A Deeper Perspective on Alzheimer's and other Dementias by Megan Carnarius

Author:Megan Carnarius
Language: eng
Format: epub
Publisher: Inner Traditions/Bear & Company

Chapter 10

The Boundaries of Quality of Life

In 1987, I was working as a nurse in a nursing home that did not have any specialized program for Alzheimer’s. Varying degrees of dementia were exhibited by the residents there—some Early Stage, Middle Stage, and Late Stage.

This is the story of G.

G. lay motionless, her breathing caused her flaccid lips to flap slightly with each exhale. Her body curled in. Rigid flexor muscles had years ago caused her legs to draw up, toes pointed, arms folded tight at her sides. Her hands held washcloths rolled up, to keep her nails from embedding in her palms. She constantly sweated. Her metabolic system was affected by the lack of movement and the liquid food given her through the tube in her stomach. Her medications were crushed and pushed into the same tube with a large syringe. Twice every shift, the nurses would provide routine liquid nutrition and meds, followed by water. She moaned when we turned her.

G. was a Late Stage Alzheimer’s patient. She took medications to prevent seizures. We gave her partial bed baths every shift and changed sweat-soaked linens. She had liquid stool, so this also created a lot of linen changes. She had no physical or verbal abilities for communication except her moan . . . and the tears that would gather and seep out of the corner of her eyes and run down her cheeks.

She had been like this for six years. Someone in her family in charge of her care had decided to have the feeding tube put in. No one ever visited her. Someone in the family paid the bill, but no family member had visited for more than eight years. It was excruciating to walk into G.’s room and feel how alone she felt but was not being permitted to let go. Someone somewhere couldn’t let her go. For a body to stay tethered to this world by a feeding tube felt really harsh. It felt as if someone else had not owned up to what they needed to do, and G. was giving them a chance day after day to do the right thing. I left employment there and inquired two years later, but the situation had not changed.

I felt I had come in contact with her in order to understand the different qualities of life at all stages and the boundaries of that phrase. G.’s situation can serve as a lesson that despite better care approaches and models of training and environments, there are limits.

Validation Therapy

“Validation techniques are based on the principle that when emotions are suppressed they fester and can become toxic. When emotions are expressed to someone who listens with empathy (Validation), the person is relieved. Validation Therapy uses fifteen verbal and nonverbal techniques to communicate with those very old elders diagnosed with an Alzheimer-type dementia and includes a method for forming Validation Groups with timeconfused elders. Validation Therapy assumes an attitude of respect for old people diagnosed with a dementia.”

—Naomi Feil developer of

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