functions, just as my friend was still a person even with an artificial leg.
With prosthetic care for Alzheimer’s patients, if someone feels lost without laundry to fold, you give them laundry to fold. If they feel compelled to go to work, and they think they still work in a saddle shop, you give them some leather harnesses to oil and clean, and see it that satisfies them. If they are obsessed with the time or the date, you put a big calendar or a big clock where they can see it. If they suffer from sundowning because the light is dim, get them brighter lights.
The prosthetic care concept actually requires a more mature view of dementia. It’s easy to say, “Oh, she wanders. Oh, she shouts.” It’s harder to acknowledge that her mind must have some reason for doing these things. Is it possible that she wanders because she’s trying to find the bathroom and doesn’t remember where it is? Wouldn’t you do the same?