Working with Clients who have Alzheimer’s/Dementia


Working with Clients who have Alzheimer’s/Dementia
Published  in Hebrew Sept. 2008 in "Reflexology Today"
Published in English Summer 2008 in the NCRA (North Carolina Reflexology Association) Newletter
Those suffering from Alzheimer’s/Dementia can benefit greatly from Reflexology and other complimentary or alternative treatments, but the practitioner needs to take into consideration some of the challenges of a client with dementia.
Dementia is organic brain damage.  It is degeneration of the brain cells.  Alzheimer’s is the main disease that leads to 50% of the cases of dementia.  It causes cognitive, emotional and personality changes.  As the disease progresses, these changes become more severe.  Treatments need to be attuned to the client’s stage of dementia, but there are some basic rules that will make your treatment pleasant and comfortable for clients at any stage:
1. Respect and Patience
Probably the most important way to have a positive relationship with clients that have Alzheimer’s/Dementia is to respect them and treat them as fellow human beings.
Although this seems obvious, I have found that many people who work with Alzheimer's/Dementia patients tend to talk down to them like children.  This is terribly degrading and hurtful.
A person with Alzheimer's/Dementia may forget who you are at each treatment.  Always introduce yourself as if it is the first time you are meeting.   Avoid putting your client into an uncomfortable position by asking him if he knows who you are; rather say your name and ask him if he would like a treatment today.   
Never talk about your client in front of him.  If you need to discuss your treatment with a family member, do this privately or on the phone.
2. Make the treatment short and precise 
The attention span of a client with dementia can be limited.   It is best to begin with a short 20 minute treatment to see how your client responds.  In subsequent treatments, you may be 
able to increase the duration of the session.
Plan your session to be only a treatment. Your client may not know the answers to your questions, which could cause feelings of confusion, frustration or incompetence.  Obtain information about health history and permission from a family member prior to the treatment session.   
3.Treatment Environment 
It is extremely difficult for a person with Alzheimer's/Dementia to focus.   The treatment 
has to take place where there are no distractions.  The treatment room should be quiet; even playing soft music may be a distraction for someone with Alzheimer's.  As much as possible, avoid distractions such has people walking in and out or noise outside the window.  
Hunger and thirst are other distractions to consider before providing a treatment.  Make sure the treatment is not set right before mealtime.
Finally, it is best to set appointments in the morning.  In the afternoon your client may be tired – an additional distraction.  Later in the afternoon Alzheimer's/Dementia patients may be most agitated, with a drop in cognitive ability.  This time is known as sun downing since it occurs around sunset.
4. Emotions
Many times a complementary treatment like Reflexology, can cause a flood of emotions. Life is already very confusing for a person with Alzheimer’s/Dementia.  Many will do their best to hide their condition from others and themselves.  They tend to find excuses to explain their memory loss and change, but the disease is scary and frustrating. These hidden emotions can come out during a treatment.  
As the disease progresses, a person may tend to remember more past than current events.   The person many times will relive their past and actually think they are the younger person they once were.  If this person had a rich and happy youth and childhood this may be a lovely experience.  If the person was, for example, in the Holocaust, he may be reliving a bitter, sad and frightening experience.   
If there is a flood of emotion, redirecting the person to another topic may reduce anger and upset.  This can easily be done by staying on the same subject, but redirecting to something more pleasant.  For example, if a person becomes upset remembering that his spouse died, try asking questions about his children and grandchildren.
I find treating those with Alzheimer’s/Dementia to be a most rewarding experience.   Complimentary treatments can have an important calming effect on these clients, but they can do much more.  These clients normally lack private and personal time with others, and can benefit from receiving the full attention of a therapist during a session.   Most people with Alzheimer’s/Dementia feel very lost and lonely.  Many have lost contact with friends and even family.  
Family members may have a very difficult time relating to their family member who has regressed due to the disease.  As a therapist, you are meeting the person as he is now and can accept him as he is today.   By caring, touching and being there for him, your treatments can have a very amazing effect on one with Alzheimer’s/Dementia.
Oran Aviv
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Oran Aviv has been practicing Reflexology since 1995 and is a graduate of the Israel Alzheimer’s Association's “Health Activities” Project course.  Oran gives Reflexology treatments and organizes activities to improve memory and cognitive ability in the Alzheimer’s/Dementia unit of the Kfar Saba Senior Day Center in Israel and  privately.  She also developed and teaches Hand Reflexology Courses to caregivers of patients with Alzheimer's/Dementia.
To have Oran teach at your facility or to arrange a Reflexology and consultation session  email her at This email address is being protected from spambots. You need JavaScript enabled to view it. or call (057)5533856


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