An Agenda is a list of action points that are designed to meet an objective. When caring for dementia, there is always a to-do-list, but not an agenda. The to-do-list is designed to maintain the status quo, not to change it.
Nursing has an agenda because the objective is to facilitate the patient getting better. As dementia patients do not get better, the carer has to accept the situation as it is, without an agenda. Being accepting requires that there is no planned objective. I cannot accept whatever occurs when I have an expectation of what should turn up. Expectation always leads to disappointment. An appointment with dementia will always turn up the unexpected. When I expect the unexpected, I am never disappointed as I am able to accept whatever turns up. When I am totally accepting of whatever occurs, there is no expectation and therefore, there is no disappointment.
An agenda is a list of the conditions under which I expect an objective to be achieved. It is a detailed plan of how I choose for things to turn out. With an agenda, caring is conditional. It is conditional on the patient adhering to the care plan. The agenda lists the conditions under which the care will achieve its objectives. When caring fails to meet its objective, or the expected standard of care is not achieved, then the carer will be disappointed and so will the patient. The carer will disappoint the patient and the patient will disappoint the carer.
With dementia, an agenda is a detailed plan to achieve a disappointing result. Dementia patients do not conform to preset conditions. They do not do anything to plan. Carers may plan to introduce a system of routine care but dementia patients have no way of remembering what is planned for them. The carer may need a routine to maintain order in their life but the patient may have no such requirement.
With dementia, I want to eat when I am hungry as I have no concept of meal times. I go to sleep when I am tired, as I have no concept of bedtime. I get up when I wake up, as I have no concept of daytime & night-time.
An agenda requires a carer to enforce boundaries. Boundaries are the standards of behaviour that the carer deems acceptable from the patient. When the carer’s agenda requires them to enforce acceptable behaviour onto the patient, it is often unacceptable by the patient and will encounter resistance and cause mutual disappointment.
The main reason for a diagnosis of dementia is because of an inability to conform to acceptable standards of behaviour. There is no sense in certifying someone as incapable of conforming to acceptable normal behaviour and then insisting that they conform to a common standard of behaviour that is determined by their carer.
An agenda is a list of agreed points that conform to a plan to achieve an agreed objective. Dementia patients have no clear way of knowing whether an agenda, an objective or a standard is agreeable or not. To assume that someone is in agreement because they do not complain is an assumption that is often based on a false premise.
With dementia, I lose the ability to form my own perspective and create my own agenda. I also lose the ability to see someone else’s perspective and adhere to their agenda. This doesn’t mean that I need someone to create an agenda for me.Without an agenda, I am free to allow life to flow effortlessly through me, without any undue resistance. Allowing life to flow in a beneficial way is never detrimental. I do not need to plan for life to flow effortlessly through me, I just need to allow it.
As a carer, I do not need to plan for the patient to be happy, I just have to allow it. I do not have to plan for a dementia patient to be healthy, I just have to allow it. I don’t have to plan for someone to be well, I just have to allow them to be well.
Whether I am the patient or the carer, being happy, healthy & well are not things that I can make happen with an agenda of things that I need to do; I just allow them to occur naturally, without resistance. The only thing that stops me being healthy, happy & well is my own resistance to the natural & beneficial flow of life.
As a carer, when I am resisting my own well-being, happiness and healthy lifestyle; I am also resisting the well-being, happiness and health of the patient. Dementia does not inhibit the ability to be emotionally happy, healthy or well. It affects the ability to look after oneself in a good, happy & healthy way.
The carer is there to assist their patient to maintain their own happiness & good health by accepting their physical & mental limitations, whilst allowing their best emotional qualities to have full reign and full expression.