Part five of 12.
In this high-tech age we all have an idea of what multitasking means. Teens do homework while listening to their awful music and watching a dull TV show, all at the same time. Strangely, the homework gets done!
I am using the expression in a much less dramatic way, but I think it illustrates another change in the Alzheimer’s process. Let’s look at the not-so-simple task of helping my wife, Joan, dress.
Not too long ago I could tell her — or she would decide — to change into pajamas or get dressed for church. Then the time came when she would not choose proper clothes. Recognizing that, I would select them, lay them out and then she would dress herself.
However, after some more time passed, that no longer worked. When I said “pajama time” it elicited only “I don’t want to” or “No” or “Why?” No explanation, even one that reminded her she really wanted to, for example, go to church, would get her to do what was needed.
Finally I figured it out. “Get into your pajamas” or “Take off your clothes for your bath” or “Get dressed so we can go to your exercise class” were all requests that confused her. The reason? Each one of those “tasks” was really a multitask!
Solution: Break it down into single tasks! So it’s “Take off your shirt”; “Take off your pants”; “Take off your bra” and so forth. And then, “Put on the …” in the same way.
If I had not figured out this problem of multitasking, I may well have treated her like a little baby, dressing and undressing her with me doing all the work, “because she just can’t do it anymore.”
That time may come, but recognizing the difference between multitasking and single-tasking certainly staves it off for a bit.
Multitasks come up all the time, particularly in asking her to do something. “Would you bring the salad bowl and salad fork so I can make our salad?” That’s two tasks! “Put the milk back in the refrigerator and put your glass in the sink.” Again, two tasks, and she can’t keep them straight. Ask one at a time and she will get it done.
I often ask her to do things that I know she wants to do, but I have to be careful how I frame the tasks. Also, I ask her to do things that really do help. She brings things to me, which I appreciate because I have walking problems.
The situation of multitasking brings up some obvious problems of placing her in a home. I cannot imagine any adult care home having the personnel and training to do things this “one-by-one” way.
The only convenient thing for them is to require the client to “guess” in matters like dressing, and certainly there will be no requests to help take care of the home! But we can predict what happens: partial independence gives way to regimentation.
Without doubt, the repetition of that regimentation, day in and day out, would lead to faster deterioration of life for her.
This provides a powerful reason for in-home care. Even after two days in an adult care home, Joan lost her desire to be active. It took a day or two back home to restore the routines that we follow every day.
Tomorrow: Coping with fecal incontinence.
