原荷兰生命公寓总经理，陪你聊聊“认知症”（六）

提供个性化的支持 

遗憾的是，我们有时会失误。让认知症患者在机构中保持活跃和娱乐的目标有时会掩盖每个人的个性和独特性。

做自己喜欢的事 

关于一位患有认知症的客户：她已经不能连贯地说话了，讲的话也杂乱无章。

她经常在屋子里徘徊踱步，似乎在自言自语，且她的情绪变化很快--从甜美、和蔼、顺从到愤怒、挑衅、激烈的反抗和肢体攻击。

她总是在椅子、桌子、电视上，甚至在其他患者和工作人员的手臂上做擦拭或摩擦的动作。

这似乎是她与自己和周围环境建立联系的方式。当她可以不受干扰地做自己的事情时，她是平易近人的，而且看起来相当惬意满足。

然而，她的护理计划必须记录她所进行的活动，她的日程安排包括与刺激和娱乐有关的内容。

结果，当她被带去参加的活动都会因为她受到过度刺激场面而变得混乱不堪。

直到一位家庭成员感叹道：难道她必须一直像这样参加活动保持活力的状态直到她去世的那一天吗？没错！我也是这么想的。

从那时起，所有的活动和计划项目都被取消了，她终于可以做她最喜欢的事情了：安静地冥想。

至少，看起来是这样。她可以在椅子上坐几个小时，双手合十放在膝盖上。她会完全陷入沉思，与周围的环境完全脱离。

通常，她会轻声哼唱或喃喃自语几句，闭着眼睛，脸上带着温和的微笑。每当她处于这种状态时，她似乎完全沉浸其中了。

在这些惬意轻松的时刻，她似乎摆脱了认知症的帽子，显得满足而平静。她不需要通过活动或外出来获得这种感觉。

事实上，这些活动和外出常常会扰乱她愉悦轻松的状态。冥想是为了洞察自己的本性，打开通往自由生活方式的大门。

这难道不美吗？我们不都希望她能有这样的自由吗？

"Blog by a Dutch Nurse (Mariet) on Dementia"

People with dementia are just as unique as anyone else. Each person has their own character, personality, changing moods, and individual ways of coping with and processing challenges, such as illness. Everyone faces life in their own unique way, and this is no different for those with dementia.

When people move into a nursing home, a care plan is created. This is mandatory because everything must be documented for insurance purposes and regulatory inspection, including the amount of care provided and the staffing levels required. Care goals must be established. Organizations are also evaluated based on these criteria.

A key aspect of care is how the day is structured and the activities offered. Activities are planned, outings organized, and so on. This is, of course, important—people with dementia need their environment to encourage engagement, as they often can no longer independently establish their daily routines. However, in all aspects of care for and with people with dementia, we must provide personalized support. Just as every individual is unique in how they spend their day, their routines, and the way they live their lives, our care should reflect that. Unfortunately, we sometimes miss the mark. The goal of keeping people with dementia active and entertained in a facility can sometimes overshadow the individuality and uniqueness of each person.

About a client with dementia: “She could no longer speak coherently; her words were a jumble of sounds. She often wandered around the house, seemingly humming to herself. Her mood could shift rapidly—from sweet, kind, and agreeable to angry, defiant, intense, and physically aggressive. She was always making wiping or rubbing motions over chairs, tables, the television, and even over the arms of fellow residents and staff. It seemed to be her way of connecting with herself and her surroundings. When she was allowed to do her own things, without interference, she was approachable and seemed fairly content.”

And yet, her care plan had to document the activities she was offered, and her schedule needed to include things related to stimulation and entertainment. As a result, she was taken to activities where she would become disruptive due to overstimulation. It wasn't until a family member exclaimed, 'Does she have to be kept active until the day she dies?' Exactly! That was my thought too. From that moment on, all activities and scheduled items were scrapped, and she was finally allowed to do what she loved most: quietly meditate. At least, that’s what it looked like. She could sit for hours in a chair, hands folded in her lap. She would be completely lost in thought, entirely detached from her surroundings. Often, she would hum softly or mumble a few words, her eyes closed and a gentle smile on her face. Whenever she was in this state, she seemed to be completely relaxed.

In those relaxing moments, she seemed free from dementia, appearing content and at peace. She didn’t need activities or outings to feel this way; in fact, those often disrupted her joyful relaxed state. Meditation is about gaining insight into one’s true nature, opening the door to a liberated way of living. Isn’t that beautiful? Don’t we all wish for such freedom for her?