Barbara Kim Stanton
Hawai‘i Herald Columnist

When you are a caregiver to someone with dementia, you need to be a bit of a detective as well as possess some of the skills of a nurse, social worker and housekeeper.

That’s what Dorothy Colby, a certified trainer and mentor, teaches in her Positive Approach to Care workshops.

Colby, who is also administrator of the Hale Ku‘ike residential dementia care facility in Nu‘uanu, said they threw a 91st birthday party for a resident. But instead of being happy, the woman appeared to be getting agitated and angry. A staff member noticed and quickly switched the 9 and 1 birthday candles so that the cake said she was 19. The woman then smiled.

“She thought she was 19,” Colby said, explaining that some dementia patients recall long-ago memories more readily than recent memories. “They are living in a different reality from ours and we sometimes try to drag them back, and that doesn’t always work.” That’s where detective work, combined with an understanding of how the disease affects the brain, can help caregivers deal with challenging behaviors.

“A lot of times, a caregiver’s best intentions are not well received and you’re less helpful than you think you are,” she said. The Positive Approach to Care workshops, developed by occupational therapist Teepa Snow, help caregivers understand what’s behind challenging behaviors and learn skills to better communicate and deal with loved ones with dementia.

The Alzheimer’s Association estimates that 66,000 people in Hawai‘i care for someone with dementia. They provide 75 million hours of unpaid care worth $944 million and many say they need help and support.

“Dementia is brain failure,” Colby said. Caregivers have to understand that they can’t make a loved one’s brain work harder or make them remember.

“The brain changes that are happening for their loved ones affects how they are taking in data from the world,” Colby said. “Things that are quite obvious to us are not obvious to them.”

Colby said a woman who attended the workshops told her afterward: “Now I understand my mom’s not doing it on purpose. She’s not doing it to make me crazy. I don’t argue with her. That just leads to a more positive relationship.”

The key is to respond to the person with understanding and not just react when faced with challenging behaviors.

“It’s our responsibility, the people with the healthy brains, to change our approach.”

Barbara Kim Stanton has been the state director of AARP Hawaii since 2005. She writes about living a life of real possibilities, where age is not a limit and experience equals wisdom.


AARP will present free workshops for caregivers on O‘ahu, Maui, Kaua‘i and the Big Island. You can register for the workshops by calling 1-877-923-8700 or going to

KAUA‘I: Saturday, Feb. 24, 9 a.m.-noon, Kaua‘i Community College – Fine Dining Center (3-1901 Kaumuali‘i Hwy.). Subject: Positive Approach to Dementia Care Workshop.

MAUI Saturday, March 10, 9 a.m.-noon, Kaunoa Senior Services Wellness Building (401 Alakapa Pl.). Subject: Positive Approach to Dementia Care Workshop.

BIG ISLAND/WEST HAWAI‘I: Saturday, Feb. 24, 9 a.m.-noon, Tutu’s House (64-1032 Mämalahoa Hwy., #305). Subject: Prepare to Care and Manage Medications Workshop.

Details about the Big Island/East Hawai‘i and Oahu workshops will be publicized in the next column on March 16.


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