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Don Desonier, JD, CSA

2019 CSA Conference


Don Desonier, JD, CSA

Caregiver Coach & Family Facilitator
Transitions in Dementia Care



A Holistic Approach to Addressing Challenging Behaviors in Dementia Care

My wife Nancy was diagnosed with early-onset dementia in January 2008. She passed away in July 2012.  Despite the passage of time, I still experience an occasional twinge of guilt and regret when recalling how I didn’t always respond in the best way possible to her periodic bouts of challenging behavior. Today I know - and constantly remind myself - that as Nancy’s caregiver I was simply doing the best I could with what I then knew during those difficult times.   

According to the March 2018 Alzheimer’s Association Factsheet, in 2017 16.1 million family members and friends provided 18.4 billion hours of unpaid care to people with Alzheimer’s disease and other dementias.  These committed individuals provided help and assistance to individuals with a disease whose trajectory defines the word “transitional”. Just when a dedicated family member or friend thinks they’ve reached a comfortable place in their care journey - especially as to difficult behavior - a new wrinkle occurs. An intervention or engagement that was supportive or helpful yesterday in addressing an issue or a concern, is no longer viable or effective today.     

Steven Atkinson, PA-C, MS has three “Best Practice” tips when facing dementia care, borrowed from his presentation on “Challenging Geriatric Behaviors” (Copyright ©, PESI Inc):   

  • 1. Understanding the ILLNESS - being aware they cannot change their behavior   
  • 2. Understanding the NEEDS of the patient     
  • 3. Being compassionate to THEIR WORLD   

Dr. Allen Power is a pioneer in the arena of person-directed and experiential care of those with cognitive impairment. In his seminal work, “Dementia Beyond Drugs: Changing the Culture of Care”, Dr. Power talks about an approach to dementia that focuses on "real time" interpersonal, active, and positive engagement - which he describes as an “experiential model” - as opposed to the bio-medical, or pharmacological - model.   

In this interactive workshop, professionals will learn about the different kinds of challenging and potentially triggering behaviors their clients face on their journey in caring for loved ones with dementia. They will gain an understanding around how holistic, engaging, compassionate and non-pharmacological approaches can work in diffusing potentially demanding situations.         

Learning Objectives

  • Recognition that cognitive impairment can inhibit an individual’s ability to communicate his or her feelings and wishes clearly and effectively
  • Awareness that angry or upset behavior displayed by one with dementia is almost always a symptom of unmet needs or interests
  • To learn basic tools of compassionate engagement when faced with an individual displaying demanding or challenging behavior

Don's Story

In January 2008 my wife Nancy was diagnosed with early-onset dementia. She had just turned 65. On the day of that diagnosis, at that precise moment in our doctor's office, our lives changed forever. Nancy pivoted from being a successful interior designer, wonderful mom, and loving wife, to a person facing an incurable disease. I pivoted from being a husband and proud step-dad to Nancy's three children, to being a loving, proactive, and devoted caregiver.

For the next several months I felt like a nomad wandering in a desert of confusion, anxiety, and fear. I had no clue around “next steps”. Both of us lacked meaningful information about dementia. In short, Nancy and I basically just went on with our lives, and didn’t talk much, if at all, about her dementia diagnosis. In fact, it wasn’t until I joined a dementia support group in the fall of 2008, that I began to gain clarity around my role as a caregiver.

Over time, Nancy's dementia progressed to a point where in July 2010, I came to the painful realization her needs would be best served by moving her to a memory care residence within an assisted living community in our home state of Washington. On July 4, 2012, Nancy passed away. It was indeed her Independence Day - freed from the bonds of a relentless and unforgiving disease.

The reach of dementia in my life provided me with a gift – the realization my true calling is to connect with and assist caregivers and families of those with Alzheimer’s and related dementias.

About Don

Don Desonier, JD (Ret), Certified Senior Advisor (CSA)®, provides individual coaching, family facilitation and mediation services to caregivers and families of loved ones with Alzheimer’s disease or related dementias. His journey to this professional calling is rooted in having been a caregiver to his wife Nancy, who was diagnosed with early-onset dementia in 2008, and passed away from this illness in 2012.

Don has a Certificate in Gerontology from the University of Washington Professional and Continuing Education Program. He also has a Juris Doctor degree, and has been trained as an Elder and Adult Family Mediator.

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