Learning From Mistakes

“Let’s take some time to think of people who have sung you into singing, smiled you into smiling, loved you into loving.”

Mister Rogers

Being present is a term you hear a lot today in spiritual texts and writings. The practice of living life fully present is a lifetime journey. One can have the realization of being present, and in the next moment find themselves thinking about the past or future and not be present anymore. In my understanding, it is like a muscle that needs to be exercised to be relied on. A practice that can become a habit so that in times of great stress and crisis, it is an automatic response. Peace, awareness, presence and then response. Churches, spiritual centers and religious practices teach being present through meditation and Mindfulness. One of my favorite books on this topic is Ekhart Tolle’s The Power of Now.

The kind of presence that I have found to be effective in working with people who have dementia is an intentional act, not a state of mind. It is an approach and a technique that can be taught. When I am successfully present with a person who has dementia or someone who is in the end stages of life, I feel a connection with them.

I was 20 years old in 1989 when I first started working with seniors. I answered an ad looking for “an enthusiastic, outgoing individual with art and music background to work with the elderly.” And so, I became an Activities Assistant in a skilled nursing facility. Sad to say, back then I did not get much training on my first days in the position. This experience helped make me passionate about the need for continuing education and on the job training.

I do not remember how long I had been working there but I know it was not the first time I was working with Sam that I truly saw him for the first time. Sam had expressive aphasia and hemiparesis. He could not express himself verbally and he was in a wheelchair. In activities with Sam, the only response I had ever gotten from him was eye contact. I did not really know that he understood everything that was going on around him until one day, he and I were alone in the care center living room. Something about how he was listening to me made me aware that he understood me. It was as if a light went on in a dark room and I spoke to him, fully present to him for the first time. I asked a yes or no question and asked him to blink two times if the answer was yes. His eyes were filled with tears when he realized that I understood him. I saw him.

I was profoundly touched and saddened by this experience. I did not feel proud of my accomplishment, instead what I felt was the weight of knowing that I had not truly seen him until then. This changed the way I spoke to other residents from that point on. I looked at them and spoke to them as though they understood every word and gesture, even if they could not engage in a conversation. I decided that even if they could not understand me, I would speak to them with the respect and honor an elder deserved. I also became passionate about teaching this to others and advocating for my seniors when I saw that they were being treated in a way that I believed was not recognizing their individual personhood.

Being present with my residents each and every day takes energy and an investment of time. I have found that the more I work at building a connection with a resident, the easier it is to assist them when they are not having a good day. I have also learned that I need to approach each person in the way that works best for them. Not every approach works for every person. The key is learning who they are, what motivates them and paying attention to their responses. When I make a mistake, I learn from from it and adjust my approach for next time.

Links/Resources:
I have had the honor of learning from some truly amazing and inspiring teachers in my career. Here are just a few links. The Pioneer Network http://www.pioneernetwork.net is a wonderful resource to learn about person centered care and other culture change initiatives. Naomi Feil https://vfvalidation.org with the Validation technique and Teepa Snow https://teepasnow.com with her Positive Approach to Care are two educators who have inspired me and who are revolutionizing eldercare.