An Amazing Presence While Working with Patients with Dementia
Dementia is a loss of brain function that affects memory, thinking, language, judgment, and behavior. I work in home health as a physical therapist and occasionally have patients with some form of dementia that impacts their independent living. The role of rehabilitation with these patients can be very challenging depending on the stage of the disease process. Summer of 2011, I had a series of patients with the diagnosis of dementia that opened my eyes in a way the mind has difficultly explaining and goes beyond the standards of belief today. I experienced an awareness of connection of all of life to the universe. Moreover, as I work with the body I am beginning to see and experience a great relationship to the eternal soul.
I started the week with a new patient that was recently diagnosed by her doctor with memory loss. I completed her home health geriatric physical therapy evaluation. As I was about to leave her home she smiled and pointed to a glass of water. She asked me, “What do you see?” Puzzled I looked at her. She elaborated by asking, “Is it half full or half empty?” I look at the patient and she smiled. I was caught in her smile of delight. "Half full?" I replied but confused by such a random question. She says, "Well..." I asked her, "What do you see?" She reports in a matter of fact tone, "Both.” As I drove to my next patient, I contemplated the glass of water, the emptiness, and fullness
My next patient could only respond to simple commands and was primarily nonverbal. Again I was caught off guard. After completing a series of transfer-training activities and pre-walking standing activities, she rested in her wheel chair. I sat with her quietly. She spoke the word, “Perspective.” I questioned, “Perspective, what do you mean?” She had no response but I contemplated the similarity of my first patient that day. I began to feel a strange possible connection between my patients.
My last patient that day was a patient of very advanced stage of dementia. She was bed bound and completely nonverbal. She is not a typical patient I receive in home health for rehabilitation. She had developed a new hamstring contracture of her knee with complications of a bed sore. My intervention was to instruct the caregiver, her daughter, in range of motion and positioning to decrease the tightness of the newly shortened hamstring muscle. The technique was a very gentle, hands-on, and slow sustained stretch of the leg muscles. I did not know if she had any pain but she did withdraw with my touch initially. I could not connect with her by words so I began to connect with her body to feel any resistance.
As I connected with her performing her gentle stretches and range of motion, I felt an opening into something that has no boundaries. Her deep penetrating stare had no signs of expression. Can you even begin to think what it is like to put yourself in that condition? It appears to be a total loss of everything. I went out on a limb and I allowed my heart to open to her. As I connected to her, I experienced what I can only call oneness. When I left her home I was spinning in a vertigo for days because I really could not put this experience into anything the normal mind of everyday reality can explain. The more I resisted this perspective the more I spinned.
Eventually I did come out of spin but I am forever moved by the experience. I connected to something grand that day beyond the body and beyond the mind. An amazing presence is in each one of us, but it is often not realized until we have nothing. I felt it after my grandmother died. Now not only could I feel it in another living being, but I felt it in everything. I began to see connections everywhere. I could see both the fullness and the emptiness. At the time I felt like I received an amazing blessing but honestly that blessing or grace is always here. The taste of oneness is worth more than any material value however shatters any and all conflicting conditioned beliefs against it.
My approach to my work has not changed in a clinical way but my perspective has changed to a wholistic view. I bring complete presence of being to the patient, caregivers, and home when working with any patient now. I am learning a new rootedness of my own being that seems to help the awareness of the patient. My experience on this subject is still so new. I am sure my experience is just the tip of the iceberg and more advanced practitioners in this area exist. I continue to work with a compassionate heart and bring a new faith and trust to my work.