What is strength based care for dementia patients?

Reports show that a strengths-based approach can improve emotional well-being and reduce stress for individuals with dementia and their caregivers.

This authoritative guide explains what is strength based care for dementia patients, a compassionate framework that focuses on an individual's retained abilities and personal identity, rather than their losses.

Quick Summary

Strength-based dementia care shifts the focus from a person's deficits and losses to their remaining capabilities and personal identity. This method creates a supportive environment that enhances well-being, promotes dignity, and maximizes independence by emphasizing what an individual can still do, not what they can't. By understanding a person's unique history and preferences, caregivers can foster a sense of purpose and meaning, leading to a higher quality of life.

Key Points

• Shift the Focus: Strength-based care prioritizes a person's retained abilities, interests, and identity rather than their cognitive deficits.

• Promote Dignity: By focusing on what a person can still do, this approach preserves their sense of self-worth and independence.

• Use Life Story: A person's past hobbies, career, and personal interests are key to developing meaningful and engaging activities.

• Engage Intuitively: Individuals with dementia may lose rational thought but often retain intuitive and emotional connections, which can be leveraged for communication and comfort.

• Reduce Caregiver Stress: By fostering positive interactions and reducing frustration, this approach can lower the stress burden on caregivers.

• Empower Independence: Offering support that encourages rather than takes over retained tasks helps the individual feel more capable and in control.

• Adapt the Environment: Creating a supportive physical space with clear cues and a calm atmosphere is crucial for success.

The Core Philosophy: From Deficits to Strengths

Traditional dementia care often focuses on the progressive loss of a person's cognitive functions, which can lead to a sense of despair for both the individual and their family. In contrast, strength-based care represents a profound paradigm shift. Rather than defining a person by their illness, this philosophy sees them as a whole person with a rich history, unique skills, and an enduring identity. It operates on the principle that the person, not the dementia, is the focus.

Key Principles of the Strengths-Based Approach

• Focus on the Person, Not the Disease: A person's identity and value extend far beyond their cognitive abilities. This approach prioritizes their preferences, personality, and life story to build a foundation for care.
• Recognize Retained Abilities: Dementia does not erase all capabilities. A person may lose short-term memory but retain intuitive thought, musical abilities, or the capacity for deep emotional connection. Identifying and celebrating these retained skills is central to the approach.
• Empowerment and Engagement: By focusing on what a person can still do, caregivers empower them to maintain independence and engage in meaningful activities. This boosts self-esteem and fosters a sense of purpose.
• Create a Supportive Environment: The physical and social environment should be adapted to promote success and minimize frustration. This includes providing appropriate cues, a calming atmosphere, and opportunities for social interaction.
• Emphasize Collaboration: The care plan should be developed in partnership with the individual with dementia, their family, and care team. This ensures that the person's wishes and preferences are at the heart of their care.

Practical Application in Daily Dementia Care

Putting strength-based care into practice involves creative and flexible thinking. It's about looking for opportunities to leverage strengths in everyday situations.

Engaging Activities Based on Retained Skills

• If a person was a homemaker: Involve them in folding laundry, setting the table, or dusting. Use sensory activities like sorting silverware or smelling different herbs.
• If a person enjoyed music: Play their favorite music. Encourage them to sing along or play a simple instrument. Music can evoke powerful memories and emotional responses.
• If a person was an artist or crafter: Provide them with simple art supplies like clay, paint, or large-piece puzzles. The focus is on the creative process and enjoyment, not the end result.
• If a person loved nature: Take short walks outdoors, spend time in a garden, or look at nature photos and discuss them. Simple pleasures can provide significant comfort.

Creating a Strengths-Based Care Plan

A successful care plan is a living document that adapts as the person's abilities change. Here’s a step-by-step guide:

1. Assess the Whole Person: Go beyond a clinical diagnosis. Conduct a life story interview with family and friends to learn about the person’s interests, hobbies, work history, and significant memories.
2. Identify Current Strengths: Observe daily behaviors to identify retained skills. Can they still hum a tune? Are they soothed by certain textures? Document these observations.
3. Collaborate on Goals: Work with the individual and their family to set small, achievable, and meaningful goals. These should focus on maintaining skills and promoting well-being, not just managing symptoms.
4. Develop Activities: Based on the identified strengths and goals, create a list of potential activities. Ensure these activities can be adapted for different stages of dementia.
5. Monitor and Adapt: Continuously assess the plan's effectiveness. What works today may not work tomorrow. Be flexible and adjust the plan as the person changes, always prioritizing their comfort and dignity.

