During the month of September we celebrate dementia awareness month with World Alzheimer’s Day commemorated annually on 21st September. Dementia is a syndrome, usually of a chronic or progressive nature, in which there is deterioration in the ability to process thought beyond what might be expected from normal ageing. It affects memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgement. The number of people living with dementia worldwide is currently estimated to be around 50 million. This number is expected to triple by 2050 (WHO 2020)
Lockdown due to COVID 19 may be easing, but people living with dementia and their families are still struggling to make sense of the changes. In fact we cannot but reflect on the added challenges presented to dementia sufferers and their loved ones due to the pandemic.
Many residents may have had their normal routines disrupted, are experiencing a lack of cognitive stimulation and are feeling lonely and anxious. Routines they once knew may have change. Morris 2020 states that “Society hasn’t figured out how to protect the elderly from coronavirus without imposing another very real health threat: isolation”. Activities like communal eating stopped due to social distancing. Other residents may feel perplexed as their relatives cannot visit them or they do not see them often anymore. Relatives on the other hand may fear that in a short space of time their loved ones may completely forget them. Whereas these days most elderly may use technology to communicate with their loved ones, it is challenging for elderly with dementia to do so causing further confusion and frustration to both them and their relatives.
Human beings need touch to feel love and affection and when words do not suffice it is touch which is reverted to, especially in care. Touch is well known for its therapeutic benefits. However with the present situation of COVID 19 and its transmission, this is being dissuaded due to cross-contamination. This lack of touch, which normally has a calming effect and lessons the effects of anxiety and agitation, may cause further stress and apprehension in persons with dementia who may find it essential as part of their daily communication.
There are other issues which come to mind when caring for clients with dementia during this time. Personal protective equipment whilst a necessity, results in healthcare workers speaking from behind masks, making it harder for persons already having cognitive issues, to determine words and understand what is being said to them. Facial expressions including smiles and kindness are hidden behind masks and carers’ faces loose familiarity. Full body suits make healthcare workers look strange and alien and may instill fear and confusion. It is all daunting, it is sudden and it is a change, all factors which are contraindicated in the care of older persons, even more so when they suffer from dementia.
A lot of grief is attached to these times as they are accompanied by a number of losses. There are losses to do with human contact, losses to do with freedom, losses to do with familiarity and losses to do with what is “normal”. It is not an easy time for either residents or their loved ones as it is one of uncertainty and fear. It is also not an easy time for those caring for them as they too may be filled with fear and scared of the unknown and of change.
We need to empathise and be sensitive in order to assess the care of both residents and relatives and see beyond the physical effects of COVID19 has on the person. We have a duty to protect our elderly through this period. This means taking into consideration and onus of the repercussions that are a result of the care we give no matter what good intentions we may have or what the research says. We must never lose sight of who we are caring for and one size never fits all, we need to think with our minds but above all care with our hearts and while protocols and policies are important we should not hide behind them to be inhumane. We must continually reflect on our actions, no matter how good intentioned, and evaluate their effects on the persons we care for.
“Those with dementia may have a brain that works differently than ours. But if we link our hands together, we can overcome anything” Teepa Snow