Dementia and Communication – A Positive Approach

We all know that caregiving is stressful, but we often forget that it is stressful to be the person with dementia. Step inside their world for a moment and think of all the stressors surrounding them. Too much noise can cause anxiety because they cannot process where it is coming from. Unfamiliar places are stressful because they do not understand where they are or why they are there. The faces of strangers are everywhere because they may no longer recognize the people in their lives.

Knowing a few strategies for communication can greatly reduce everyone’s stress level. Let’s look at some important pointers.

• Borrowing a term from nationally-recognized dementia expert, Teepa Snow, use a “positive approach.” To improve communication, place yourself where your loved one can see you. Do not approach from the side or the back and expect to have a good conversation. You may startle them in what seems like a sneak attack, which certainly was not your intention! Approach from the front, get down on their eye level, and start with a calm voice and pleasant expression.

• Body language is important. Your loved one will take your cues. Your tone of voice, facial expression, degree of patience, and approach are much more important than your actual words.

• Respect their personal space. Avoid approaching too quickly, especially when hands-on care is needed. Imagine how you would react if a stranger suddenly approached you and began taking off your clothes, all the while stating in a cheery voice that it was bath-time. You would resist! Your loved one will, too.

• Unless your loved one is hard of hearing, raising your voice will not improve their memory.

• Avoid the guessing game. “What did you do at the day program?” “Did you take your blood pressure pill this morning?” Or, the mother of all guessing game questions, “Who am I? Don’t you remember me?” No, they don’t. If they did, you would be the first to know.

• Give them time to express themselves. People with dementia often have word-finding difficulties, making conversation frustrating for everyone. Avoid the temptation to finish their sentences. Also, avoid rushing them to “hurry up and spit it out.” They simply cannot do it. If they could, they would.

• Avoid arguing. People with dementia no longer have the power to reason; therefore, your arguments are meaningless to anyone but you and will only lead to frustration for all.
• It is not important to be “right.” It is more important to get a positive or desired outcome. If the desired outcome is to get mom in the car for her doctor’s appointment, your best chance is to approach her calmly, give her time to get ready (a LOT of time), and keep your cool. Rushing her, raising your voice, and showing your frustration will only cause anxiety for everyone and slow the “getting ready” process to a halt.

• If things get too intense, walk away. Not far away, just far enough to give yourself and your loved one some space. Even going to another room and taking deep breaths can keep a situation from escalating.

• When your loved one seems frustrated, anxious, or tearful, try to validate their feelings. They may not be able to verbalize the reason for their emotions, but they still need to be comforted. With a positive approach, you can provide a good hug or squeeze of the hand, smile while making eye contact, and let them know that their feelings have been acknowledged.

Choosing to interact positively, calmly, and patiently will save you time and may save your sanity. As the caregiver (and the person with the intact brain), it is important to call on all of your patience and skills for a “positive approach” that will lead to a positive outcome.

On April 25, The Keys to Caregiving Conference will be held at Trinity Oaks, providing a wealth of information on meeting the challenges of caregiving. Dementia expert Melanie Bunn will be the presenter. Family caregivers are encouraged to attend. If needed, your loved one can be cared for at Trinity Living Center while you attend the conference. The event is free, but registration is required and can be made by calling Teresa Dakins at Trinity at Home: 704-603-2776.

 

Barbara Garwood is the transitional care coordinator for Lutheran Services Carolinas. For more information about caregiving, call Trinity at Home at 704-603-2776.