Use this search box to find articles that have run in our newspapers over the last several years.

‘Engagement boxes’ connect caregivers, dementia patients

Date: 4/3/2015

WEST SPRINGFIELD – Homewatch Caregivers has been thinking outside the box when it comes to caring for dementia patients.

Well, kind of.

On the shelves at the West Springfield office are a small fleet of patterned boxes containing gloves and pearls, baby dolls and blocks. Though seemingly unconnected, these boxes have a purpose.

They help caregivers engage their clients in meaningful conversations.

A former intern at Homewatch, Christina Vernon, developed these engagement boxes, after taking an online class about dementia care through the organization.

A few shopping trips later and Vernon had created something that changed how the organization looks at dementia care, according to co-owner Judy Yaffe.

Each box has a different theme, which can be used to help encourage conversations with clients. Examples include a box dedicated to an elegant evening, including long gloves, pearls, a purse, a teacup and a CD with music from the time.

Caregivers use the items to trigger memories from earlier in the clients’ life and ask questions about what comes up, Yaffe said.

Yaffe said that the boxes can be tailored to a client’s interests or backgrounds or it could be one that anyone can talk about, like the “beach box” with shells, sand and a plastic shovel.

“It’s a way of stimulating them,” she said.

Kate Tyler, the community liaison manager, said that even though patients with dementia some times forget short term, events from early on in life could still be fully engrained.

“People remember things from 40 years ago, not what happened two days ago. They have forgotten that, but 40 years ago they’ll remember in detail that day at Coney Island,” Tyler said. “Last in for memory, first out so they remember this stuff.”

Kristin Mauk Bowde, a caregiver and the elder care and dementia specialist, said that the boxes have been great tools for her to relate to her clients. She said that she used the baby box with one of her clients with moderate dementia and learned more about her past.    

“We talked about when she raised children and when she was a little girl. I found out, for example, that she didn’t have a lot of toys. She came from a very large family,” Bowde said. “It brought back a lot of good memories. We had conversations, sang lullabies. It was a really great way to stimulate memories.”

The goal of this approach is to meet dementia patients where they are mentally, rather than pull them into the present moment. The latter was a technique that Homewatch used to use, but Bowde said it was traumatic for patients.

“We at try to find with each client where they are. We work with them at the level where there are,” Yaffe said. “That’s why the engagement boxes are so important because for a lot of people this is where they are, this is where they can relate to a rotary dial phone as opposed to a cellphone.”

Bowde said that some of the caregivers tried to assess the effectiveness of engaging clients with the boxes and they found that it made a remarkable difference.

“They found that before the activity they could be really disengaged, napping a lot, not really talking a lot, just sort of there. Then they do the activity and they become, they’re energized, they’re making conversation, they’re happy and sometimes the effect lasts longer than others,” Bowde said. “Regardless, in that moment, they were with us. They were more like themselves. Whether the effect is just in the moment, whether it lasts a couple of hours, it’s something. It’s meaningful.”

She said that, for caregivers, it is easy to fall into a rut with clients, just going through the motions of daily necessities. This pushes them to go one step further.

“The worst thing to do is just to say, ‘I’m coming in. I’m going to do my thing,’ then you don’t see that individual as a person anymore,” Bowde said. “They’re just somebody you take care of, and you’re not really a person either. You’re just the person who does X Y and Z. The engagement activities allow you to both be people again with a more meaningful relationship. It makes a world of a difference. Everyone wants to be seen and heard.”

The staff at Homewatch said that this can happen with families, as well. When someone shows symptoms of dementia, relatives can attribute the signs to forgetfulness or an off day, Tyler said. They do not necessarily understand that the relationship with the client will change as the dementia progresses. They, too, need to enter “their world” rather than push them back into the present, she said.

“It’s so hard for people to grasp on to what [dementia] really is,” Tyler said. “Most people aren’t reading the research, so they’re treating the person as they always have and they are astounded when they get bizarre behavior and that’s when you get friction.”

Yaffe said that the staff is trying to help, not only clients with the engagement boxes, but also help their families understand this new approach. They all agreed that a change of perspective on dementia treatment is effective and is worth the effort.

“You can a meaningful relationship with somebody no matter what stage of dementia. It’s whether you can adjust to this new reality or not,” Bowde said.

For more information about Homewatch Caregivers in West Springfield, call 785-1111.