Friday, April 5, 2019

Therapy vs Just Do It!

As usual, my friend Kate continues her mission of making sure that the diagnosis of and living with Dementia/ Alzheimer's does NOT have to be a death sentence. In a recent post on her BLOG, she wonders why regular, everyday activities have to be considered "therapy" and if that doesn't over "medicalize" day to day life for those with the diagosis.

Here is her post. It opens in a new window.

Below are my comments.

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I seem to always agree with your observations but then feel the need to "point/counterpoint" and to look at the "Gray" vs the "Black and White." I think that this tendency is a mirror to who I am when I look at most things in life! I will agree and give you that it is easier to refute, argue, fine tune, etc an idea or theory than it is to come up with the idea in the first place. So here's to you, my friend, keep up the important discussions.

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I agree with avoiding "Medicalization" in dealing with Dementia/Alzheimer's and that has been one of my platforms in discussing Gregory and my "Alzheimer's: A Love Story." We spent our time on "Redefining Sense of Family, Home, and Relationship" NOT on "medicalizing" the twelve years we lived with Dementia.

In this post, you ask "we might need to stop imposing ‘therapy’ into all people living with dementia." Your comments on "therapy" caused me to wonder about the relationship between "therapy" and your recent discussions on framing Dementia/Alzheimer's as a "disability" in which it should be treated as a right of the person diagnosed with Dementia to have support in compensating for their faltering abilities

Trambling's quote that most do not actually enter therapy and/or drop out by the third session is a different issue and is most likely related to all the other care strategies for PLWA that need attention and "fixing;"  like caregiver training, safe environments, elder abuse, sufficient staffing, etc etc etc.

(People Living With Dementia  = Did I get that acronym correct? P.S. It is easier typing PLWD than it is People Living With Dementia, but I hate reducing people to acronyms ... but that is yet another "front" on with to debate "-)

Perhaps the answer to the statement "Let's all go into therapy!" might be as easy as when an activity is studied in depth and applied to help remediate and or compensate for abilities lost; physical, mental, cognitive, etc; it becomes a therapy. In other words, playing music is for a greater need and seeking a more important outcome than just for the purpose of listening. Perhaps for someone who has lost the ability to play the piano, like my Gregory did, the conscious study of possibilities and use of piano music can provide greater results: listening with headphones to a CD of piano music, going to a piano concert, sitting in front of a piano and "playing" with the keys, and more.
So I googled various types of "therapy." What I found is briefly discussed below. Perhaps those "everyday" activities about which you wonder "the need to be therapized or medicalized when need extra, special, and/or differentiated attention do come under the "medicalization" umbrella.

These are links (opens in a new window) to three sessions I had with Gregory at the piano at his memory care facility: Attempt 1: Encouragement    Attempt 2: He gets a little more involved. Attempt 3: In which he is frustrated.

I am not sure if the experience was a good one for Gregory or not. I wanted, at least, to try it to see if there would be a positive interaction with a "skill of the past" and perhpas worth while to "play" at the piano more often.

In the videos, you can see that he struggled with the experience and eventually became frustrated. But you can also see the "muscle memory" fighting to come back to his once experienced fingers and at the end of the second video, it seems like his fingers were almost "making love" to the piano keys he used to love so much and to the memory of being able to play at close to concert level.

It ended up that we never did "try again" before Gregory died. And while possibly painful for both of us, I am glad we did try at least once!

What is Music Therapy?

Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.

Music Therapy is an established health profession in which music is used within a therapeutic relationship to address physical, emotional, cognitive, and social needs of individuals. After assessing the strengths and needs of each client, the qualified music therapist provides the indicated treatment including creating, singing, moving to, and/or listening to music. Through musical involvement in the therapeutic context, clients' abilities are strengthened and transferred to other areas of their lives. Music therapy also provides avenues for communication that can be helpful to those who find it difficult to express themselves in words. Research in music therapy supports its effectiveness in many areas such as: overall physical rehabilitation and facilitating movement, increasing people's motivation to become engaged in their treatment, providing emotional support for clients and their families, and providing an outlet for expression of feelings.

What is art therapy?

Art therapy is a mental health profession in which clients, facilitated by the art therapist, use art media, the creative process, and the resulting artwork to explore their feelings, reconcile emotional conflicts, foster self-awareness, manage behavior and addictions, develop social skills, improve reality orientation, reduce anxiety, and increase self-esteem. A goal in art therapy is to improve or restore a client’s functioning and his or her sense of personal well-being. Art therapy practice requires knowledge of visual art (drawing, painting, sculpture, and other art forms) and the creative process, as well as of human development, psychological, and counseling theories and techniques.

What is play therapy?

Play therapy can also be used to treat issues faced by teenagers and adults. By adulthood, most people have lost their ability to playfully explore themselves. Play therapists are trained to help adolescents, adults, and even the elderly relearn the values of play. Playful exploration has been proven to enhance both cognitive and physical behaviors, and there is a significant amount of research from the fields of neurophysiology and molecular biology that supports play therapy as a valid therapeutic technique for those past childhood. A growing number of organizations and experts are dedicated to play research and advocacy, believing that play is important for people of all ages.

Play has been shown to optimize learning, enhance relationships, and improve health and well-being. Adults and children engaged in a therapeutic alliance that focuses on play have an opportunity to choose from a variety of modalities such as movement (body play), sand play, dream play, nature play, social play, pretend (fantasy) play, creative play, storytelling, and vocal play. Play therapy may be used to address a variety of health challenges experienced by adults, especially if incorporated with other treatment modalities. One of the most significant benefits is that play can provide a comfortable and safe environment that may prompt an adult to approach more serious issues.

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