DEMENTIA SUFFERERS HAVE NOT LOST THEIR REASON-JUST THEIR SHORT TERM MEMORY

In his excellent book 'Contented Dementia'. Oliver James explains how Penny, a highly recognized caregiver, understood that her patient Dorothy had not lost her reason, 'merely the recent information as to what she and penny had been doing moments before.`
Penny is the creator of 'SPECAL',  [Special Early Care for Alzheimer's] which in 1999  was commended by The Royal College of Nursing.
Penny's method is based on the fact that the only difference between a dementia patient and others is that 'their memories can no longer store new information efficiently`.So to deal with problems springing from the stress of trying to remember recent events, is to change the direction of the patient's memory to happy activities or events from their past. This theory is based on the fact that dementia and Alzheimer's patients usually retain their long term memory, especially of things that they like to remember.
To be effective, the caregiver needs to know something of the biography of the patient and a vivid imagination and ability to discover and share the old memory. This has the effect of the patient feeling relaxed, contented and happy. Penny's theory is that by making the effort to set this system in motion the caregiver will not only help the patient by taking away the stress of trying to ecall recent memory, but also in due course lessen the caregiver's task enormously. A wonderful investment of time.
Penny has three fundamental rules to enable her system to work;
1.  Don't ask questions.
2.  Learn from them as the experts on their disability.
3.  Always agree with everything they say, never interupting them.
Penny's system involves replacing the normal 'common sense' way that we usually communicate with what she calls; 'SPECALSENSE. This means that we recognize that dementia sufferers lose most of their recent memories as the brain deteriorates, but retain memories from long ago, that are mostly complete and undamaged.
To make these ideas work the caregiver needs to have the ability and courage to act out roles. Penny quotes an example of a man who dived under a table. She dropped something onto the ground in order to have a reason to join him. She knew that he had been in the Second World War and assumed from the fact that he had his hands over his head that he was re-enacting a war experience. She then joined him by role playing and said something like; "I think that it's all clear now." She then continued with other assumed links and the patient quickly returned to the present in a happy and relaxed state.
The thing to be borne in mind with dementia patients is that for a lot of the time they are perfectly rational and coherent and often able to do most of the tasks of living. It is the stress of questions that they cannot understand or answer that often plunges them into despair and consequent strange and disagreable behaviour or even anger.