संखेपुत्तरं
Santavihāre ṭhāne kathatha, tassa sammukhaṃ nisīdatha, nāmena āmantetha, ca saṇikaṃ saṅkhittāhi saralāhi vācāhi vadatha. Ekasmiṃ khaṇe ekaṃ pañhaṃ pucchatha, vivatapañhānaṃ ṭhāne dve vikalpe detha, ca yathābhūtato dīghataraṃ kālaṃ paṭimānetha. Na vivadatha, na sodhetha, na parikkhatha. Vacanānaṃ pacchato vedanaṃ paṭivadatha; vācā dubbalaṃ honti, phassa-sadda-mukhabhāva-cittesu ca sahabhāgehi saññāpetha.
- Kathanārambhato pubbe parito saddaṃ hāpetvā tassa cakkhūhi samphassaṃ karotha.
- Saṅkhittā vācā, ekasmiṃ khaṇe ekaṃ atthaṃ, ca so, sā, te ti nāmānaṃ ṭhāne nāmaṃ payojetha.
- Vivatapañhānaṃ ṭhāne dve vikalpe vā āma-na-pañhaṃ vā pucchatha.
- Uttaraṃ paṭimānetha. Sace na bujjhati, tāneva saddāni puna vadatha, tato aññe saddāni payojetha.
- Na vivadatha, na sodhetha. Yaṃ vuttaṃ, tassa pacchato vedanaṃ paṭivadatha.
- Saddā hāyante, phassena, sarena, mukhabhāvena ca sahabhāgehi cittehi saññāpetha.
इमस्मिं पृष्ठे (8 खण्डा)
- Dementia rogena sahajīvantena saddhiṃ kathane sabbapadhānā upāyā ke?
- Kathaṃ kathanaṃ ārabheyyaṃ?
- Kiṃ vadāmi, kathaṃ vattabbaṃ?
- Kathaṃ sādhukaṃ suṇeyyaṃ?
- Sace so asaccaṃ vadati, kiṃ kātabbaṃ?
- Dementia vaḍḍhante kathanā kathaṃ parivattati?
- Citrāni ca kammāni ca kathanāya sahāyakāni honti nu?
- Sace mayhaṃ khanti hāyati, kiṃ kātabbaṃ?
Dementia saddānaṃ gavesanaṃ, dīghaṃ vācaṃ anugamanaṃ, vā parito saddaṃ nivāranaṃ dukkaraṃ kātuṃ sakkoti. Etaṃ na dasseti yaṃ so sambandhaṃ icchituṃ virato. Kathaṃ kathanaṃ sajjetha, kathaṃ vadeyya, kathaṃ suṇeyya ti appakesu parivattanesu ubhinnaṃ kathanā sukhatarā santatarā ca bhavituṃ sakkoti.
Dementia rogena sahajīvantena saddhiṃ kathane sabbapadhānā upāyā ke?
Tassa manasikāraṃ labhatha, saralaṃ karotha, khamatha. Sace pañca eva dhāretha:
- Gharaṃ santaṃ karotha, sammukhaṃ nisīdatha. Dūrasaddaṃ vā dūrasaddanissaraṇaṃ vā nibbāpetha, cakkhusamena ṭhāne nisīdatha, ca tassa nāmena āmantetha.
- Ekasmiṃ khaṇe ekaṃ vadatha. Saṅkhittā vācā, eko attho, eko pañho.
- Dve vikalpe detha. «Teyyo vā kāphī vā?» ti pucchanaṃ «Kiṃ icchasi?» ti vivatapañhato sukharaṃ hoti.
- Paṭimānetha. Uttarāya yathābhūtato dīghataraṃ kālaṃ detha, ca antarā na chindatha.
- Na vivadatha, na parikkhatha. Tathyehi sammattehi vā asammattehi vā, tassa vedanaṃ paṭivadatha.
Kathaṃ kathanaṃ ārabheyyaṃ?
