The Need to be Needed

How to Help People with Dementia Help People 

*Resident names and any identifying details have been changed for privacy.

August 7, 2020

There must be exceptions out there, but most of us human beings have a real need to be needed.

Feeling useful, productive and helpful is something that brings meaning to (many of) our lives – whether or not we happen to have dementia.

When we don't feel useful or helpful we may find ourselves feeling… well, useless and helpless.

We may even start to feel worthless, or like a burden on others. Feeling like a burden is tremendously distressing. It is a major contributor to depression and a cause of great suffering.

Vocational Wellness

One of the six dimensions of wellness is occupational, or vocational, wellness. The word vocation comes from the Latin root vocare, which means "to call".

Vocational wellness is about fulfilling one's calling.

It's about utilizing one's unique skills and abilities for activities that are personally meaningful and rewarding.

This aspect of wellness often tends to focus on an individual's career, although there are also plenty of unpaid avenues for maintaining vocational wellness.

- Volunteering

- Sharing knowledge or mentoring others

- Participating in a committee

- Leading a community group

So long as it fulfills a personally meaningful calling, any of these – or other – activities could fill the bill.

Those who are retired or unemployed are not exempt from maintaining their vocational wellbeing.

Nor are people with dementia.

Minimize Feelings of Helplessness by Helping... Less

People may feel helpless when they need a lot of help from others, or when they are unable to give help to others. There are four major ways we can help to minimize feelings of helplessness in someone living with dementia.

1. Reduce Their Dependence on Others

There are many ways to set up the environment to support their independence. Placing pictures, labels or signs about or removing extra items to reduce confusion are often effective interventions.

Technology is coming a long way in helping to increase independence for people with dementia. Inventions like this smart dresser designed to help people with dementia dress with less dependence are also becoming more commonplace. 

2. Give Them Only the Amount of Help They Actually Need in the Moment

When we do things for people with dementia that they can do for themselves they quickly lose their ability to do it at all. We inadvertently rob them of their remaining abilities and skills. We hasten their decline and increase their dependence on others.

Their abilities can vary from day to day or moment to moment. We should be alert as to what they can do for themselves in each moment and support them just as much as needed.

This can be a real challenge for caregivers who - as human beings ourselves - also have an innate need to be needed.

It can feel odd to stand by as someone struggles to tie their shoe or pick up something from the ground. Our instincts often have us jumping right in to take over the task for them.

We should be aware of any risk and, if needed, be prepared and positioned to act immediately. By all means, step in if they are unsafe, frustrated, or for other reasons as needed… just be careful not to rob them of opportunities to be independent when you can help it. Abilities like balance, fine motor skills, strength and flexibility can erode frighteningly fast when not practiced.

As abilities erode, feelings of self-sufficiency and self-worth can wash away with them. 

3. Look For and Acknowledge Ways They are Contributing

Sometimes it's as easy as noticing how the person is already helping you. A genuine smile and “thank you” can go a long way.

- "Thanks for letting me spend some time with you."
- "Thank you for your cooperation. You have been such a big help!"
- "I love your smile! You’ve really brightened my day!" 

4. Support or Provide Opportunities for Them to Help Others

Giving people with dementia opportunities to help you is often the quickest and easiest course to enable them to be helpful and useful.

Find excuses to ask for help

Get in the habit of asking for help almost constantly. Whether you actually need the help or not is secondary. In fact, you should expect a lot of “help” to take more of your time and energy than just doing it yourself.

Look primarily for tasks that the person is able to do and will give them a sense of accomplishment. Don’t forget to ask for their opinions! Helping people by giving advice can be very rewarding - and doable.

- "I'm learning how to take blood pressures and I need practice. Would you mind if I take yours?"
- "Do you have any advice on how to get my kids to eat their vegetables?"
- "Would you mind putting this book away in that bookshelf for me?"

Coupon Club

We focused a lot on finding ways for residents to help out in our memory care center. Coupon Club was a weekly endeavor in which a group of residents were armed with scissors and tasked to cut coupons from newspapers. The idea was to send the coupon clippings to less fortunate folks who could use them to save money during hard times.

It was quality time together spent chatting about all sorts of things: from today's prices versus yesteryear's, to how much they were helping the poor people who were to receive the coupons, to the idle chit chat of friends sharing a workload together.

Did the coupons ever get to the people who were intended to use them? Eh, maybe sometimes.

But the activity utilized their fine motor skills, sorting skills, hand eye coordination and social skills. It was rewarding work, doing for others, and it was fun. The residents felt good to be helping others.

Helping others doesn't just happen in a group setting with lots of planning. We can also help each other one on one!

