When someone loses their cognitive skills or finds themselves not being able to suddenly do something they always could do, it can lead to frustration, embarrassment and withdrawal. On the other side, caring for a loved one with dementia can be difficult, stressful and expensive.
However, Judy Cornish, author and founder of the Dementia & Alzheimer’s Wellbeing Network (DAWN), said in a presentation during the On Aging 2022 conference presented by the American Society on Aging, a new approach and way of thinking is long overdue for those who provide care for someone with the condition.
Specifically, Cornish believes people should consider using the DAWN method, which trains families and caregivers to instead provide kind, strength-based and person-centered treatment to a loved one suffering from dementia by teaching caregivers to recognize patterns of emotion.
“We’re talking about a condition that affects our cognitive skills, rational thinking skills, our ability to follow a sequence, to see cause and effect and to use prioritization. We should expect emotional reactions to finding this happening to ourselves; it’s pretty catastrophic,” she said. “So how on earth do we, as professionals, as family members, people who adopt somebody who’s going through this process, experiencing this condition, work with it? We can’t, but you have to step back and remove yourself from the context and look at it from a different perspective.”
Resetting the caregiving approach: medical model vs. experiential model
Cornish said caregivers currently use an approach based on a medical model, which includes a series of solutions and areas that “we cannot always solve.” In terms of treatment, this typically includes testing to diagnose and then using drugs or surgery to treat and normalize symptoms. The medical model in patients with dementia often includes prescribing drugs to minimize certain behaviors.
“With a medical model, we’re talking about a purpose of treatment, and treatment means this person who is now behaving in a different manner, we will treat this person and bring them back to what they were before,” she said. “We’re going to take unhealthy and return the person to health, to being healthy.”
However, the experiential model works to identify a person’s abilities and emotional needs, expects change, modifies the environment to support changing skills/needs, and maximizes well-being. Furthermore, the experiential model helps caregivers learn to recognize skills being used in patients with dementia and alters their environment to enhance function and limit risk.
“If I’m going to use the experiential model, that means I’m going to be paying attention to this individual, I need to know what skills they are using and which ones they aren’t, and I need to know if they can still see cause and effect,” Cornish said. “If I’m experiencing this condition or a disease that I will be forced to live with until I die, your goal is not to change me, your goal is to make my life as good as it can be.”
According to Cornish, the experiential model is appropriate to use when no treatment or cure exists for a condition.
“If you want to change my behavior, you change how I feel. If you’ve ever lived with a two-year-old, you need to get dialed in with how they feel if you want to change the way they behave,” she said. “Let’s aim for comfort, and when we aim for comfort, then things become less expensive for both parties and for governments that have to pick up the bill when somebody can’t afford 24/7 care for safety.”
The benefits of this approach? No medical training is necessary, Cornish said, and it increases the caregiver’s understanding of the senior’s changing needs—which in turn increases the empathy of anyone caring for them. This also translates to not only lower financial costs but reduced emotional distress for both the person with dementia and the person caring for them.
No medical training is necessary and [this approach] increases the caregiver’s understanding of the senior’s changing needs—which in turn increases the empathy of anyone caring for them.
What else do you need to know about the DAWN method?
The first tool for the DAWN method is mood management, which means maintaining a positive mood and creating a sense of security for someone who is living with cognitive impairment. The other tools include providing security in confusion, a sense of control, social success, a sense of value and security in the future. Using the DAWN caregiving method also means looking at a person with dementia and what they can do, rather than focusing on dementia and what they cannot do.
“People with dementia are losing rational thought, but they will never lose intuitive thought (being in the moment, appreciating beauty, music, etc.). If their companions and caregivers know how to support their rational thought losses and capitalize on their strengths, there is less stress for both the person with dementia and for those providing care,” DAWN officials said in a statement.