Evaṃ sajjetha yathā so tumhesu manasikātuṃ sakkoti. Family Caregiver Alliance maggo paṭhamaṃ parito saddaṃ hāpetuṃ ovadati: radiyo vā dūrasaddaṃ vā nibbāpetha, pavesanapaṭṭaṃ vā dvāraṃ vā pidahatha, vā santataraṃ ṭhānaṃ gacchatha.
- Sammukhato upagacchatha. Pacchato vā passato vā āgamanaṃ taṃ ubbijjāpetuṃ sakkoti.
- Attānaṃ nivedetha. «Namo tāta, ahaṃ Sārā, tava dhītā.» Evaṃ so tumhākaṃ nāmaṃ gavesituṃ na kilamati.
- Tassa samena ṭhāne nisīdatha. Sace so nisinno, nisīdatha vā jāṇukehi ṭhatha vā yathā tumhākaṃ cakkhūni samāni honti.
- Tumhākaṃ mukhaṃ ca saddaṃ ca oloketha. National Institute on Aging (NIA) sarassa, uccatāya, mukhabhāvassa ca sarīrabhāvassa ca satiṃ dhāretuṃ, ca usumaṃ pākaṭaṃ ākāraṃ payojetuṃ ovadati.
- Cakkhupāni ca savana-sahāyakāni ca yathāṭhāne santi ti vīmaṃsatha. Yaṃ na sakkā sammā passituṃ vā sotuṃ vā, taṃ anugantuṃ dukkaraṃ hoti.
Kiṃ vadāmi, kathaṃ vattabbaṃ?
Sarale sadde, saṅkhitte vācā, santañca nīcañca saddaṃ payojetha.
- Ekāya vācāya eko attho. «Āgaccha, nivāsanaṃ nivāsema. Tato bahi gacchissāma.» Na ekaṃsena ubho.
- Sarvanāmānaṃ ṭhāne nāmāni payojetha. «Jean mātulā pakkositvā avadi» ti «Sā pakkositvā avadi» ti tato pākaṭataraṃ hoti.
- Nīcataraṃ, na uccataraṃ. Family Caregiver Alliance uccasaddato nīcasaddaṃ ovadati.
- Puna vadatha, tato aññathā vadatha. Sace na bujjhi, tāneva saddāni ekavāraṃ puna vadatha. Sace na sampajjati, khaṇaṃ paṭimānetvā aññehi saddehi vadatha.
- Dassethāpi, na kevalaṃ vadatha. Kapālaṃ dassetha, dve nivāsane uṭṭhāpetha, vā paṭhamaṃ padaṃ dassetha.
- Tena saddhiṃ kathatha, na tassa pariyantato. NIA taṃ janaṃ asammukhaṃ viya kathaṃ, bālakathañca vajjetuṃ ovadati.
NIA sāmantapañhānaṃ saralataraṃ rūpaṃ dasseti. Idha tādisā udāharaṇāni:
| Etassa ṭhāne | Evaṃ vadatha |
|---|---|
| «Sāyaṃbhojane kiṃ icchasi?» | «Macchaṃ vā kukkuṭamaṃsaṃ vā icchasi?» |
| «Kathaṃ vedesi?» | «Kilanto asi nu?» |
| «Jighacchā atthi nu?» | «Pañca-nimisesu sāyaṃbhojanaṃ sajjaṃ bhavissati.» |
| «Evaṃ na kātabbaṃ.» | «Etena ākārena karoma.» |
| «Sarasi nu amhākaṃ taḷākayātrā?» | «Amhākaṃ taḷākayātrā anussarāmi. Tattha kiṃ te rucci, taṃ kathehi.» |
| «Ahaṃ pubbe vuttavā.» | Mettāya puna vadatha, paṭhamaṃ viya. |
Kathaṃ sādhukaṃ suṇeyyaṃ?
Kevalaṃ sadde na, atthaṃ ca vedanañca suṇātha.
- Paṭimānetha. Tuṇhībhāvo bahudhā cintanakālo hoti. Antarā pavisitvā pubbe dasa gaṇetha.
