I want to make it clear before I post this piece that I have not been drinking alcohol today.  In fact I put a can of beer in the fridge and there it remains.  Only water based drinks have passed my lips today.  The acronym of what I am suggesting PIST is the obvious reason for this level of detail.

I would contend that the current approach to supporting those with dementia needs to be reviewed.  There is an emphasis on the person with dementia getting involved in all sorts of groups from Memory Cafes to Singing for the Brain and much more.  I want to argue that such an approach has limitations and that the emphasis should be on the carer rather than the cared for one.

It is possible that M’s disposition has pushed me down this road.  M tends to be introverted: the listener who avoids crowds.  So joining the throng of Groups would have required a personality change at a time when she would feel even more vulnerable than ever in strange surroundings.  Imagine the anxiety of someone with dementia seeing a sea of faces in unknown surroundings.  I hope I have made my point.  Therefore, something different has been required in our little world.

When dementia strikes the individual concerned seeks safety in familiar surroundings.  Their world begins to get smaller and new experiences are avoided.  ‘Get them out more; involve them with others’ is a familiar cry from the professionals.  I would argue that such an approach was not appropriate in M’s case: the battle could never be won and the victory would have been shallow. I accept that with my background in adult learning I perhaps thought I could do it better.  Now I know with PIST that I can, and do.

It is possible to integrate most of the approaches that are used to stimulate people with dementia, in the home, throughout the day.  A little bit of imagination can build such things as singing and reminiscing into all sorts of activities.  I have already mentioned how our Glen Miller evening did just that: M was reminiscing about her dad to music.  Conversation can be steered in the right direct at most times of the day to provide cognitive stimulation.  The other advantage is that you can pick your moment to introduce elements of PIST.  We all know that  ‘Duvet Days’ are a feature of dementia and that is a time to let rest be the panacea and stimulation to be put on hold.

If home based PIST is seen as the way forward then the focus needs to shift to carers and equipping them with tools for the job.  Some form of induction and ongoing training needs to be developed and implemented pretty darn quick.  If I still have failed to make my point then think of this.  Home based carers are with their loved one 24/7: just think of the damage they can do if they don’t really know what they are doing.  How can couple of hours at a Memory Cafe every week do any more than scratch the surface.  Having a chat about things with fellow carers is one thing but what are all those who enjoy their weekly getogether doing for the rest of the week?

I will look at some of the options for training home based carers in a later post.