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Wednesday, March 06, 2013
Dementia: Making a little time for time
From PS or PublicService.co.uk:
A Blog Entry by Sarah Reed
For older people with dementia, time can be a big issue. Understanding where they are in relation to time can be a cause of deep anxiety
Tick tock, tick tock – in my line of work, the subject of time ticks round quite frequently and takes many different forms. It is often a source of stress.
Time is relative and I find it quite surprising how many different and often complex forms it takes. Consider these for a moment: there is the time that we remember (or don't remember); the time that passes too slowly, or seems to rush by so that there's not enough time to enjoy it; the time when we are young, which seems to stretch so elastically into the future; the time at the end of someone's life which may seem more precious than ever; the time that hangs heavy when we are bored; the time that fizzes when we are waiting with anticipation or excitement; the time that we squander; the time that must be managed; the time that is unmanageable; the morning time that might seem to travel faster; the late afternoon time that takes its time.
As all carers of older people will attest, time may have different dimensions for people at the end of their lives. There is not much time left for them, yet decades of time have passed before.
For older people with a dementia, time can be a big issue. Their understanding of time can alter and it may feel different to them. They may get up in the middle of the night believing it to be daytime, or may repeatedly ask the date and the time, being unable to 'hold' the information from one minute to the next. Understanding where they are in relation to time can be a cause of deep anxiety for them (and shows that clock-watching is not just confined to those who work in caring environments!)
Last year I worked on a UK-wide project that asked 3,000 people living, visiting and working in care homes what would make life better for them. One of the headline answers was 'time'. That is, relational time with others, whether it be with loved ones, those they care for or those in receipt of care.
In truth, we all need time to share and explore our experiences over time. Carers crave more quality time to do what they are paid to do and work that is less task-focused, but still as timely. So often, in a system that may be clocked at every step in one way or another, it can be challenging to deliver this.
Fortunately, there is slowly growing recognition that care delivery ruled by clock-watching is not only inadequate but is also monstrously disrespectful. How are we to overcome this metrics-driven, broken time?
Until we respect time and give ourselves time, nothing can change. It is up to us to cultivate a healthier relationship with it. One way to do this is through mindfulness.
Mindfulness means being truly still and "in the now", or "present" so that we can become more aware of our own existence against the backdrop of time. Mindfulness techniques are simple to learn and do and require little more than a few minutes.
Before I start any REAL Communication workshop, (focussed on improving people's meaningful interaction through reminiscence, empathic engagement, active listening and life story gathering) we always take a few minutes for a physical and spiritual reflection, when participants are invited to give just to themselves. It helps them leave their other (earlier) distractions behind, helps them relax and to brings them into the present. Some tell me that this is their favourite part of the day (which speaks volumes about the levels of stress and complexity they work under and carry with them).
Mindfulness is practically effective as well. To simply be with a person who is living with dementia is widely recognised to be one the most effective and meaningful ways to communicate with them.
When we approach our own days with attention, mindfulness and presence, we are more likely to feel more at peace as we move through the day and we enjoy ourselves more.
If carers were encouraged to practice mindfulness daily, not only would they enjoy the benefits of the feeling and awareness of their life energy being rekindled, they would also feel less stressed. This would translate positively into their work – and this in turn would influence the bottom line – so everyone wins.
Paying attention to what is happening in the present moment takes us out of ourselves, helping us to be less judgmental of ourselves. By reducing our mental clutter, it helps us make better choices. Best of all, time spent in these small ways feels longer and richer than the reality of it and thus our relationship with time – and life – can change for the better, too.
Why not try it for yourself!
Sarah Reed is a dementia communications and reminiscence specialist and a REAL Communication workshop facilitator. After ten years' experience with her mother who had Alzheimer's disease and vascular dementia, and twenty years' volunteering for an older people's charity, in 2008, she left a successful career in film and creative media to start the social enterprise Many Happy Returns. The company designs and develops products, services, skills development workshops for carers and projects that help connect the generations (especially those with dementia) more enjoyably, through more meaningful engagement.
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