Who is going to be with the person, hold their hand, listen and talk with them when they have Alzheimer’s, especially in the later stages? This is where the role of the ‘trusted companion’ comes in. As the title suggests, a prerequisite for this role is trust. This role involves putting ones own thoughts to the side, feeling compassion, and being totally present with the person. Through this and being respectful and authentic, trust is established.
Ideally the trusted companion should know something of the person’s personal history so that they, the companion, can relate to what is being presented. However, when that is not possible, the person with Alzheimer’s still needs a witness who is present and will listen and acknowledge what they are thinking and experiencing. So the trusted companion need not be a relative or friend.
The term ‘trusted companion’ grew out of Validation therapy which was developed by in the mid ‘60s to ‘90s by an American, Naomi Feil. She worked with people with cognitive impairments and dementia and taught the importance of reciprocal communication in which the person is acknowledge, respected, heard and treated with respect. These principles are aligned with the principles of person-centred therapy introduced by American psychologist, Carl Rogers.
When people have advanced Alzheimer’s, the cognitive structures that have held everything firmly in place through out life, weaken, allowing memories from the unconscious to surface. Carl Jung said, “forgotten or repressed material surfaces in a state of diminished consciousness”. The filters that monitor our thoughts and moderate what we say to the outside world no longer work effectively, so people say what they are actually thinking. This is often disregarded as gobbledygook, but if we really listen we may be able to find out the meaning of what is being said and help the person to process it. This may involve working through and resolving previously unresolved issues.
I did this with my mother and through this process she was liberated and able to move on. Troublesome memories surfaced on many occasions, seemingly out of the blue, and when they did she and I worked through them together. Every time she felt better for doing this. It is not unlike the last rights when the person can say, without judgement from others, what is on their mind, feel exonerated and gain relief from this. As a result of this continuing emotional clearing my mother left this life with no baggage. A magnificent achievement!
Should everyone have a trusted companion at the end of life? How much better their ending would be if they had.
Looking forward to the next stage of our journey.
Maggie La Tourelle