Cover image for A dignified life : the best friends approach to Alzheimer's care
A dignified life : the best friends approach to Alzheimer's care
Bell, Virginia.
Personal Author:
Publication Information:
Deerfield Beach, Fla. : Health Communication, [2002]

Physical Description:
xxv, 323 pages ; 21 cm
General Note:
"Based on the author's earlier work: Best friends approach to Alzheimer's care"--T.p. verso.
Format :


Call Number
Material Type
Home Location
Item Holds
RC523 .B434 2002 Adult Non-Fiction Non-Fiction Area

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More than 5 million Americans are currently living with Alzheimer's disease or a related form of dementia. By the year 2030, experts estimate that as many as 66 million people around the world will be faced with this life-altering disease. Unfortunately, these staggering statistics impact millions of caregivers, too. Compared with all types of caregivers, those who assist someone with dementia experience the highest levels of burnout, depression, poor health, and premature death. A Dignified Life, Revised and Expanded offers hope and help with a proven approach.

Ten years ago, the first edition of A Dignified Life changed the way the caregiving community approached Alzheimer's disease by showing caregivers how to act as a Best Friend to the person, finding positive ways to interact even as mental abilities declined. Firmly grounded in the latest knowledge about the progression and treatment of dementia, this expanded edition offers a wealth of immediately usable tips and new problem-solving advice. It incorporates practical ideas for therapeutic activities--including the latest brain-fitness exercises--stimulate the brain while adding structure, meaning, and context to daily routines. With new stories and examples as well as an updated resources section, A Dignified Life, Revised and Expanded gives caregivers the support and advice they need to be successful and inspired in their demanding roles.

While medical treatment of the disease hasn't changed in the past ten years, our understanding and awareness of treating people in a more caring way has changed substantially. With no cure on the immediate horizon, respectful care by effective and compassionate care partners is the only real "treatment" available to people with dementia. The Best Friends(tm) Approach is successful because it sustains people's connection to their world, their loved ones, and themselves. It's a universal program which has been embraced by professional and family caregivers throughout the United States, Europe, Asia, the Middle East, and South America. In its revised form, A Dignified Life offers caregivers an antidote to the burnout and frustration that often accompanies the role of caring for a person with Alzheimer's and dementia. Rather than struggling through a series of frustrations and failures, A Dignified Life shows the new generation care partners how to bring dignity, meaning, and peace of mind to the lives of both those who have Alzheimer's and dementia and those who care for them.

Author Notes

Virginia Bell developed the Helping Hand Adult Day Center sponsored by the Lexington/Bluegrass Chapter of the Alzheimer's Association in Lexington, Kentucky.



Chapter 4A New StartThe Art of Friendship Alzheimer's disease changes us all. Because of the associated memory loss and confusion, your mother, father, sister, brother, husband, wife, or partner may no longer know you or understand his or her relationship to you. Many caregivers are confused, frustrated, sad, or even angry about these losses. Your mother may have always been your closest confidante and strongest supporter; now, she does not recognize you. A spouse whom you counted on for many years to balance the checkbook, pay bills, file the income taxes, or cook three meals a day is no longer able to do these things. As a result, your relationship with the person changes whether you like it or not. Adopting a Best Friends approach can help diminish this pain and loss and can have a powerful impact on the person with dementia. When you rethink, or recast, your relationships to individuals with dementia and become a Best Friend to them instead of just a caregiver, the person now feels you are on his or her side. In addition, friendship helps evoke some of the social graces or learned manners of the person with dementia. It helps put the person on his or her best behavior. Caregivers using the Best Friends approach have made the Helping Hand day program of the Greater Kentucky/Southern Indiana Alzheimer's Association one of the most admired adult day programs in the United States. Many individuals with dementia in Helping Hand have been considered difficult and challenging by their own family caregivers. Yet at Helping Hand, because the staff and volunteers are acting as friends, they thrive. Families can have similar success using the Best Friends approach at home. Rather than staying in a state of despair, caregivers can learn to work through the pain and focus on gaining maximum value from the present; caregiving is transformed from a terrible burden to a job that becomes meaningful and satisfying. The process changes from a series of failures to a series of successes. Recasting this relationship to become a Best Friend does not mean taking away love or loving the person with dementia any less. It simply means approaching the relationship differently. One caregiver told us that he had always had a troublesome relationship with his father-so bad, in fact, that he ran away from home at age 16. He now cares for his father full time and says they have never been closer. They take a daily walk together, have an evening scotch and soda, and watch the grandchildren play soccer. They have found that they now enjoy each other's company. Because the father has forgotten much of the past and is often unsure of his relationship with his son, the son has realized that he, too, must let go of past slights and injustices. "What's the point of me dwelling on it?" the caregiver asks. "What's past is past." Like many caregivers, the son never dreamed he would be in the position of taking care of his father, a father whom he admits disliking for Excerpted from A Dignified Life: The Best Friends Approach to Alzheimer's Care, A Guide for Family Caregivers by Virginia Bell, David Troxel All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.

