At The Window with Dementia - S1E15
Laura Banner

Laura Banner

Family Nurse Practitioner, Dementia Trainer & Advocate,
Keynote Speaker (Available for speaking engagements on Dementia)

How to improve the self-esteem of your loved one with dementia

How do you measure your own success?

That might seem like an awfully strange question to ask, but consider this, have you ever wondered how your loved one with dementia feels about themself. We know that depression is very common in senior citizens in general, but specifically in the population who suffers from memory impairment. They have social isolation, even outside the pandemic, and as a result, they often will suffer from depression. So back to my question. How do you measure your own success? Well, I think it wouldn’t be a surprise to anyone that most men will measure their success, based on their income, they tie their self worth to the dollar amount on their check women, on the other hand, often tie their level of success to their family, their family is a reflection of their level of success.

But what happens when we get older. When we’re not gainfully employed anymore, or our family doesn’t live under the same roof, and maybe they don’t come to us for all of their needs, how then do we measure our success? And what if we need assistance with the most basic activities from day to day. I don’t think it would surprise anyone that that would certainly impact all of our self-esteem.

So what can we do that will help promote the success for those who are struggling so that they can feel better about themselves. Well, it’s certainly not talking for them, or doing for them. Obviously, when they need assistance, we want to provide that, and we always want to keep safety at the forefront of every action that we do. But what else can we do to promote their self-esteem, their feeling of self-worth?

Well, I always tell people that we want to keep individuals, independent, for as long as possible, and allow them to function at the highest level that they are able to do. What I mean by that is if someone is able to go ahead and bathe themselves, we want them to.

Or what if they’re able to provide their own snack during the day, they don’t have to ask someone to make it for them. Well then, again, we want to encourage that activity. What we don’t want them to do, is we don’t want them to just shrivel up in the corner, and let everybody do for them so that they don’t even have to meet any of their own needs. If they’re able, this is where one-step commands, come into play. A one-step command is where you are promoting the individual to participate in different activities throughout the day. To help with household chores and activities of self-care. What’s different about one-step commands, is how you are delivering the instruction.

For example, if I wanted my husband to help me clean the kitchen. After dinner, I would probably say, can you go ahead and help me clear the plates from the table, and then go ahead and rinse the dishes and put them in the dishwasher, and when we’re done, would you mind taking out the trash. Well, there’s a lot of different instructions that I’ve included in that.

But what we don’t want to do is we don’t want to overwhelm or overstimulate somebody who has memory impairment. So you can still ask them to do all of those activities. But instead of having it as one ongoing instruction, instead, deliver it this way: Can you help me take the plates from the kitchen table to the kitchen?

Can you help me rinse the plates off and put them in the dishwasher?

You can even break it down further than that and say, “Can you help me rinse the plates?”. And once the plates are rinsed, then you can go ahead and provide additional instruction and say, “Can you put them in the dishwasher?”. And when that is completed, then you can say, “Can you take the trash out?”. So again, you are covering all the different steps, but you’re breaking it down into smaller pieces, segments that are easier to understand and not overwhelm someone. So again, you deliver the instructions one step at a time. People are able to process one-step instructions, much easier than they can a string of activities.

It gets overwhelming, and it’s very easy just to say no, or to do it incorrectly and get frustrated and not want to try it again in the future. 
But, by providing a one-step command, you’re promoting their self-esteem, because they’re going to feel useful. And isn’t that what everyone wants? We all want to feel as though we contribute. We help out. That we participate in our life, and we make the lives of those around us better by helping, by giving, not just receiving. And one-step commands, allow individuals with memory impairment to give, to participate. And by allowing them to do that with some meaningful tasks, you’ve made them feel good; you’ve made them feel good in a way that just a compliment can’t, you’ve allowed them to understand that they help out, that they have done something for someone else. And that’s important because that’s what we all want. We all want to be useful.

What I think is that depression comes from a place of feeling useless. Especially when we understand that dementia knows no boundaries, it doesn’t matter what your socioeconomic background is; what your educational level is, what your last name is, what the color of your skin is, or what type of religion you have. We know that dementia crosses all boundaries. And everyone wants to feel useful. That’s human nature. So I encourage you to try giving a one-step command to your loved one, and see how they feel about themselves, look at the expression on their face. Look at their interest level in participating more than they had in the past because everyone wants to feel successful. And by giving them that one-step command. You’ve empowered them. You’ve made success something that’s attainable for them. And you’ve given them the best gift of all, which is self-esteem and a feeling of self-worth.

Go ahead and try it. You might be surprised. Anyway, I hope you find this information helpful, please subscribe to my podcast I release new episodes every Tuesday. You can also find me on Compassionateeducation.com, that’s my website, check out some of the different tabs there. You can find the transcripts to all my previous podcasts. You can also check out Dementia Grypes, which are some observations that I have, frustrations, if you will, assumptions that people make about those with dementia, and other types of memory impairment. You can also check out my Instagram. Again, if you haven’t already, please subscribe to my podcast, and thanks for listening. Have a great day.

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