Strengths-Based vs. Deficit-Based Care: A Comparison

Feature	Strengths-Based Approach	Deficit-Based Approach
Focus	Retained abilities, personal identity, interests	What the person has lost, limitations
Goal	Enhance quality of life, dignity, self-worth	Manage symptoms, prevent deterioration
Care Plan	Collaborative, person-centered, flexible	Task-oriented, rigid, symptom-focused
Outcome	Improved well-being, reduced anxiety, engagement	Increased frustration, behavioral issues
Language	Positive, empowering, supportive	Clinical, problem-oriented, patronizing

Overcoming Challenges in Strengths-Based Care

Transitioning from a deficit-based to a strengths-based model can be challenging, but it is achievable with patience and training. Some common hurdles include caregiver burnout, difficulty in shifting mindset, and resistance from the individual with dementia.

• Caregiver Burnout: A strengths-based approach can actually reduce caregiver stress by fostering positive interactions. Training on techniques like validation and redirection can help manage difficult behaviors, leading to less conflict and a more peaceful environment. For more resources, explore the Alzheimer's Association website.
• Shifting Mindset: It takes time to stop focusing on what’s wrong and start looking for what’s strong. Caregivers should be encouraged to celebrate small successes and focus on the joy of shared moments, rather than dwelling on what has been lost.
• Individual Resistance: A person with dementia may resist new activities. The key is gentle persistence and flexibility. Start with short, familiar activities and build from there. If one approach doesn’t work, try another, always respecting the individual's feelings.

Conclusion: Empowering Life with Dementia

Adopting a strengths-based approach revolutionizes care for dementia patients by prioritizing their dignity, well-being, and sense of purpose. By shifting the focus from limitations to abilities, caregivers can create a supportive and engaging environment that allows individuals to continue living meaningful and fulfilling lives. This compassionate model ultimately benefits everyone involved, reducing caregiver stress and fostering deeper, more positive relationships.

Frequently Asked Questions

How is strengths based care different from traditional dementia care?

The primary difference lies in the focus. Traditional care often emphasizes managing symptoms and mitigating losses, viewing the patient through the lens of their disease. Strengths-based care focuses on the whole person, their retained abilities, and personal identity to promote dignity and well-being.

What are some practical examples of a strengths-based activity?

Examples include asking a former baker to help measure ingredients for a recipe, playing favorite music for a former musician, or taking a person who loved gardening for a short walk in a garden. The goal is to connect with their past interests and current capabilities.

Can strengths-based care be used at any stage of dementia?

Yes, it can be adapted for any stage. In early stages, it might involve active participation in complex tasks. In later stages, it might focus on sensory experiences, such as listening to music, holding a familiar object, or enjoying a pleasant scent.

How can family members incorporate a strengths-based approach?

Families can start by creating a 'life story' for their loved one, documenting their past and present strengths and interests. They can then build daily routines and activities around these areas, remembering to focus on connection rather than performance.

Does this approach mean ignoring the person's deficits?

No, it doesn't ignore deficits but rather re-frames them. Instead of focusing on what's lost, it uses retained strengths to accommodate limitations. For example, if a person forgets how to use a fork, the strength-based approach offers finger foods rather than constantly correcting them.

What if a person with dementia shows no obvious strengths left?

Everyone retains strengths, even if they are not immediately obvious. These can be as simple as an intuitive sense of rhythm, an emotional connection to a beloved pet, or a capacity for comfort and warmth. Focus on simple, sensory-rich experiences that tap into these fundamental human capacities.

How do caregivers handle challenging behaviors using this method?

Challenging behaviors are often a result of unmet needs or frustration. A strengths-based approach seeks to identify and meet these underlying emotional needs. By offering meaningful engagement and a supportive environment, caregivers can proactively reduce triggers for frustration and agitation.