Choices Matter

Well of course choices matter,
but do they still matter when I’m living with dementia?

The easy answer is YES! Choices do matter for anyone, but especially for people living with dementia. Over time these choices become so much more important than they were in the beginning. Why is that?

Choices help us feel like we are a part of the decision-making process. When someone is living with dementia, it’s common to think you as the care provider need to do everything for them. When we get into the cycle of doing for, the person receiving starts to forget how to do and feels less than. To extend and enhance their quality of life, we offer choices that meet them where they are and allow them to feel in control again.

choices allow us feel more in control

As a person living with dementia’s disease process progresses, choices can become more and more difficult. It can become much harder for a person to make decisions. Sometimes there’s no decision made. Difficulty with decision-making is caused by an overload to their brain. All that information and stimuli stops their focused ability on selecting an answer.

Scientifically speaking this is happening in the executive function portion of the brain. Also known as the pre-frontal cortex. This area helps us focus to make those choices.

Does this mean they can’t make decisions?

No, it means we need to present options that meet them where they are. Let’s relate this to an art project for a visual. Should you have them decide between three or twelve different colored markers? This is going to depend on how they react to 12 markers in front of them. If they look at the markers and maybe look at you with no words or with a lot of anxious talk, then try to take away a few of the markers and see what happens.

If we are working with a new client, we use the less is more approach. We might give the person four markers to choose from. If they feel confident and like they want more options, we will gradually increase the amount of choices until we are in a balanced space for them. The key is to be aware of verbal and physical anxiety (i.e. speaking to themselves with worry, wringing hands, excessive tapping) that a person might present. It’s all about finding balance and creating an environment where they feel content.

Another point to be aware of is that we change our minds all the time. Try to give different color selections each time. Be aware that while someone’s favorite might be pink, that they might not want to use pink every time. Favorites change over time, so we want to be mindful with options that are new and exciting as well.

Disclaimer: The disease process is different in each and every person living with dementia. Some of ideas presented may work and some may not. These are suggestions and we want to hear how they work for you.