The reality of the other person is not in what he reveals to you, but in what he cannot reveal to you. Therefore, if you would understand him, listen not to what he says but rather what he does not say.
About a month ago, I put a vinyl decal of a bookshelf over one of our doors in Memory Care. It was a test, in my mind, to see if we could prevent residents from trying to exit through the door.
I’m happy to report that the bookshelf decal absolutely has worked. While a couple of my residents used to go through this door five to ten times a day, two residents have opened it twice in the past month. It has worked so well, in fact, that I’ve ordered a new decal for another door in the community. This bookshelf decal has worked so well that the residents who used to go through the old door now go through a door up the hall with no decal on it.
It’s amazing to see what a photo of a bookshelf has done to completely change the way my residents perceive the door. Dementia changes the way that the brain sees and understands information. While a flat photo of a bookshelf would look unreal to anyone else, people with dementia see it as real. The same thing goes for the baby dolls and stuffed animals we have in Memory Care. If it looks like a baby, feels like a baby, and is the same size and weight as a baby would be, it becomes real to a person with dementia. Our brains are very pattern-seeking: they make sense of things that don’t necessarily make sense. Therefore, if something looks and feels real, it is real.
Dementia changes our depth perception awareness, our eyesight as a whole, and the way we understand color in relation to space. This is also why, if you put a black floor mat down on the ground, many people with dementia will see it as a hole.
By utilizing the deficits that the disease brings, we can actually make the world a better place for people with dementiawhen we do things like disguise doors and provide baby dolls.
Systems analysis, goals commissions, PPBS, social indicators, the several revolts, the poverty program, model cities, the current concerns with environmental quality and with the qualities of urban life, the search for new religions among contemporary youth, and the increasing attractiveness of the planning idea–all seem to be driven
by a common quest. Each in its peculiar way is asking for a clarification of purposes, for a redefinition of problems, for a re-ordering of priorities to match stated purposes, for the design of new kinds of goal-directed actions, for a reorientation of the professions
to the outputs of professional activities rather than to the inputs into them, and then for a redistribution of the outputs of governmental programs among the competing publics.
H. Rittel & M. Webber (1973). Dilemmas in a Generel Theory of Planning. Policy Sciences. 4:155-169.
Reactive change, in response to central nervous insult. Historically given a negative connotation due to its appearance in many CNS diseases, gliosis has been shown to have both beneficial and detrimental effects. The balance between these is due to a complex array of factors
