Understanding the Three Stabilizers for a Stress-less Journey

In this episode, Lizette discusses the concept of stabilizers in the dementia journey. She compares them to the stabilizers on an airplane that help to maintain balance and stability. Lizette explains that there are three types of stabilizers in dementia: horizontal stabilizers, vertical stabilizers, and a rudder.

Horizontal Stabilizers: Communication Mastery

Lizette starts by discussing the horizontal stabilizers, which control the up and down motion of the airplane. In the context of dementia, she focuses on communication as a horizontal stabilizer. She emphasizes the importance of understanding how to effectively communicate with someone who has dementia in order to make their day-to-day experiences easier and more successful.

Lizette explains that people with dementia often struggle to regulate their emotions, so it's crucial for care partners to be mindful of their own emotional state when communicating with them.

Vertical Stabilizers: Crafting Meaningful Activities

Moving on to the vertical stabilizers, Lizette explains that they control the side-to-side motion of the airplane. In the dementia journey, the vertical stabilizers represent the facilitation of meaningful activities for individuals with dementia.

Lizette explores the concept of meaningful activities and how care partners can structure and engage individuals in these activities. She emphasizes the need to create a smooth and stable journey for individuals with dementia.

Rudder: Guiding Through Transitions

Finally, Lizette discusses the role of the rudder in the dementia journey. The rudder controls the position of the airplane during turns. In the context of dementia, Lizette explains that the role of the care partner transitions as the person with dementia progresses.

Initially, the person with dementia is in control of their decisions, with the care partner providing support. However, as the dementia journey continues, the care partner gradually takes on more decision-making responsibilities to ensure the well-being of the person with dementia.

Thriving Through Turbulence: Strategies for Challenging Behaviors

Throughout the episode, Lizette emphasizes the importance of creating a stable environment and offers strategies for managing challenging behaviors, which she refers to as turbulence.

She explains that challenging behaviors exhibited by individuals with dementia are often a result of unmet needs, both physical and emotional. The goal, according to Lizette, is not just to survive the dementia journey, but to thrive in it.

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[0:53] So welcome to today's program.

[1:01] Welcome back to the Baffled Brain Demystifying Dementia. I'm so glad you joined me again today.

Thank you for joining me. I so enjoy doing these programs.

And I don't know if you guys can tell, but I just had a cat walk around behind me, kind of distracting when he's meowing underneath me. But that's part of it, right?

When you record things live, there's always a chance of a misstep.

So my husband and I live in South Carolina. I know we have two cats and we have a dog and we have nine chickens, eight hens and a rooster.

We call the rooster Rooster because he's rude and he attacks us.

But anyway, I digress. I am here again. This is Monday, the 25th of October 2021.

[1:48] And we are continuing in our series called Dementia Made Simple.

And here's my cat. But he is definitely wanting to be part of today's program, today's broadcast.

Exploring the Stabilizers: Communication in Dementia

[2:01] So what are the stabilizers?

So we're continuing in our journey of breaking the framework down of how to use an airplane and the analogy of an airplane to explain dementia to people, to make it simple to understand.

And so the next section in the journey is what's known as the stabilizers.

So stabilizers are just exactly that. They are things that help to stabilize an airplane.

So I learned a lot about an airplane when I started to work through this process, right?

[2:34] Excuse me horizontal stabilizers that control the pitch which is the up and down of the airplane or the nose we have vertical stabilizers which control the nose swinging from side to side which is which controls the yaw and then we have the rudder which changes the position of an airplane on the turn and so we're gonna we're gonna divide our dementia journey into to a couple of different places regarding how to understand how to stabilize things in dementia.

And I'm not talking about necessarily how to decrease the signs and symptoms of dementia, even though that is a part of this process, which would be to stabilize it, right?

How to prevent it from going up and down, up and down.

And we can do a whole segment just on prevention and invite people into the podcast to talk about preventative measures and what kinds of things are possible to do.

There's a lot of research talking about what is possible to do to prevent dementia.

[3:44] But that's not really what I have in mind when I talk about the stabilizers.

So when I talk about the stabilizers and we're going to start with the horizontal stabilizers which controls the pitch the up and down the up and down what I have included in this section is communication how do we communicate with somebody who has dementia how do we talk to them how do we structure our communication with them so that we're actually making it easier for them instead of making things harder.

[4:18] Because when we don't know how to speak to somebody who has dementia, and I'm not talking, I'm talking about more than just language, even though language is obviously a part of it.

But how we communicate with a person with dementia can vastly impact their ability to either be successful or not successful in their day.

We forget we oftentimes forget people with dementia because they're going through these changes in their life they lose a lot of their ability to regulate their own emotions and we talk about that a lot in the podcast how to how people start to struggle to regulate their own emotions but if they cannot regulate their own emotions what happens is they become an emotional sponge.

And so when we're communicating with them, if we're frustrated or if we're angry or if we're tired, they suck up all of our emotional energy because they cannot maintain or control their own.

And so communication as a horizontal stabilizer will control the pitch or the up and down that that a person has on a day-to-day basis. And we're going to explore this further.

The Vertical Stabilizers: Meaningful Activities in Dementia

[5:39] So what about vertical stabilizers? What are vertical stabilizers?

[5:45] Well, vertical stabilizers control the nose swinging side to side in a plane.

The vertical stabilizers, that's what they do. So what are some vertical stabilizers in our dementia journey?

