Course content – PFLEGE-16
2. Module 1 · What is dementia?
2.3. Case, consolidation & transfer
Two cases and what to take away
The good feeling remains
Mrs L. (advanced dementia) can no longer remember anything and often recognises no one. One carer takes a moment for her at every encounter – a smile, a gentle touch, a kind word, her favourite music. Mrs L. never remembers these encounters, but afterwards she is noticeably calmer, more relaxed and more content – the good feeling remains. On days marked by haste and harshness, by contrast, she is anxious and restless. The case shows how preserved emotional memory shapes wellbeing – and why every encounter should be handled mindfully, even if it is not remembered.
Mr Okafor and the afternoon shift
Mr Okafor (fictitious), 81, has moderate dementia and moved into a care home two months ago. In the mornings he is calm and likes to read the newspaper headlines aloud. From about three in the afternoon he walks the corridors, tugs at doors and speaks sharply to staff. On Tuesday a new care assistant, in a hurry, takes his arm and says, “Come on, sit down, you are in the way.” Mr Okafor pulls away and shouts. Later that evening he refuses his meal and is awake half the night.
Analysis. (1) His state changes during the day, so the cause is probably not “bad character” but tiredness, noise and unmet needs in the late afternoon. (2) The hurried grip signalled threat. He may not remember the words but the feeling of being pushed stayed, and it shaped his evening and night. (3) A better approach: meet him in the corridor, walk with him, offer a drink and the newspaper, and tell the team that the late afternoon is his hardest hour. (4) The team can plan quiet activity, a short walk or a snack at that time. The case shows that one rushed minute can cost hours of wellbeing, and that observation turns a “difficult” person into one we understand better.
Is dementia a normal part of ageing?
What is the difference between a syndrome and its cause?
What usually remains late in dementia?
Why must a sudden change in confusion be reported?
What does section 2 SGB XI say about the aim of care?
Key messages
- Dementia is an illness with several possible causes, not normal ageing.
- Forgetting is only one sign; orientation, language, judgement and daily skills change as well.
- Stages are a rough guide; people differ greatly in speed and pattern.
- Feelings and the need for dignity, closeness and security remain. How you act directly shapes the person’s wellbeing.
- A sudden change needs quick medical attention. You describe, you do not diagnose.
- German law links care to dignity and self-determination (SGB XI, sections 2, 14, 15 and 43b).
- Think of an encounter in the last week where you were in a hurry. How might the other person have felt afterwards?
- Which of your own assumptions about “normal age” could stop you from looking closely?
- Which small habit from this module could you start tomorrow?
- ☐ I say my name and greet the person by name at every encounter.
- ☐ I describe what I see in plain words and pass changes on to the team the same day.
- ☐ I do not argue facts. I respond to feelings first.
- ☐ I note what calms a person, and share it with colleagues.
- ☐ I know the five care levels exist and which areas of life they look at.
Exercise: Become aware of how a person with dementia feels after your encounters. For one day, make a point of making every encounter positive and dignified (smiling, calm, appreciation). Observe the effect on their mood.