Few people who know someone living with a form of dementia grasp the science behind how the brain is affected. Experts say that by increasing our knowledge of the brain's functions, we can more effectively approach caring for those struggling to live with this disease every day.

“Studies have shown that, in general, skills retained in the left temporal lobe are lost earlier in the disease process, while those in the right temporal lobe are retained until much later,” said Mary Beth Quinn, Director of Specialty Program Development with Kindred Hospice.

Quinn helps develop clinical programs that support Memory Care for people living with dementia.

Image of a man living with dementia, with his wife, listening to music on headphones

To better understand how to interact with your loved one, it’s important to know what they may be experiencing during the phases of dementia. Early on, they may experience left-brain function losses in:  

  • Logic and the ability to consider multiple options
  • Words and language, beginning with nouns and objects
  • Math, often first seen with the inability to balance their checkbook
  • Comprehension when doing daily reading, such as a newspaper or instructions
  • Reality, specifically losing understanding of what is fact versus fiction
  • Strategic thinking, or the inability to plan ahead
  • Safety awareness

“A person living with dementia will miss one out of every four spoken words,” Quinn said. “If the word that was lost is a noun, for example, then the ability to truly comprehend the discussion and follow along is hopelessly lost. They may think they’re getting it, but they don’t know what they don’t know.”

To help your loved one as these left brain functions begin to fade, Quinn said to engage the right side of the brain where strong and powerful emotions are housed. You can do this through playing music, singing along with them, reciting familiar poetry or prayers, or even dancing with them if they're able. These activities are processed in the right side of the brain, which is said to help connect to the left side of the brain to temporarily allow lost functions to improve.

“Music memories are kept because they are hooked into our emotional center in the right side of the brain,” Quinn said. “Sometimes in home health, we leave the family with homework assignments, and if they aren’t having success, we tell them to try putting a little music in the background or dancing with their loved one.”

Quinn said if your loved one is able to stand, dancing has been proven to help even if a person has to use a cane to be more mobile and music helps the brain function on a deeper level to help the person become more functional.

The documentary Alive Inside showed that music is an optimal way to connect with people living with dementia. The filmmaker played each participant's favorite music through headphones, where the sound would be concentrated near the person’s brain. People who had very little interaction with their environment and barely spoke were suddenly becoming more engaged in their surroundings.

“This speaks to the power of music,” Quinn said. “It shows how much it’s retained and how we can use it to communicate.”

Rhythm is also important – in music and in the scheduling of the day.

“In dementia, it’s all about the approach, and you need to understand that of the two of us, one of us is in brain failure,” Quinn said. “You can’t expect the person in brain failure to adopt and change. We have to be the one to adopt and change as the disease progresses.”

Quinn gave the example of a daughter caring for her mother. The daughter began mentioning that her mother refused to shower in the mornings. As it turned out, morning showers were the daughter’s idea because she would be too tired in the evenings to help her mother shower. In reality, her mother never showered in the mornings, she preferred evening showers.

It isn’t uncommon for caregivers to place their agenda on the person living with dementia, unknowingly, and with the best of intentions. It wasn’t that the mother refused to shower or feared water, she didn’t recognize the change in the rhythm of her day.

“It’s best to engage the person living with dementia in what they can do, and what they have been used to doing in their lives,” Quinn said. “They might not be able to cook, but they could peel the vegetables or help with a recipe. You have to focus on as much as they can do in the rhythm of the day.”

Try to establish a routine as closely to how you know your loved one spent their day, if possible. They may not remember the routine each day, but they will remember the rhythm to the day, and that is helpful.

“Most people who are around others living with dementia tend to see these diseases as a series of challenging behaviors,” Quinn said. “They tend to see what is wrong, not what is right. If we understand what is retained versus what is lost, then we can change our approach to interacting with a patient living with dementia, including managing anxiety or behaviors of sundowning.”

For people with Alzheimer’s disease or dementia, “sundowning can cause a variety of behaviors, including confusion, anxiety, aggression or ignoring directions.

If you are caring for a loved one living with dementia or Alzheimer’s disease and think care at home may be beneficial, call us at 1.866.KINDRED to learn about your options. We are here 24 hours a day, seven days a week to answer your healthcare questions.

About Mary Beth Quinn

Mary Beth Quinn is the National Director of Specialty Program Development for Kindred at Home, a division of Kindred Healthcare. She is Board Certified in Hospice and Palliative Care, a National Approved Educator for the Hospice and Palliative Nursing Association, a Corporate Trainer for the Virtual Dementia Tour and a PAC Certified Independent Trainer. Her passion is focused on improving the care provided to those living with dementia by focusing on what an individual remains capable of doing instead of what has already been lost. Her focus in Program Development allows her to continue promoting clinical excellence through both Memory Care and Palliative Care.

By Blair Klayko