- Sace so laggo hoti, saddaṃ upanetha. Family Caregiver Alliance vadati: yo kilamati, tassa saddāni upanetuṃ yujjati.
- Yaṃ sutaṃ taṃ vīmaṃsatha. Alzheimer’s Association kathana-maggo tassa saddānaṃ pacchato atthaṃ gavesituṃ, ca taṃ puna vatvā sammā bujjhitanti vīmaṃsitunti ovadati. «Rathassa atthāya cintesi nu?»
- Mukhāni ca sarīrabhāvañca oloketha. Vācā dukkarā honti, NIA vadati, mukhabhāvā sokaṃ, kodhaṃ vā vibādhaṃ vā saddehi pākaṭataraṃ dassetuṃ sakkonti.
- Tassa cintā gambhīraṃ gaṇhatha. Sace cintā viruddhatathye patiṭṭhitāpi, vedanā saccā hoti.
Sace so asaccaṃ vadati, kiṃ kātabbaṃ?
Na vivadatha. Tumhe jinituṃ na sakkhissatha, so ca lajjito vā bhīto vā bhavituṃ sakkoti. Tassa ṭhāne vedanāya sambandhaṃ karotha, tato mudukena aññattha gacchatha.
Family Caregiver Alliance vadati: aññattha nayituṃ pubbe vedanaṃ sampaṭicchatha. Udāharaṇaṃ: sace tumhākaṃ mātā dārake pāṭhasālāto gahetuṃ gantabbaṃ ti daḷhaṃ vadati:
- Etassa ṭhāne: «Amma, tava dārakā vuḍḍhā jātā. Taṃ cattālīsa vassāni atītāni.»
- Evaṃ vadatha: «Tvaṃ sadā mettacittā mātā ahosi. Tesaṃ gahetvā āgamanaṃ kathehi. Paṭhamaṃ appakaṃ bhuñjāma nu?»
Alzheimer’s Association pi yaṃ tumhe na anujānātha, tattha vivādaṃ na kātunti ovadati. Khaṇaṃ cinotha: sace viruddhā diṭṭhi ahitā na hoti, taṃ ṭhātu.
Dementia vaḍḍhante kathanā kathaṃ parivattati?
Kālena atthā parivattanti, tasmā tumhākaṃ ākāraṃ pi parivattetha. Alzheimer’s Association tayo saṅkhepato avasthā dasseti:
| Avasthā | Yaṃ sahāyakaṃ hoti |
|---|---|
| Ādikā | So saññāpetuṃ na sakkotīti mā maññatha. Kathāsu taṃ antokarotha, tena saddhiṃ ujukaṃ kathatha, kiṃ sahāyaṃ icchatīti pucchatha, ca sace sahāyakaṃ hoti, hāsaṃ payojetha. |
| Majjhimā | Santasmiṃ ṭhāne ekekena kathanaṃ. Saṇikaṃ kathatha, cakkhusamphassaṃ dhāretha, āma-na-pañhe pucchatha, padānupadaṃ ovādaṃ detha, ca na ujjhāyatha, na sodhetha. |
| Antimā | Sammukhato upagacchatha, attānaṃ nivedetha. Aṅguliyā dassanaṃ hatthavikāre ca ussāhetha. Phassaṃ, sadde, dassanīye, gandhe ca payojetha. So asammukho viya mā kathatha. |
Ekoeko puggalo viseso hoti, ca ekasseva puggalassa sukhadivasā dukkhadivasā ca honti. Nāmena na, idāni so kathaṃ atthīti taṃ paṭivadatha.
Citrāni ca kammāni ca kathanāya sahāyakāni honti nu?
Āma. Sahabhāgaṃ cittaṃ pīḷanaṃ hāpeti, ca ubhinnaṃ oloketuṃ dassetuñca kiñci deti.
- Cittanimantanāni. Conversation Cards citrāni vivatapañhehi saddhiṃ denti, ye kadāci na parikkhanti.
- Kulacitrāni. Photo Pairs tumhehi cinitāni citrāni mudukaṃ samayojanakammaṃ karoti, yaṃ bahudhā kathā uppādeti.
