Understanding the Most Commonly Missed Human Need in Dementia Caregiving Situations?

Behavioral changes are among the most challenging and misunderstood aspects of memory care, often stemming from unmet needs. This article reveals which is the most commonly missed human need in dementia caregiving situations and provides actionable strategies for a more compassionate approach.

Quick Summary

The most commonly missed human need is the deep-seated desire to feel valued, needed, and to belong, often overlooked as caregivers focus on physical tasks.

Key Points

• Emotional Over Physical Needs: The most overlooked aspect of dementia care is the emotional and psychosocial need to feel valued, needed, and included, as caregivers often prioritize physical tasks.

• Validation vs. Reality: Trying to correct a person with dementia's reality can cause distress. Validation therapy, which focuses on the emotion behind their words, is a more compassionate approach.

• Personhood is Key: Care should focus on maintaining the individual's sense of self and personhood by recognizing their unique history and preferences.

• Meaningful Activities Matter: Engaging a person in simple, purposeful activities helps fulfill their need for occupation and competence, improving mood and well-being.

• Behavior is Communication: Challenging behaviors like agitation or withdrawal are often an expression of unmet needs such as loneliness, fear, or boredom, rather than random actions.

• Foster Social Bonds: Counteracting social isolation through activities and maintained relationships is crucial, as connection significantly impacts the quality of life for those with dementia.

Beyond the Physical: The Most Commonly Missed Need

Caregiving for a loved one with dementia often centers on physical tasks like medical appointments, meals, and hygiene. However, this focus can overshadow a critical emotional need: the need to feel valued, needed, and to belong. This unmet need can lead to challenging behaviors like agitation or withdrawal, which are often attempts to communicate distress or a loss of purpose. Recognizing and addressing this emotional reality is vital for improving well-being.

The Psychosocial Needs Defined by Tom Kitwood

Tom Kitwood's person-centered care model emphasizes the importance of psychological needs in dementia care. His "Flower of Psychological Needs" identifies several core needs:

• Comfort: Feeling secure.
• Attachment: Having close relationships.
• Inclusion: Belonging to a group and social interaction.
• Occupation: Engaging in meaningful activities.
• Identity: Maintaining a sense of self and history.

Prioritizing Emotional Safety Over Factual Reality

Caregivers sometimes try to correct factual errors, known as "reality orientation," which can distress someone with dementia. Validation therapy, a person-centered approach, focuses on acknowledging and validating the emotional content of their communication instead of correcting facts. For example, responding to a desire to go home by asking what they miss about it validates their feelings and avoids confrontation, building trust and reducing anxiety.

Strategies for Meeting Emotional Needs

Meeting emotional needs requires intentional strategies:

1. Engage in Purposeful Activities: Simple, familiar tasks like folding laundry or sorting items provide a sense of purpose and competence.
2. Foster Social Connection: Combat loneliness with social interactions, even if specific memories fade. Small gatherings or day programs can provide positive feelings.
3. Use Reminiscence and Life Story Work: Creating a life story book or using music can trigger positive memories and help caregivers understand the person's history, reinforcing identity.
4. Create a Stable Environment: Consistent routines and familiar objects provide comfort, predictability, and reduce confusion.

Person-Centered vs. Task-Oriented Care

Shifting from task-oriented to person-centered care is essential for addressing emotional needs. The table below highlights key differences:

Feature	Task-Oriented Care	Person-Centered Care
Primary Focus	Completing tasks (medication, meals)	The person's unique needs, preferences, and emotions
View of the Person	Defined by their diagnosis and deficits	Seen as a unique individual with a life story
Communication Style	Factual, directive, often correcting	Empathetic, validating, focuses on emotional meaning
Interaction Goal	Efficiency and management of symptoms	Building a meaningful and respectful relationship
Addressing Behavior	Sees behavior as a problem to be controlled	Interprets behavior as communication of an unmet need
Decision-Making	Made by the caregiver or professional	Involves the person where possible, respects preferences

Conclusion: Cultivating Connection and Dignity

While logistical aspects of dementia care are important, neglecting the need to feel valued and to belong significantly impacts well-being and can increase challenging behaviors. A person-centered approach, incorporating validation, meaningful activities, and connection, provides compassionate and dignifying care. This focus on the person, not just the disease, enriches the lives of both the person with dementia and their caregiver, reminding us that the need for dignity and connection endures. For more resources on dementia caregiving, the Alzheimer's Association is an invaluable resource [].

Frequently Asked Questions

What is the most commonly missed human need in dementia caregiving situations?

The most commonly missed human need is the emotional and psychosocial need to feel valued, needed, and to belong. Caregivers often focus on managing physical health, but these deeper emotional connections are crucial for the person's overall well-being and sense of self.

Why are emotional needs so often overlooked in dementia care?

Caregivers are frequently overwhelmed by the day-to-day physical and medical demands of dementia care. This intense focus on practical, immediate needs can unintentionally lead to the neglect of a person's emotional and social requirements, which are less tangible and require more patience to address.

What are the core psychological needs of a person with dementia?

According to Tom Kitwood's model, core psychological needs include attachment, comfort, identity, inclusion, and occupation. Addressing these needs helps sustain a person's sense of self and dignity despite cognitive decline.

What is validation therapy and how does it help?

Validation therapy is a communication technique that focuses on the emotional content of a person's words and actions rather than factual accuracy. By validating their feelings, caregivers can build trust, reduce anxiety, and prevent agitated behaviors that often arise from feeling misunderstood or dismissed.

How can I tell if my loved one's emotional needs are not being met?

Unmet emotional needs can manifest as challenging behaviors like agitation, repetitive questioning, withdrawal, or restlessness. These actions are often attempts to communicate feelings of fear, loneliness, boredom, or a lack of purpose that they can no longer articulate verbally.

How can caregivers practically address the need for purpose?

Involve the person in simple, meaningful, and familiar activities. These can include daily chores like folding towels, hobbies like gardening, or engaging with music they enjoyed in the past. Creating a structured routine also provides a sense of predictability and control.

How does person-centered care differ from traditional care?

Traditional care often focuses on tasks and managing symptoms, treating the person as a diagnosis. Person-centered care, by contrast, sees the person as a unique individual and prioritizes their well-being, preferences, and feelings, adapting the care to their unique needs.