Table of Contents

Dedicationp. xiii
Acknowledgmentsp. xv
Introductionp. xix
I Alzheimer's Disease and Dementia
1 What's Happening? The Experience of Alzheimer's Diseasep. 3
Worry and Anxiety
Isolation and Loneliness
The Best Friends Approach
2 What Is Known? Diagnosis, Treatment, and Researchp. 21
Is It Normal to Have Memory Lapses Now and Then? Can a Doctor Help Someone Determine if There Is a Problem?
What Does It Mean if the Doctor Diagnoses Some Form of Dementia? Is That the Same as Senility?
Disorders That May Be Treatable
Disorders That Are Currently Irreversible
What Does It Mean if My Doctor Is Using the "A" Word--Alzheimer's Disease?
Do All People with Alzheimer's Disease Have the Same Course of Illness?
What Kind of Medical Treatment Is Appropriate?
Can Other Health Problems Worsen the Effects of Dementia?
What Are Psychotropic Drugs and Can They Help?
Is Alzheimer's Disease Inherited?
Can Alzheimer's Disease Be Prevented?
How Does a Person with Alzheimer's Disease or Dementia Become Part of a Research Study?
What Happens at the End?
3 What Now? Making Sense of the Diagnosisp. 45
Be Open with the Person About His or Her Situation
Deal with Denial
Be Open with Others About Your Family Situation
Get Legal and Financial Affairs in Order
Make a Financial Plan for Health Care Services
Make a Realistic Assessment of Yourself and Your Community
Make a Realistic Assessment of Your Loved One with Dementia
Work to Preserve, or Even Enhance, Family Relationships
Continue to Be Part of the Community
Make the Environment Simple and Safe
II The Best Friends Approach
4 A New Start: The Art of Friendshipp. 63
Friends Know Each Other's Personality and History
Friends Do Things Together
Friends Communicate
Friends Build Self-Esteem
Friends Laugh Together Often
Friends Are Equals
Friends Work at the Relationship
5 Memory Making: Honoring a Person's Life Storyp. 97
Ingredients of the Life Story
Young Adulthood
Middle Age
Later Years
Other Major Ingredients
How to Use the Life Story
Greeting the Person and Improving Recognition
Introducing the Person to Others
Improving Communication through Clues and Cues
Designing Appropriate Activities
Pointing Out Past Accomplishments
Helping to Prevent Challenging Behaviors
Incorporating Past Daily Rituals
Broadening the Caregiving Network and Resources
Life Story of Rebecca Matheny Riley
6 The "Knack": Basic Principles of Dementia Carep. 137
Being Well-Informed
Having Empathy
Respecting the Basic Rights of the Person
Maintaining Caregiving Integrity
Employing Finesse
Knowing it Is Easier to Get Forgiveness than to Get Permission
Using Common Sense
Communicating Skillfully
Maintaining Optimism
Setting Realistic Expectations
Using Humor
Employing Spontaneity
Maintaining Patience
Developing Flexibility
Staying Focused
Being Nonjudgmental
Valuing the Moment
Maintaining Self-Confidence
Using Cueing Tied to the Life Story
Connecting with the Spiritual
Taking Care of Yourself
Planning Ahead
III The Best Friends Approach in Action
7 Connecting: Communicating with "Knack"p. 163
Communicating with Knack
Avoid Arguments
Make Directions Clear
Coping with a Mother's Accusations
Doing Extra Work to Understand Seemingly Incomprehensible Words
Encouraging a Bathroom Stop
Dealing with Loss
8 Being Together: Managing and Valuing Activitiesp. 183
Be Productive or Make a Contribution
Experience Successes
Be with Others
Build Skills
Have a Sense of Control
Feel Safe and Secure
Fill Religious or Spiritual Needs
Experience Growth and Learning
9 Inner Passage: Spiritual Journeying and Religionp. 209
Celebrate the Person's Religious Heritage
Embrace Simplicity
Look to the Creative Arts
Nourish Your Own Spiritual Life
Give Spiritual Care Throughout the Illness
10 Finding Help: Navigating the Long-Term Care Mazep. 223
Care in the Home
Adult Day Center Care
Residential Care (Assisted Living, Skilled Nursing Facilities, Continuing Care Retirement Communities)
IV Living with Dignity
11 Self-Care: Being Your Own Best Friendp. 251
Ways to Take Care of Your Own Needs
When Everything Is Going Wrong
Consider the Future
The Power of a Diary: Rebecca and Jo Riley
12 Transformationsp. 271
Serenity and Peacefulness
Community Resources for Making In-Home Care Easierp. 279
Organizations, Web Sites, and Recommended Readingsp. 287
Biographiesp. 299
About the Authorsp. 321