Ky. Voices: People will Alzheimer's can develop caring relationships

January 14, 2013 

  • At issue | Nov. 16 New York Times article, "For Alzheimer's, detection outpaces effective treatments; new scan can show plaques in brain"

The excellent New York Times article focused on the fact that Alzheimer's detection outpaces effective treatments.

Reporter Gina Kolata notes, "The ability to detect the disease has leapt far ahead of the treatment. There are none that can stop or even significantly slow the inexorable progress to dementia and death."

I have worked in dementia care for the past 30 years, and have rejoiced each time a piece of the puzzle is put into place for the treatment of Alzheimer's and other dementia. But this puzzle is far from being solved, medically, as the author of this article and many other researchers and advocates know full well.

In fact, it is rather shocking to realize that it has been almost 10 years since the FDA has approved a new drug for dementia in the United States. A truly effective treatment remains to be discovered.

But there is a nonmedical treatment that looks at the person beneath the disease. It is proving to be the best medicine yet for persons diagnosed with an irreversible dementia.

One expression of this treatment is called the "Best Friends" approach to dementia care. This approach is well aware of the limitations dementia places on persons but looks beneath the cloak of dementia and sees a person with a rich life experience, with varied skills and abilities, often an amazing sense of humor and a zest for life, and one who longs to be known, connected, loved and respected.

This approach had its beginning almost 30 years ago in Lexington and has been a laboratory of learning. At that time it was thought that there is little to be done if a person is diagnosed with Alzheimer's disease. We have learned that by matching a person's present functional level with meaningful time together, it is amazing what a person, even with advanced dementia, can learn, perceive and share with others.

Today we are still learning and growing in our understanding of the person beneath their dementia. The better we understand the life story of each person, their feelings, their traditions, their longings and their remaining strengths, the more the person feels in the flow of life. None of us wants to live for naught, and the same is true of persons with dementia.

From the very first day in 1984 that a center (then called Helping Hand now Best Friends Day Program) for persons with dementia opened in Lexington, we related to persons as friends and talked about being best friends together. Our approach has always been relationship- centered, not just person- centered, care.

This philosophy of care is being replicated nationally and internationally and might be the best treatment yet for persons with dementia.

Virginia Bell, founder of Best Friends Day Program in Lexington, is co-author of A Dignified Life: The Best Friends Approach to Alzheimer's Care.

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