**This is part two in a three part blog series on Mental Health and aging. To read part one, click here.**
Part 2: The Effectiveness of Counseling for People with Dementia
While most of the research and service on the topic has focused on giving the caregiver support, there are benefits of counseling for those with dementia or cognitive decline. In the past, persons with Alzheimer’s disease were perceived as unable to benefit from intensive therapy (Davies et. al., 1998, pg.201). However, people who are newly diagnosed with dementia can and do benefit from counseling.
This is the second in a three section blog post on dementia and counseling. The first part was a general introduction to dementia. This part focuses on what a person with dementia can gain from counseling specifically in the following areas: emotions, identity, and practical everyday lifestyle changes.
Emotions
Being able to express feelings is the most important part of counseling for patients with dementia. Having a safe place that one can express grief, loss, fear, anxiety, and anger are crucial. While there have been some marvelous advances in our understanding of Alzheimer’s, there is no known cure for dementia at this time. Helping an individual navigate their expectations that they will improve is a major focus of much therapy for clients with dementia. Additionally, the general population does not understand dementia well. Our culture is very youth and ability focused. Dealing with stigma is often an additional focus of therapy. Some clients find acceptance of the diagnosis difficult. Accepting and coming to terms with the full extent of their diagnosis may come slowly. Identifying and expressing feelings around these issues are imperative. It is important for a counselor to understand where a person is in their understanding of the illness and the impact it is having on their psychological well being.
Counseling focuses not just on dealing with the negative parts of the illness, but on emphasizing the client’s inherent strengths as well. Focusing on strengths and successes is necessary for a healthy life. Championing a positive attitude, acceptance, and facilitating letting go of what can’t be changed is a key part of counseling. Another component of psychological well being is having a purpose in life and spirituality. Counseling can be a good place to find things that nourish you and to learn ways to focus on pursuing those aspects. Creating new relationships, encouraging already existing relationships, and building a strong support network is also vital going forward.
Identity
Questions of identity often arise for people with dementia. Many people experience a profound loss when they are diagnosed. Their sense of self is changed. Existential issues of “who am I” are fundamental to this shift. One’s self concept can shift due to their role within their family changing. A person’s self esteem can also be affected when one has to depend on family members whom one had previously supported. This adjustment is oftentimes harder for people who have worked all of their lives. It can be difficult to transition from being fully independent into slowly becoming more dependent. Sometimes there is a quandary over whether or not to tell one’s work about the diagnosis. Working out these issues in therapy can be a great boon and help improve one’s self esteem.
Practical matters
Dementia affects all aspects of one’s daily life, but a major focal point of therapy can be ways to manage these difficulties and still fully enjoy life. Finding the memory tools and calendars that works for you can be a focal point of therapy. Counseling can also help with learning ways of simplifying your life, managing stress, incorporating cognitive exercises, getting physical exercise, relaxation techniques, and coping with communication disruptions. Therapy can help with navigating the feelings that come up along the way.
The structure of counseling sessions also can become important for people with dementia. Because of memory loss, clients sometimes have difficulty maintaining a flow of a weekly structure in their lives. One thing that hugely helps with this is having a regularly scheduled space and time that they can rely on and during which they can talk about what they are going through. People with dementia can feel comforted by and come to depend on the structure of this time. Sundowning or “late-day confusion” is common for people with Alzheimer’s. For this reason the best time to schedule a session for someone with this condition is late in the morning or early afternoon.
While this post touched on the identified client’s changing role within the family, the next post will focus on the needs of the caregivers and families.
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This is part 2 in a three part blog series on Mental Health and Aging written for ASRBC by Karen Goldsum, M.A., LPC-Intern
If you or your loved one is needing support around a recent or ongoing diagnosis of dementia, counseling can help! Visit our book online page to schedule your free phone consult with Karen or one of our other therapists.