It’s “politically incorrect” to refer to a person with dementia as a child or speak to them as such. Although the regression caused by progressing symptoms certainly resembles that of a child, what is the difference?
Jane was out of control and fighting tooth and nail not to be forced into the shower. She struck out at her husband as he led her into the bathroom and grabbed onto the sink, refusing to move. Screaming and swearing, she picked up the soap and threw it at him, "No, damnit, not shower; already did.” She then slid to the floor and stubbornly refused to move.
Jane hadn't showered in a week, and she was often incontinent. Her husband was her sole caregiver, and this scenario was repeated each time she needed a shower, usually after he couldn’t take the smell anymore. She would refuse to bathe, often kicking or hitting out at him if he tried to force her. He was exhausted and at the end of his rope.
He kept thinking about how Jane's actions reminded him of their daughter's temper tantrums when she was four; she hated to shower and would fight tooth and nail against it. What was happening to Jane and her behavior certainly seemed like she was regressing to becoming a child.
Jane could no longer use eating utensils, dress, or figure out how to do most things. She used adult diapers at night, and rails had to be attached to her bed to prevent her from falling out. It was like caring for a child again for Jane's husband, but this child was already a grown adult and couldn't learn.
No matter how advanced the dementia symptoms are, those experiencing it are not reverting to being babies. Yes, the behavior may seem like that of a child, but there are significant differences.
A child is born with more than 100 billion neurons. This network of cells is the primary system that operates their physical and mental functions. These cells receive, process, and store the data, creating connections to the information. However, the infant’s neuronal web is undeveloped, and the cells are relatively a blank slate waiting until the baby begins to experience their environment. Babies must learn to use their bodies, think, reason, and communicate.
With dementia, this development is reversed. However, the neuronal web of a person with dementia is not a blank slate. Their billions of neurons are filled with a lifetime of stored and connected experiences and sensations. Even though dementia progression damages billions of neurons, operational cells with intact information always remain despite the advancing physical and cognitive impediments.
Despite dementia progression, there are always times the person is more in touch with the world than you might imagine. An adult with dementia has more information than a small child, regardless of their outer behavior. Remember, their billions of undamaged neurons still contain innumerable experiences.
When a baby can’t call you by name, we understand they can't, but we know the baby recognizes you as someone important to them, even though they can't reason who you are? When a person with dementia forgets your name, it doesn’t mean they don’t recognize you or your importance to them. Like the baby, they may not be able to figure out who you are, but they still feel a connection to you.
When a child hasn't learned to dress or feed themselves, we have such patience. We automatically do it for them. Changing diapers is a part of our daily routine for the first couple of years and eventually, having to deal with temper tantrums and answering the same questions over and over becomes part of our day. When they are small, they can get lost or hurt if we don't carefully watch over them. We have to "babyproof" our homes.
Why can't we have the same patience and acceptance for an adult with dementia?
The developing child can only do what it has learned to do over time. They have to be shown how to do things and follow the steps. We patiently repeat the steps over and over until they can do it on their own. Advancing dementia takes away the ability to learn; they can only do what they’ve already learned if it hasn't been damaged by dementia.
So why is it so often the caregiver expects them to know how to do things and gets frustrated when they can't?
We use endearing words like sweetie, missy, or honey in a soft singing voice with children. Our tone and words convey caring and love.
So why is this considered unacceptable for us to do with someone with dementia?
In Costa Rica, I'm older, and it's common in this culture for people to address me this way. It conveys heartfelt communication, and I don't take offense at all. I also use this with the elderly, especially those with dementia. Not one has ever taken offense because it's all in your intent. They don’t feel diminished; they feel special and loved.
We have lots of patience, acceptance, and unconditional love for children, regardless of their behavior or abilities, and this is how we should always treat our loved ones with dementia.