It's 10:30 in the morning.  Your job is to facilitate the reading of the morning newspaper to a group of dementia care patients and you have a choice as to how to best carry it out.

Option #1. You gather a group of thirty or so people into a large circle while you summarize the newspaper headlines and articles aloud.

Option #2.  You gather a group of five around a small table. Each holds a copy of the paper, turning the pages while one, or more, read the headlines, taking the group in a multitude of conversational directions.

As the leader, which would you choose?

Now put yourself in the place of a person living with dementia and imagine you have difficulty, integrating sounds, figuring out the environment, seeing and hearing who is talking and wondering if they are even talking to you.

Most of us don’t give much thought to items we use in our everyday lives. But the memories of these seemingly benign objects reconnect us with moments of meaning in our lives.

When elderly people spend time in a hospital, they often leave more disabled than when they got there. That’s pretty stunning considering the condition they may be in when admitted.  Some of the most common reasons for hospitalization are injuries from a fall, pneumonia, infection, cardiovascular disease and dehydration. Treatment of the acute condition frequently doesn’t include special care needed to prevent rapid, and sometimes irreversible, physical and mental deterioration. Weakness from bedrest, weight loss, adverse drug reactions, delirium, and hospital-acquired infection are all too common. At a time with people 65 and older make up the fastest-growing segment of our population, our hospitals should take notice. Fortunately, some are. Special services such as the Acute Care for Elders (ACE) unit exist, but in only small number of our 5000+ hospitals in the U.S. What’s different about this specialized care? There’s a greater emphasis on maintaining mobility and preventing functional decline, cognitive assessment, a communal dining room to encourage better nutrition and social interaction, early discharge planning, and staff with training in geriatrics play key roles. I’m glad to see that hospitals are addressing this pressing issue, but wonder if it’s enough to prepare for the sheer number of us baby boomers beginning to need this kind of care.

What happens when an eldercare professional becomes a family caregiver?  This situation hit home when my husband had a cycling accident and fractured his hip. I was surprised by my reaction to suddenly becoming his care partner, juggling the role of home nurse, personal care attendant, meal provider, and problem solver of getting around in our two-story house. Somewhere in the mix I was also moral support and empathizer. The first week centered on creating a new routine, helping with pain management and personal care. Oh, and wound dressing changes. I quickly was reminded why I never became a nurse, calling a nurse-friend in a panic because the dressing from the hospital was stuck to the wound and I was sickened by pulling it off! If I’m perfectly honest, I felt angered at times by this turn of events that intruded our lives- I didn’t have time for this! It didn’t help seeing my active husband now using a walker- making him “old” to my eyes, bringing up fear about what’s to come as we age.

What is it about skilled touch that decreases distress for those living with dementia that can lead to behavioral symptoms?  Common responses include decreased aches and pains; sensory stimulation resulting in increased body awareness; relaxation; aids sleep; decreased feelings of loneliness; uplifted mood.