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Experts Offer a Glimpse into a Dementia Patient’s Reality

Book of the Month: February 2015

Lanny Butler — My Past Is Now My Future, A Practical Guide to Dementia Possible CareWhen a loved one’s self-sufficiency declines, the caregiver’s instinct is often to help as much as possible. But stepping in at the first sign of struggle can become a slippery slope, which may unintentionally endanger a loved one’s independence: when people start to do things for us, we lose the inclination to do these things for ourselves, and we come to depend on the assistance.

Caring for a loved one with a cognitive disorder like dementia can be full of such pitfalls. It can be second nature to take over when a loved one appears to struggle or takes a long time with a task, but this tendency has a side effect. Over time, the list of things he or she is ‘unable’ to do (getting dressed, eating, using the bathroom, and so on) only grows, expanding the caregiver’s role exponentially. Our book selection for February offers a different, more sustainable approach.

Calling upon years of hands-on experience with patients with dementia, practicing occupational therapist Lanny D. Butler encourages clinicians and caregivers to ‘enter the patient’s reality.’ Together with physical therapist Kari K. Brizendine, Butler has developed a strategy termed Dementia Possible Care©. Their philosophy and practice are encapsulated in a slim, quick read, My Past Is Now My Future.

Billed as a practical guide, the book’s straightforward organization and plain explanation in everyday language can be eye-opening to caregivers and family members. In less than a hundred pages, Butler and Brizendine shift through the seven defined stages of dementia, from least to most symptomatic, following a patient’s usual progression. There is a section for each stage; each section begins with a preamble written in the voice of a representative ‘patient’ or ‘caregiver,’ expanding on the thought processes that many people experience as they work to manage the disease. Each stream-of-consciousness narrative, brief but likely familiar to readers, is followed by a valuable explanation of the typical patient’s worldview, behaviors, and capabilities while at that stage. Through numerous real-life anecdotes and concrete instructions, the authors help to illuminate not only why patients with dementia behave the way they do, but also what actions and environmental adaptations caregivers can make to help patients stay oriented and capable in their current reality — whatever that may be.

An appendix at the end of the book includes a tool for caregivers and their loved one with dementia to use together. The intent is to catalog a patient’s preferences and personal rituals, everything from hobbies to what hand he or she uses to hold a fork, so that caregivers can help to replicate these behaviors at later stages. This exercise reflects the cornerstone of the authors’ theory: triggering a patient’s deep-seated residual memory, as often as possible and for as long as possible, helps him or her to complete tasks independently, and with positive outcomes.

For caregivers wanting to do more to help a loved one with dementia, the insight and instruction contained in My Past Is Now My Future will be a valuable preparatory resource. Readers can decide for themselves what tips and tactics might benefit them as they work to keep loved ones living independently and safely. But even without adopting the suggested practices, readers can use this glimpse into the reality of dementia to better understand what to expect through the passing stages and what level of care may be appropriate.

My Past Is Now My Future: A Practical Guide to Dementia Possible Care©
Lanny D. Butler, MS, OTR
Kari K. Brizendine, PT
Warwick House Publishing
90 pages, $20.00