- Paricitā vācā. Finish the Saying paricitā vacanāni payojeti, pacchā kathananimantanaṃ deti.
- Samayojanakammāni kathanaṭṭhāne. Picture Pairs kathentānaṃ hatthehi kiñci kātuṃ deti.
Adhikaṃ kathaṃ saha kīḷitabbaṃ ca anussaraṇakammāni passatha. Dassanehi ca pakkosanehi atthāya amhākaṃ dassana-maggo ca dūrasadda-dūradassanapakkosana-maggo ca pathatha.
Sace so anekabhāsāsu kusalo hoti, amhākaṃ bhāsantarena kathana-maggo passatha.
Sace mayhaṃ khanti hāyati, kiṃ kātabbaṃ?
Etaṃ sabbesaṃ hoti. NIA vadati: sace vighātajāto hosi, samathaṃ pāpuṇituṃ kālaṃ gaṇhāhi. Aññaṃ gharaṃ pavisitvā, saṇikaṃ katipayavāre assāsa-passāsaṃ karitvā, sace sakkosi santena cittena puna āgaccha. Kathaṃ puna ārabhituṃ sakkā hoti, ca so tumhākaṃ santabhāvaṃ paṭivadituṃ sakkoti. Sace vighāto niccaṃ hoti, etaṃ dasseti yaṃ tumhākaṃ adhikaṃ sahāyo icchitabbo, na yaṃ tumhe asamatthā. Amhākaṃ paṭijaggakassa attasaṅgaha-maggo gatabbāni ṭhānāni dasseti.
साधारण पुच्छा
Dementia rogena sahajīvantena saddhiṃ kiṃ na vattabbaṃ?
Parikkhāpañhe ("Sarasi nu...?") vajjetha, sodhanaṃ ("Taṃ micchā") vajjetha, hāniṃ anussaraṇaṃ ("Ahaṃ pubbe vuttavā") vajjetha, ca tassa asammukhā viya kathanampi vajjetha. Bālakathanaṃ vajjetha. Ime ākārā lajjāṃ vā dukkhaṃ vā uppādenti, na ca sahāyakā honti.
Sace so tathyaṃ virujjhati, sodhetabbaṃ nu?
Yebhuyyena no. Sace viruddhaṃ tathyaṃ ahitaṃ na hoti, taṃ vissajjetha. Vivādo tassa matiṃ viralaṃ parivatteti, bahudhā pana taṃ dukkhiṃ karoti. Idāni tassa vedanāya ca tass’ atthāya ca manasikarotha.
Sace saddaṃ na labhati, kiṃ kātabbaṃ?
Paṭhamaṃ kālaṃ detha. Sace so pākaṭaṃ kilamati, mudukena saddaṃ upanetuṃ vā yaṃ adhippetaṃ taṃ anuminitvā pucchituṃ vā yujjati. Aṅguliyā dassanaṃ, hatthavikārā, citrāni ca sahāyakāni honti.
Antimāvasthāya dementia rogena sahajīvantena, yo viralaṃ katheti, kathaṃ kathitabbaṃ?
Sammukhato upagantvā attānaṃ nivedetha, santaṃ saddaṃ mudukañca phassaṃ payojetha. Vedanāsu mukhāni ca sarīrabhāvañca oloketha. Tumhākaṃ sannidhānaṃ, paricito gītaṃ vā hatthaggahaṇaṃ vā, saddavirahitepi bahuṃ saññāpetuṃ sakkoti.
सोता
यानि संस्था-अध्ययनानि इमं पृष्ठं अवलम्बति, तेसं सम्बन्धा मयं दस्सेम। पृष्ठस्स अद्यतनकाले प्रत्येकं परिक्खितं।
- Communicating With Someone Who Has Alzheimer's Disease · National Institute on Aging
- Communication and Alzheimer's · Alzheimer's Association
- Caregiver's Guide to Understanding Dementia Behaviors · Family Caregiver Alliance