Many people do not know that people with Dementia are still able to learn new things. Hundreds of studies have been done about the learning ability of people with Dementia worldwide. Because the brain functions less well, this learning is slower and different, but it is not impossible.
By making use of the learning capacity of people with Dementia, very positive results can be achieved:
- the quality of life of both the person involved with Dementia and that of the family and caregivers can greatly increase;
- those involved can function independently for longer, learn to use tools, become more active;
- behavior can also be learned and unlearned.
Research shows that especially people with severe Dementia, a high degree of involvement in activities causes positive feelings and less restless behavior. Their learning capacity must then be invoked for this.
Forms of learning
Different forms of learning can be used for people with Dementia. The most important are:
The memory disorders mainly concern the memory for ‘facts’ (explicit memory), while automatic forms of learning remain intact for a relatively long time (implicit memory). A method that uses this (relatively long intact) implicit memory is error-free learning. This is an instructional method whereby the aim is to prevent errors during the learning of new knowledge or skills as much as possible.
For people who have been affected by the explicit memory (such as with Dementia), these errors are no longer recognized and therefore not corrected. Instead, they are stored in the long-term memory via the implicit memory. These errors will be visible when the action is repeated, but will not be recognized as ‘error’ (the explicit memory is affected). By preventing errors during the learning phase, only the correct response will be saved and therefore remembered.
In errorless learning, the task of learning is divided into small steps and then trained step by step until finally the complex goal behavior is achieved (chaining). The person with Dementia will only proceed to the next step if he completed the previous step without errors, hesitations or gambling feed. For example, you can take photos of each individual coffee making operation. Then you practice the different steps in making coffee in the correct order using the photos. Just until it goes well. That can sometimes take a few weeks.
Besides, people with Dementia learn something new through the use of strong emotions. Raise awareness and undergo new emotions in a specific place. Suppose your loved one with Dementia does not want to go to the toilet. Then put a radio on the toilet that plays the favorite music from your beloved’s childhood. This is how you evoke a positive emotion with this action.
Another form of learning is association learning; old associations are linked to new situations, also known as classical conditioning. Positive associations, such as preferred music and scents that are linked to pleasant memories, are promising possibilities. A good example of association learning is learning a route indoors by hanging crafts that your loved one has made himself or photos/paintings that your family member likes.
Operant learning (rewarding and punishing)
This method of learning that occurs through rewards and punishments for behavior. Through operant conditioning, an association is made between a behavior and a consequence for that behavior. Operant conditioning relies on a fairly simple premise – actions that are followed by reinforcement will be strengthened and more likely to occur again in the future. If you tell a funny story in class and everybody laughs, you will probably be more likely to tell that story again in the future. If you raise your hand to ask a question and your teacher praises your polite behavior, you will be more likely to raise your hand the next time you have a question or comment. Because the behavior was followed by reinforcement or a desirable outcome, the preceding actions are strengthened.
Points for attention
Important points of attention for all learning forms are:
- monitoring a good atmosphere;
- take into account the limitations of the person with Dementia;
- be consistent;
- set clear goals.
Good observations are the basis of every learning process. One form of learning is much more labor-intensive than the other. Learning forms can also be combined. If it succeeds, it will also save time and quality.
To use this learning capacity, the role of the family and professionals is crucial. The person with Dementia needs guidance from his permanent environment. For the environment it will also be a question of what works or does not work for the patient; every person is, of course, unique and Dementia also develops differently for everyone.
Important to realize
It is important to realize that the learning capacity is always there, both for starting and advanced Dementia. Even if a professional or family is not consciously involved in this, they will still learn.
This is one of the reasons why, for example, hospitalization after the first weeks of admission to a nursing home is an issue. Patients quickly learn many things that they did just before admission because caregivers (unconsciously) take over too much…
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