Game, Videos Can Enhance Lives of Elders with Dementia
Cohen, Gene, Aging Today
To live in the hearts we leave behind is not to die.
Too often, one hears the unqualified statement that "there is no treatment for Alzheimer's disease." This belief reflects either a misunderstanding or a misrepresentation of intervention opportunities for Alzheimer's and related disorders. What more accurately characterizes clinical reality is that there is no treatment that can prevent, cure, reverse or arrest the progression of Alzheimer's disease. But, as with other chronic and progressive disorders, a range of clinical and psychosocial interventions can alleviate symptoms and suffering and maximize coping at different points in time or stages during the course of the disorder. There are interventions that can improve the quality of life for both those who suffer from Alzheimer's and their families.
I will describe two such quality-oflife-enhancing approaches I have developed that were recently awarded first place in the Blair L. Sadler International Healing Arts Competition, through the Society for the Arts in Health Care, Washington, D.C. The first, a project involving video biographies, was funded by the Helen Bader Foundation. The second, the development of the first board game for people with Alzheimer's and related disorders, was supported by the National Institute on Aging. Both projects employ the same concept, but with different media; the board game uses biographical flash cards, applying images similar to or the same as those used in the video biographies. I got the idea for both of these studies in struggling to help my father, who had Alzheimer's, when he died. Now I am employing both of them in helping my mother, who has multi-infarct dementia.
Even if one applies state-of-the-art medical treatment optimally for Alzheimer's patients, their quality of life is still severely impaired, especially by the time they reach the moderately severe to severe stages of the disorder. Medical treatments focus on signs and symptoms that interfere with functioning and cause discomfort. These clinical problems include memory impairment, depression, agitation and psychosis. Treatments here help with suffering and coping, but quality of life remains very compromised. What else can one do?
I have learned from my 35 years of clinical work and research with individuals suffering with major memory disorders that beyond signs and symptoms, two other s-words have intervention significance-residual area of strengths (or skills) and satisfactions. These strengths and areas of satisfaction do not reflect clinical problems but individual potential, even in the face of decline. We all have them to varying degrees. Tapping into these areas of residual strengths and satisfactions enhances the quality of life for both the patient and the family. The process responds to the patient as a person.
The painter Willem de Kooning, a towering figure in modern art, developed Alzheimer's disease in his mid-7os. Despite progressive problems, though, he continued to paint 40 works of art during the seven years following his diagnosis-works that were accepted for exhibition at the Museum of Modem Art in New York City. Although his work was no longer considered museum quality after that, he nonetheless continued to paint, deriving considerable satisfaction from this area of preserved skill, with the net effect of an enhanced quality of life. He could still gain access to residual personal potential in the face of worsening clinical problems.
Generally, among those who suffer from major memory disorders, a common area of reserve strength consists of pockets of residual memory that, with creative and gentle prompting, patients can tap to provide significant satisfaction for both themselves and visiting significant others.
Both the video biographies and the board game for patients and families struggling with dementia share the following goals:
* They can positively alter the experience of a devastating illness by increasing intervals of time that enhance the quality of life. …