From left: Diane Johnson, Sharrie Wade, Kathy Klinger and Jill… (Barbara Haddock Taylor,…)
When she was fresh out of nursing school in the early 1970s, the last thing Mary Fridley expected to do with her life was work with the elderly.
"How depressing would that be?" she says she thought at the time.
Then she took a temporary job at a nursing home, where she met the Caroler.
She doesn't remember his name, but Fridley could not recall the man more clearly. He was so far along in his dementia that he needed caregivers to feed him. He had such a bad habit of scraping his knuckles on things that he had to wear mittens. He never spoke.
"His family never visited, so we knew very little about him," Fridley says.
Like the rest of the staff, she found him difficult — until one holiday season, when a school choir came to perform. As they launched into a carol, the man began to sing.
"He knew all the words, and he had the most beautiful voice I have ever heard," says Fridley, an Annapolis resident and president of Gero-Resources, a private firm that advocates for caregivers for the elderly. "From then on, whenever we wanted to communicate with him, we'd sing carols, whether it was winter or the middle of July. And it helped."
Just last week, Fridley finished teaching "Living in the Land of Oz," a three-part educational series on dementia for Anne Arundel County caregivers. Among its many lessons was the insight that changed her: As frustrating as every case can be, the most helpful thing a caregiver can do is to find the language a dementia sufferer can understand, then speak it.
"They're in their own world, but we can make contact with them," she says. "It's a matter of finding the key."
The process can feel odd and be exhausting, Fridley told the family and professional caregivers who took part in the series, one of dozens she has conducted through the county's Department of Aging and Disabilities.
But she long ago gave up the notion that dealing with older people and their illnesses is dispiriting. "I saw how badly [those residents] needed to communicate," she says. "How can we not reach out?"
Yellow brick road
In a conference room at the Pasadena Senior Center, 15 class members sit along three long tables, their lecturer in front.
"We're going to have fun today," says Fridley, an energetic woman who has the manner of an encouraging social studies teacher. "Now, how was everyone's week?"
"Long," says Bob Bankey of Pasadena in a weary voice.
Small wonder. Sessions taught by Fridley include time for students to share their experiences, and within a half-hour, Bankey has told a story of his elderly mother, an Alzheimer's sufferer who once wandered away while shopping at a grocery store, only to be driven home by a kind stranger.
"They had a helicopter and 11 police officers looking for her before my father or I knew she was missing," Bankey says.
A woman in the class describes her mother-in-law, who has lost the ability to wash herself but refuses help. Another tells of an elderly father who went for walks in the middle of the night — wearing only shoes and socks. Another says her octogenarian mother howls intermittently, for no apparent reason.
"All [these] behaviors are emotionally driven, and all are expressions of some kind of need," Fridley says. "Keep in mind, this is not their fault. Try to think, 'That's not my mother [causing the problems]; that's not my spouse. It's the disease.'"
Fridley, a registered nurse who is board-certified in gerontology and has lectured on caregiving for the elderly for more than 20 years, titled her series "Living in the Land Of Oz" because, in her view, when dementia strikes in a family, it's a lot like the tornado touching down in Dorothy's hometown: It upends everything and leaves all concerned in a wholly new reality. Her sessions help codify the new rules.
The first, "We're Not in Kansas Anymore," which met in early December, was largely informational: Fridley named and described the major forms of dementia (scientists have identified more than 70), the ways in which they progress and the courses of treatment in use.
"I always thought the terms 'dementia' and 'Alzheimer's' were interchangeable," says Joseph Anthony of Pasadena, who has been caring for his dementia-impaired father for months. "Now I realize 'dementia' is an umbrella term, and Alzheimer's is just one form of it."
The second, "Follow the Yellow Brick Road," stressed behavior management. Dementia sufferers live in an isolated and frightening world, Fridley taught, and caregivers should be aware of techniques that can bridge the gap: making and keeping eye contact while talking, using respectful touch, removing background noise, engaging sufferers in conversation about things they do remember.