Before I explain habilitation therapy, let me give credit where it's due. I knew nothing about habilitation therapy. I was an activities worker who "developed" a method of communicating with my residents through trial and error. What I did worked for me. Recently, I learned that even though I practiced habilitation with my residents, I was only applying a method that an incredible lady pioneered three decades ago. I give total credit to Joanne Koenig Coste, who cared for her husband for three years after he suffered a stroke and developed vascular dementia. She was the first, and thanks to her, she will not be the last.

Okay, you ask, what is habilitation therapy, and how can it help me? In a nutshell, habilitation therapy is the practice of focusing on the skills a person with Alzheimer's or other related dementias has at the moment, and not the skills that have been lost. Rehabilitation and habilitation are different; rehabilitation assists people in recovering from a physical injury. Habilitation focuses on current ablities and responds to emotions. Alzheimer's disease eventually robs a person of their physical and mental capacities, but the ability to feel emotions never fades away.

According to Koenig Coste, "The person with Alzheimer's disease -- like anyone with memory loss -- may soon forget what you say, but he will never forget how you made him feel."

Habilitation therapy can be successful if the caregiver:

Makes the home environment work

Realizes that communication continues to be possible

Focuses on remaining skills

Lives in their loved one's world

Keeps their lives productive by ensuring social and at-home activities

Undesirable behaviors are often blamed on a lot of things, and some caregivers have told me that they wonder if their loved one "acts out" on purpose. The simple truth is that Alzheimer's alters perception. Something as seemingly insignificant as a shadow can be terrifying to someone with Alzheimer's. Because their perception is altered, a shadow is often perceived as a stranger in the house. In that instance, the way to avoid shadows would be to make sure the surroundings are brightly lit. Avoiding floor lamps is a way to reduce shadows and avoid possible falls.

Communication is more than words. You've heard that actions speak louder than words; so do facial expressions, posture and tone of voice. What you project through your tone of voice and your posture comes through loud and clear to a person with impaired memory. It is entirely possible that it is you who sets the tone for the day. If you have tried your best to be positive, but your loved one remains agitated,then listen to what he is saying, but try to understand the emotion behind the words. If they keep asking, "Where am I'they might be saying, "Where am I?", but the real question is, "Am I safe?". Reassure by letting them know that they are safe with you, and that you will take care of them.

No matter how much ability they lose, there is going to be something they can still do. Maybe your mom can't wash the clothes anymore, but put some unfolded towels or some mis-matched socks next to her and she will instinctively begin folding and matching. You've given her value, and she knows she still has a purpose. Best of all, you don't have to remind her that she can no longer do the laundry. What about dad? What did he do? He might not be able to work on cars, but he can sort nuts and bolts. The point is to focus on what they can do without reminding then of what they can't do.

I know that all these things are important, but living in their world is the most important to me. When someone who has lost the ability to reason, it is pointless to try and reason with them. They can't be in your reality; you must meet them in theirs. This is the only way their dignity can be preserved. Don't tell them their mom is dead when they ask for her; that's not her reality anymore. An effective answer would be to say, your mother is not home right now; she will be gone for a couple of hours." You have validated her concern and left her dignity intact.

Activity is important. The desire to feel needed doesn't go away for the person who has Alzheimer's. They need to feel successful and have failure of any kind eliminated. They need to feel that they are still a part of society in a way that is safe for them. Music is an activity and so is reminiscing. A tea party with one or two familiar friends is a wonderful way for them to socialize.

There is a lot more to learn about habilitation therapy, but these are the basic principles. Consider this Basic Habilitation 101. I encourage everyone who reads this to learn more.