Housework can be therapeutic and rewarding work

Washing dishes, wiping down tables, folding laundry… These tasks are typically familiar to seniors, repetitive and rely on skills they learned long ago.

Sweeping with a standard broom can also be a great intervention for some. Sweeping leaves up off the patio combines the best of physical activity, outdoor time, and feeling productive.

Carpet sweepers, by the way, are a must have for many! A wonderful way to contribute to the household with no cords or electricity to worry about. You can even sprinkle bits of paper (like hole punches) when someone isn't looking. You can help them keep busy in a safe area. We used to sprinkle strategic trails of those dots to lead one gentleman out of the other residents' rooms.

Set them up for success

As you find ways for them to help be sure to set them up for success. We don’t want them to feel overwhelmed, embarrassed or frustrated by their efforts.

- Think about how much they can handle physically and cognitively at the moment.

- Consider their current energy levels.

- Break tasks into segments as needed.

- Praise readily and sincerely.

- Avoid patronizing or condescending language or tone.

- Consider what will give them a sense of accomplishment. It may be that just helping you is rewarding enough, or they may have a preference for certain types of activities over others.

Reaching Out to the Community

There were a lot of great programs at our memory care center, but one of my very favorites was our Community Outreach Program.

With staff set up and guidance, our residents were able to provide an astounding amount of service to the community, despite their moderate to severe dementia.

They enjoyed lots of opportunities to participate and contribute without ever leaving the center. Many also enjoyed regular outings into the community to volunteer.  

Staff planned ahead to make the outings safe and successful for everyone

- They coordinated with the other agencies to ensure the timing worked right for all.

- They scouted out the terrain to be sure that the residents who went out were able to safely navigate it.

- They were always mindful about the residents’ stamina and took care not to stay out too long or push them beyond their limits.

- They never took more than a couple residents out at a time. They carefully considered the compatibility of residents they took out together - from their temperament, all the way down to their walking speed. 

Food Bank Sandwich Donations

Residents would make peanut butter or lunch meat sandwiches and then deliver them to a small food bank. The fresh sandwiches were provided for the food bank patrons to eat during their visit.

Stocking Food Bank Shelves

On occasion residents spent time helping stock cans and other goods at the food bank's shelves.

Clothing Donations

Staff often brought in bags and boxes of clothing to be donated. The residents would then spend time sorting and folding any kids clothing to prepare it for donation.

Although it wasn't actually necessary to sort the clothes, it was a great way to enable lots of residents to participate - plus, baby clothes are so cute! It made for a meaningful activity ripe with purpose, sensory stimulation, fine motor opportunity, reminiscence fodder and socialization.

Staff and a couple residents would then deliver the clothing to a women's and children's shelter.

Delivering Donations to the Dog Shelter

The residents would help bake batches of homemade doggie biscuits from a simple recipe. They would then deliver them to the animal shelter.

Sometimes they would have tattered blankets that had been donated by the laundry department or staff members to drop off as well.

It was always a great excuse to stop in and see the kittens while they were there!

Preschool Volunteers

Several residents enjoyed volunteering at a local preschool. They would spend time reading to the kids, or singing together.

Sometimes they would just listen, spellbound, as the kids chattered on about Pokemon, or whatever else was on their minds. The preschool staff said that was often the kids' favorite part - they just ate up the undivided attention!

One of my favorite stories from this program is about a bilingual resident who was able to spend some quality time interacting with one shy little girl.

The preschool staff said that the girl had been very isolated recently. They had lost the only bilingual teacher they had and there was no one else around she could easily understand.

The school staff noticed a big change in the little girl after their time together. They said it had made a big difference to her coming out of her shell.

What a real difference this resident had made!

Holiday Adopt-a-Family

The center adopted a few families for the holidays each year through community charity programs. Staff and residents picked up food donated by the facility's dining department and delivered full Thanksgiving and Christmas meals to hungry families.

For Christmas, they didn't stop at food; they delivered entire Christmases to families experiencing hardships. All December they shopped for stocking stuffers and gifts, and then helped wrap piles and piles of presents! They would then help deliver the food and gifts to the grateful families.

Passionate staff members make the difference

This program wouldn't have existed without the tremendous dedication and hard work of a few key staff members. But the results were amazing!

Despite their challenges, our residents were legitimately involved in and contributing to their community in meaningful ways. 

You could see what it meant to the residents in their faces and their behavior

The usual red-faced anxious questions were replaced (for the afternoon) with relaxed smiles. Relentless negative commentary on peers was momentarily forgotten. In its place: patient explanations about why it is important to help those less fortunate than ourselves. 

How do you help people with dementia help others?

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