Some vertical stabilizers in our dementia journey is how can we, as the care partners coming alongside somebody with dementia, how can we facilitate or help them be more active in meaningful activities?

And what are meaningful activities?

And how do we structure those meaningful activities? And how do we make them harder or easier?

Or how do we engage somebody who has lost the ability to initiate their own activities on their own?

And so the stabilizers, the vertical stabilizers, just kind of keep the nose from going too far one way or the other and keep us on a nice, smooth journey, right?

That's the idea behind Dementia Made Simple is to have a smooth journey, not a journey full of back and forth, up and down, all over the place.

So those are the vertical stabilizers.

[7:01] So also we have a rudder, right? What is a rudder?

A rudder on an airplane controls the position on turns.

So if you think back to my analogy of using our life as a flight, where we have our developmental years like the takeoff and our life's journey like a flight, and then our gradual decline through our end of life process, whatever that may look like.

Like everybody, you know, technically we're all in a process of dying, if you want to think about it that way.

Some of us just know that we are and some of us know that we have things that we need to be doing right now because we're in a process.

And I'm not talking about like the last, you know, hospice phases, even though that is another conversation we will have.

But how, you know, through our life, we talked about the pilot and the co-pilot and that the pilot is going to slowly stop being the pilot and the co-pilot, the person who is with us in our life is going to turn into the pilot. Well.

The Rudder: Changing Directions in the Dementia Journey

[8:09] The rudder also helps to change the direction of a plane.

And so initially, the person with dementia, when they're the pilot of their own plane, they're going to be controlling the rudder of their plane.

But as a person with dementia goes from being independent and making these decisions for themselves to having a care partner come alongside them and helping them make these decisions for them, the care partner is going to eventually be the one that is changing the direction of the plane, whether that be helping to decide to move in with a family member, an assisted living, a memory care facility, all of these different decisions that we navigate and negotiate when we're working with and coming alongside a person with dementia as well as their care partner.

[9:04] Initially, they will still be making these decisions, and we will be supporting them in these decisions.

And then as their process continues, ultimately, we will, as care partners, be helping to take over some of these decisions and when to make these decisions and how to make these decisions and to support our loved ones with dementia in that regard.

We're going to talk about turbulence under the stabilizers because I see turbulence as not being stable, right?

Any of us who've been on an airplane, if you've been on a long flight, you've been on a flight that's had turbulence.

Turbulence is a normal part of a flight. And with dementia, a person with dementia has, over time, possibly has what we call challenging behaviors.

Now, challenging behaviors, I want to be very careful and sensitive when I use the word challenging behaviors, because challenging behaviors is just a term.

It's just like any other thing. We put a name to something, right? A person with dementia.

[10:13] Has unmet needs. And I contend that all of us, when we are having challenging behaviors, because we all have challenging behaviors, we just don't think about them as challenging behaviors.

I'll use myself as an example. A few weeks ago, I did a presentation and I was preparing on a Saturday and was a little bit testy with my husband. Well, you know what?

I was having having challenging behaviors. My challenging behaviors were because I was stressed and I was trying to get this presentation put together and get done in a timely manner.

And my husband, my dear husband of 28 years was trying super hard to support me.

And I just came out there, all, all blazes going.

And if you, if you want to consider my bad behavior was a challenging behavior to my husband, right?

And there's mostly nothing wrong with my thinking processes.

I don't, as far as I'm aware of right now, have dementia.

[11:16] So we all have challenging behaviors. What is a challenging behavior?

In the terms of somebody who has dementia, a challenging behavior is their attempt, a person with dementia's attempt to try to communicate something to you as their care partner.

They're trying to communicate an unmet need.

Unmet needs can be either physical unmet needs or emotional unmet needs or both.

They can be facilitated or made worse by things like the environment or the care partner's stress or something going on in the person with dementia.

[11:55] So we're going to talk about challenging behaviors under the heading of turbulence on a flight because it makes it hard, right?

These are the things that make it hard to keep a stable environment, to keep our homes from being disruptive and full of dissatisfaction and unhappy people.

I want to encourage you. There are strategies.

There are things that we can do. There's lots of information out there on how to manage some of these challenging behaviors without making your life crazy and with keeping your own sanity and with keeping your own health needs in consideration.

So I want to encourage you. We can thrive.

We can thrive in the midst of a dementia journey. You don't have to just survive.

We can. And so under the stabilizers, we're going to talk about strategies that will help you with a dementia journey in keeping things more stable.

The more stable things are, the easier it is on everybody, including you as the care partner, including the person with dementia.

So thank you for joining me today in today's episode of the Baffled Brain, Demystifying Dementia. I am so excited to be doing these programs and this podcast for you.

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About the author

“Think Different” Dementia’s owner, Lizette Cloete, OTR/L graduated as an Occupational Therapist from the University of Pretoria in South Africa in 1992. Lizette has almost 30 years of experience as an Occupational Therapist in a variety of settings, the latest being in the home health environment. She enjoys teaching on the topic of dementia, most recently presenting at a national conference on the topic “Dementia Made Simple”.

Disclaimer: These blogs, videos and any work done by Lizette Cloete OT, as a Member of Think Different Dementia, LLC, is given only as educational content and consulting work. This does not create an Occupational Therapist-Patient Relationship. The educational content and consulting work performed should not be considered medical treatment as an Occupational Therapist. The consulting work does not take the place of medical work normally performed by a licensed Occupational Therapist. Please consult a licensed Occupational Therapist for medical advice.

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