By Dr. Richard Castaldo, Lawson Castaldo, and Katelyn Granville
When dementia patients and caregivers struggle with addressing agitation and stress, daily activities can become very challenging. However, there are many practical interventions that can supplement treatments and medications. By engaging loved ones in new routines, families can achieve greater comfort in navigating unpleasant symptoms, difficult situations, and feelings of isolation, while also alleviating their stress.
A great tool for dealing with these challenging situations is a non-pharmacological approach called sensory engagement. Sensory engagement helps alleviate challenging conditions and creates more positive outcomes in patient comfort and quality of life for everyone involved. Examples include pet therapy, music therapy, and physical therapy, all of which can ease the unpredictable, demanding effects of dementia illnesses. Accommodating patient preferences, strengths, and abilities help to reframe Alzheimer’s and dementia outcomes through rewarding and encouraging patients, rather than restraining them. Patients, families, caregivers, and health providers can work together to develop the best care plan and tailored solution for each situation to counter the physical and emotional symptoms that correspond to each type of illness.
Another major issue affecting dementia patients during the progression of the disease is called sundowning, which is a state of confusion that occurs in late afternoon and lasts into the night. Sundowning can be triggered by an urge to go the bathroom, thirst, hunger, pain, or boredom. It also leads to a variety of different behaviors, such as anxiety, aggression, depression, ignoring directions, pacing, or wandering.
Activating any type of sensory intervention can help fulfill a patient’s unmet needs, desires, or interests related to daily living. Creative memory-driven activities help engage the body, mind and social instincts, and represent important non-pharmacological approaches to the various disease states a patient is experiencing. While good diet, adequate sleep and regular companionship are essential to managing a patient’s condition throughout the disease progression, there are other ancillary routines to consider in developing a care plan and creating new habits.
Cognitive-stimulating activities, such as reading, playing games, walking, and participating in social gatherings play a vital role in re-shaping how individuals feel and behave. Regular involvement in these pursuits help to prevent a patient’s descent into helplessness and despair. Even playing a patient’s favorite music from the past or watching old movies can enhance their psychological health, mood, and overall demeanor.
Sensory-driven approaches to changing lifestyle and socialization habits result in a noticeable difference in stabilizing a patient’s condition and adjusting their erratic personality tendencies. Physical activity such as walking and sensory interactions customized to each patient’s passions produce significant and positive outcomes in helping to manage their emotions and symptoms. Socialization, being productive, learning through games, listening to music, and staying connected with family and friends can yield dramatic improvements.
Dr. Richard Castaldo is the Medical Director of Niagara Hospice & Pathways Palliative Care in Niagara County. Lawson Castaldo is a first-year medical student at the University at Buffalo Jacobs School of Medicine & Biomedical Sciences, and Katelyn Granville is a former social worker at Niagara Hospice.