The following is an excerpt from an interview with Elisa Byard, graduate of the June 6th 45-hour Dementia Care Training (featured in our Fall 2008 issue), about using a journal as a tool for enhancing care for people with dementia.

Nancy: What got you started using a journal? When did you begin?

Elisha: Several years ago I was taking care of one person during the week and another client on the weekend. Each had a different diagnosis. They had specific medications, conditions, allergies, etc. There were times when I was sent to the pharmacy to pick up medications, but I knew that I had been there already. It was getting pretty confusing. I needed to create a way to keep track of what was going on. I wanted to record the client’s dietary needs, medications, toileting patterns, sleeping habits, things like that.

Nancy: Were you journaling the specifics of the person’s health in order to keep things organized?

Elisha: Yes, it became helpful to note if there was a particular incident. As an example, one person that I cared for was refusing to eat spaghetti. His wife and I weren’t sure of the cause. Looking back in my journal, I found an entry stating that the last time he was off ered spaghetti, he choked. We realized this was not an isolated episode. From that time on we made sure his food was cut into bite-sized pieces.

Nancy: Did you find yourself writing additional things about the person in the journal?

Elisha: One of the people that I worked with enjoyed making rhymes. We spent a lot of good times playing with words. I would write them in a journal. As his illness progressed he was less able to use language. He expressed this frustration as “looking for something.” I understood his irritation to be the loss of language, the loss of a rhyming word. An activity he had enjoyed in the past was no longer available to him.

Nancy: How else have you used a journal?

Elisha: My personal journal helps me to focus and sort out my own feelings. Taking care of people with illnesses can be diffi cult and stressful. Writing allows me to fi nd happiness. When I write, I can fi gure out how to better manage what is going on.

Nancy: How does writing down your feelings help you?

Elisha: If I didn’t write, I couldn’t center myself to better take care of people.

Nancy: Can you see any value to making a journal with the person you are taking care of?

Elisha: Yes, one of my people used to write down the weather every day. I would sit with her. She was able to maintain her writing skills for some time. The journal gave us a starting point for conversation.

Nancy: What about journaling just for fun? Maybe you could use pictures or cutouts from a magazine?

Elisha: That sounds great. I think it would be a good activity for men. Sometimes it is hard to find activities to do at home with them. They are not often interested to do chores, cooking, etc., things that women can usually find satisfying. One of the men I care for would love to make a journal of the cars that he had owned. I think that would be wonderful!

Elisa is currently studying to become a medical assistant. She plans to continue her education toward the goal of becoming a nutritionist. We wish her the best of luck.

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