The power of rituals in dementia care – 3 tips for positive reinforcement

News & Blog

Stay up to date on what’s going on in the world of enhancing life in senior care.

The power of rituals in dementia care – 3 tips for positive reinforcement

Posted on February 21, 2014

To provide the best possible care for dementia patients, we need to get past some important misconceptions about the disease. One is that Alzheimer’s, which accounts for about 80 percent of dementias, is strictly a disorder of memory. In fact, it usually involves many mental processes, including the abilities to focus attention, organize thoughts, and make sound judgments. Another is the notion that Alzheimer’s is strictly a disease of cognition. In reality, it can affect emotions and personality, as well. But perhaps the biggest misconception we encounter is to see a dementia diagnosis as the end. There are ways to enjoy life after that event both as the caregiver and the person affected. To reinforce this positive attitude and provide structure in the journey, the establishment or reinforcement of rituals or schedule plays a huge role.  As Theresa Klein, an occupational therapist at Augustana Emerald Crest Assisted Living in Minneapolis recently mentioned in an article from the Atlantic: “We should dwell less on what dementia patients are incapable of and focus more on celebrating what they are capable of doing.”

Rituals in the face of losses such as the death of a loved one or the end of a relationship are ubiquitous. There is such a wide variety of known mourning rituals that they can even be contradictory: crying near the dying is viewed as disruptive by Tibetan Buddhists but as a sign of respect by Catholic Latinos; Hindu rituals encourage the removal of hair during mourning, while growing hair (in the form of a beard) is the preferred ritual for Jewish males.

As described in this Scientific American article, it was found that people who wrote about engaging in a ritual reported feeling less grief than did those who only wrote about the loss. Despite the absence of a direct causal connection between the ritual and the desired outcome, performing rituals with the intention of producing a certain result appears to be sufficient for that result to come true. While some rituals are unlikely to be effective – knocking on wood will not bring rain – many everyday rituals make a lot of sense and are surprisingly effective.

In the world of dementia care & life enrichment, schedules and rituals are rather easy to implement. Basic structure and rituals can established and reinforced such as:

1. Calendars & continuance in activities: Having a common thread among events throughout the day or the week will help people feel more comfortable and “connect the dots”. It also helps the team engage the residents when there is a lot of overlapping elements between programs.

2. Themes: Going slightly further, themes are a great way to orient people (St Patrick’s Day in March, 4th of July, etc.) and they also help to provide consistency. It’s a great way to support creativity when it comes to experience and engagements.

3. Establish rituals throughout the day: having events happen at set times help residents be oriented, support more efficient staff scheduling and, for dementia care, allows behavior control. Behavior is often worse at the end of the day or at night so establishing rituals around this time is very important and helpful.