From the end of Part 1: “Part 2 will have some of RP’s ideas comparing and contrasting her ASD [Autism] clients and her only experience wth AD [Alzheimer’s].” To recap, we have a companionship caregiver, RP, who happens to be certified to do home therapy with ASD kids.
When asked about similarities, RP noted that her regular young clients also have communication issues; some talk excessively, but many won’t say much, and it all tends to be focused on expressing their own wants and needs. They also use non-verbal clues that might take some interpreting, and some will do similar “self-talk,” babbling or “scripting” (see below) with some fluency, as if conversing with a non-existent third person.
After certain medications, my wife now has repetitive movements. ASD children will sometimes have repetitive movements or actions. There may be personal care needs.
One of the major differences is with eye contact and greetings. Many times, RP will elicit a smile and eye contact from my wife, but no verbal greeting. RP may get very little eye contact with ASD children. Some of the children have good language skills, but may need prompting.
Some of her clients use monotone speech, but my wife’s speech elaboration seems to have more emotional content when expressed, even if it’s only disjointed syllables.
During self-talk, some children will be “scripting,” basically quoting lines from TV or movies, even using scripts to answer questions; my wife does use some phrases, but not identifiable as scripts, and at this stage, not always complete.
Some young clients haven’t learned enough self-control to prevent tantrums, while RP thinks that my wife has better “zones of regulation,” and can settle herself after being upset. [She did go through a phase of agitation and aggression, which actually improved off of medication]. Physically the young ones are usually very active and strong, but physically my wife has less ability now. And the young ones seldom nap.
ASD and AD are different conditions, after all, each with individual variation; neither RP nor this Old Guy, still a board-certified ped person, have ever seen a spectrum kid with an advanced dementia-like status. That’s besides the point here. Can an Autism approach help an AD person in a therapeutic way?
Using ABA in Alzheimer’s is not a new idea. ” Behavioral gerontology” is a term that some use for ABA therapy in older folks. The recent (2019) JAMA review of dementia mentions a few behavioral approaches, but not ABA specifically.
BMJ published a massive “systematic review of systematic reviews” (2017), listing numerous non-drug therapies for AD ( the authors looked at over 4000 review articles!!).
The BMJ article covers things from animal assisted therapy (good dog!) to hand massage to music and dance. It mentions behavioral analysis, but not ABA specifically, and suggests there may be benefits to behavioral therapies, at least when reviewed in aggregate.
That’s nice. That’s important. But in the CareGiving Old Guy world, what we are doing might be called “multicomponent interventions;” maybe, just maybe, something is helping in Quality of Life, which is the real goal right now, and we think we see improvements!
OK, Boomer.….in this context, here goes two SHAMELESS Boomer notions that will extend our Boomer stereotypes with millennials:
First, husbands and wives may not be the best communicators on the spectrum of communication. In “good” relationships, there are natural differences of opinions that can co-exist. Sounds like the foundation of an Old Guy joke, right? So, a communicative companion might really be a salve or balm to that lovable but slightly irritating spouse.
Even when couples are great communicators, sometimes a person just needs or wants a confidant or buddy as an outlet. So the Second shameless Boomer notion is gender based: that women may need “girltalk,” and Old Guys without handy drinking buddies can try writing annoying blogs.
