Why Caretakers Know Their Loved Ones Better Than Anyone

By Daniel C. Potts, MD, FAAN | Caregiving

I remember, as a boy, walking in the countryside with Dad to a place at the edge of the woods where, in his youth, he had quenched his thirst with cool spring water after ploughing the fields.

Burying his boot in a couple of blind sinkholes, he finally found the spring, which had become overgrown and silted over the years. All I could see was mud, but Dad knew there was a wellspring of sparkling, cool, refreshing water below.

After clearing some debris, the water began to freely flow and wash away the impurities. In just a few moments, there was enough fresh water so that we could each dip our hands in for a drink.

I remember thinking that water was the best tasting, most satisfying liquid that had ever passed through my lips. And all it took was a seeker who remembered where the spring was, and who cared enough to clear the way.

Thinking back on this experience, I see it metaphorically as a lesson for care partners of those who have dementia. We know our care partners better than anyone, their unique self-elements that persist despite cognitive impairment. We know where to find their personhood, although dementia’s debris may have impaired its expression, or disguised it from unperceptive eyes.

If we care, then perhaps we can find ways to remove the obstructions so that the clear waters of the self can begin to flow again. And even a small sip of the shared inner essence of others and ourselves can be soul–filling for all.

There are many ways to tap into this personhood and clear the way for its expression. Most of these involve engaging the spirit in deep relational experiences beyond the superficial accoutrements of social façade and failing cognition. If you have ever seen a person with dementia brighten or become more relational in the presence of a child, a pet, or spontaneous expressions of humor or joy, you will know what I mean.

The expressive arts, when combined with reminiscence and story sharing, can produce similar results.  Examples of the power of the arts to awaken and promote self-expression in those with dementia can be seen in documentaries such as Alive Inside and I Remember Better When I Paint. Not only music and visual art, but also dance and movement, improvisation, drama, art viewing experiences, poetry and creative writing, and other forms of creativity that dip into imagination, remote and emotional memory offer means of self-expression, and have many other positive effects, including the expression of vitality and joy. (see http://www.nextavenue.org/special-report/artful-aging/)

Simply by being wholly, mindfully present to our partners, and offering non-judgmental open space for centering together in the moment, we can clear the way for the waters of self–expression. Mindfulness practices have numerous benefits for persons with dementia and their care partners. (see http://www.huffingtonpost.com/marguerite-manteaurao/are-you-caring-for-a-love_b_9470110.html)

We must carefully reshape our own cognitive constructs of our partners’ identity – constructs that may have more to do with who we think we need them to be than who they really are – so that we can meet them in their current reality, offering them the safety and freedom required to be unashamedly themselves.

Getting lost in the flow of laughter and play, having fun and safe nature-based experiences, and helping our care partners continue to share their innate gifts while doing the things they still enjoy doing liberates their spirits to sing like kids splashing in a spring-fed stream.

So, let’s go hunting for the inner springs, clear out the stream beds, and watch the waters freely flow. We will know just where to find them.