Visiting Angels’ Caregiver of the Year, Paula Perez, was recognized for her compassion in caring for her clients with dementia.
Four years ago, when Paula Perez decided to join Visiting Angels, a private duty service agency, part time, she would have never thought it would become her full-time job. However, she’d always had the calling to be nurturing.
Her own family situation prepared her well for the job. For years she served as a caretaker, alongside other family members, of her mother, who had dementia, and an adult grandson with cerebral palsy.
“When it happens to you in the family setting for the first time, you’re in shock. You start reading and trying to learn a bit more,” Perez said about being a caretaker. “When I got my position with Visiting Angels and got the dementia training, it just confirmed that what we were doing as a family had worked to some degree. And then it just expanded our knowledge of how to do it with clients.”
While Perez brought plenty of caregiver experience to the job from caring for her own family, Visiting Angels provided additional training through their Visiting Angels University program. The modules and videos are online, covering different situations including those where a client may have dementia. Caregivers also participate in a two-day in-person training course, where they review the different levels of dementia and Alzheimer’s.
Clients with the disease can be classified as different levels—gems, opals, etc.—with caregivers understanding that they can have the characteristics of more than one level. With dementia, Perez said, not everyone declines the same way, nor is everyone affected the same, so, caretakers must be ready to manage it, sometimes hour-by-hour.
“What worked yesterday may not work today. You have to be proactive, and you have to know what the signals are and how to redirect,” she said. “You don’t become combative, you don’t say no. We agree, we calm them down, and redirect.”
Perez offered three ways that caregivers can help clients maintain their dignity:
1. Treat the person in front of you
A client’s temperament can change daily, so it’s important to meet them where they are and move forward in a way that either reinforces their good mood or redirects their bad mood.
“If they’re happy, then we’re going to have a happy day. You have the weeping; you just hold their hand and understand and redirect them to a subject that they like, or something that they did, or photos,” Perez said. “I also find that if I let them think that they’re helping me that the attention isn’t on them, and their caregiving [nature] kicks in.”
2. Allow them to be as independent as they can
Allowing clients the autonomy to do things for themselves encourages their sense of independence.
“When it comes to bathing, I make sure that they handle the washcloth, that they dry as much as they can, and that they pick out what they want to wear,” Perez said.
“You make it seem like they’re making the choices and let them do as much as [they’re able],” Perez said. “We’re not looking at their disabilities, we’re looking at their abilities, and as much as they can do, they do.”
For clients with more limited capabilities, redirecting their attention or the situation is a method that’s usually successful. If it’s difficult for them to move around, simply sitting outside will give them a nice change of scenery, or even just talking to them about themselves.”
“The fact that they don’t feel like they’re a drain on the family, that they can do things, makes them happy,” she said. “They used to be very productive people and all of a sudden, they feel they’re not. And so, we have to be reinforcing and positive.”
3. Accept the person and abilities they have now
Perez will often share what she’s learned from experience and agency training with her client’s family members.
“I was able to show the family so they could learn,” she said. “Knowledge gives them power and they’re not afraid and then they learn to redirect as well.”
She encourages family members to continue to include their loved one in regular activities, showing them ways to adapt them so they’re able participate. When clients are more aware of things they can’t do, Perez said, it draws them further inward.
“We recall the person they were, instead of accepting the abilities they have now,” Perez said. “You hear a lot, ‘I can’t believe he was such a big, strong, working man and look at him now.’ OK, that was then, this is now. The hardest part is accepting the reality today versus the reality of them at their prime.”
“We’re not looking at their disabilities, we’re looking at their abilities, and as much as they can do, they do.”
Paula Perez, Visiting Angels Caregiver of the Year
Positive reinforcement and redirection allow caregivers to give patients the freedom to do things for themselves.
It’s important that families understand and accept the person that their loved one is now, even if they’re more limited in their abilities.
As often as a client’s temperament changes, its important to either reinforce their good mood or redirect their bad mood.