My 91-year-old West-Indian father, a wiry, 5″6′ US Army veteran with Alzheimer ‘s-related dementia, used to be far more cantankerous. He had even taken to frustrated cursing—something I’d never heard him do in the 55 years I’d been his son.
But then I decided to smile at him.
And I learned that he was much more likely to finish his breakfast, take his medication, and allow me to aid him in the bathroom when I did.
I started treating my Dad like a client
The inspiration came from reading a 2011 National Institutes of Health study that said “a recognition bias favoring positive faces and other stimuli in older compared to younger adults.” The takeaway resonated with my experience working in retail.
If anyone deserved the same world-class customer service, it was the man who helped create me. So, I began treating my father like a client — albeit a pro bono one.
Whenever I greeted him, I did it with a grin as genuine as I had the capacity for at any given moment. To achieve this, I reached into our shared history to remember the man who tucked me in with nightly bedtime stories; the man whose shoulders I happily rode on during trips to cricket games, the circus, and Walt Disney World; and the man whose words of encouragement over the years helped keep me afloat.
That is the man whose end-of-life-dignity it is now my duty to maintain.
It didn’t always work
If I was away from him for longer than a couple of hours, I greeted him anew upon our reunion. Not only did it mentally engage him; it elevated his mood: Sparks of recognition combusted in his bright brown eyes, and for a few brief moments, there he was, my old dad — my captain, my hero — smiling back at me, his firstborn.
While I had remarkable success with improvised smile therapy, I confess it didn’t always work. Every so often, he’s confused by his surroundings, or sometimes his Wheel of Dementia spins and lands on Lash Out. And that’s what he does — whining petulantly, followed by agitated and inflictive tantrums.
This is when I make maximum use of my customer service skills: I summon the best, most professional smile I can muster and grant him the time he needs for his temper to run its course. Due to the long-term damage done to his ever-shrinking attention span, he often forgets what he said or did within minutes.
It helped me not to take it personally
The shift to customer-centric professionalism also kept me from letting his behavior distress me. It also creates a psychic barrier that keeps me from falling victim to his mood shifts. At the beginning, middle, and end of the day, it isn’t personal — it’s dementia — so I’ve armed myself with an impenetrable mindset that helped see me through the more challenging moments.
Now that our roles were reversed, it was I who must parent him, making him feel safe and seen. I did this by checking in with him several times an hour — through a series of smiles, affirmative nods, and upward-pointed thumbs. Since he’s lost significant use of his lingual abilities, the gestures make it easier for him to express himself.
It also makes it easier for me to care for him. As a disabled queer male, I have significant weightlifting limitations that keep me from being able to assist him in the ways I would prefer to. I can’t move, shower, or assist him physically, so my emotional support and improvised smile therapy are really the best I can offer. But it seems to make a difference, so I keep at it — for the love of Dad.
Adapting to change is part of being a caregiver
If I learned anything from this experiment, it was the enduring power of nonverbal communication. Sure, I missed the ease and clarity of our former, more verbose manner of pontificating, but adapting to change is a key part of the caregiving process. Plus, expecting him to be the man he used to be is not only delusional; it’s unfair to him and wastes the precious little time we have left together.
When Dad was diagnosed, it was important to me that he, who worked his entire life to provide for his family, be surrounded with as much warmth as possible near the end of his life. So, if wearing a smile — or faking it, when necessary — helped achieve this, then I was all about it, because he’s worth it.
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