Communication Strategies In Dementia Hollie Glover, LPC hglover@jameslwest

1. Communication Strategies In Dementia Hollie Glover, LPC hglover@jameslwest.org

2. COMMUNICATION NEVER SAY THE WORD REMEMBER

3. When we use the word “okay” all we are doing is acknowledging that someone spoke and we heard them. We are not necessarily agreeing with them. When we say “okay” with a pleasant tone and positive look on our face we can diffuse the situation rather than argue. Even if they are accusing us of doing something we didn’t do we can say “okay.” THEN we will……….

4. Fix it with a therapeutic story. If you are being accused of stealing all of their money then “call the bank” and have your name taken off of their account. You can call your cell phone, a friend, a relative, etc. GO TO THEIR WORLD, they can’t come to ours. Don’t get emotional, just “fix it.” If they are looking for someone that has passed away tell them they are at the store, golfing, deployed, etc. Whatever works for them and then………

7. Music is powerful. Play music from their past. Have a playlist ready and downloaded on a phone or iPod. Purchase headphones or an individual speaker that can set directly in front of your loved one. Sing along with them or dance.

10. What do you know? Ages? Symptoms?

11. Communicating With People With Dementia • Communication is the exchange of information between two or more people. • Communication involves: • Both the spoken work and non-verbal message • The emotions of the people involved • The cultural background of the people involved-this effects the understanding of the message

12. ACTIVE LISTENING Listening is the most important of all communication skills. Active Listening is the ability to completely focus on the other person as they speak This Photo by Unknown Author is licensed under CC BY-SA

13. To do active listening: Do not interrupt Listen to everything being said Understand that what is being said might not be what the message is about Do not judge. Try to understand the other person’s thinking. It is okay to not agree, but try to understand

14. More Active Listening *Stop what you are doing *Focus on what is being said *Remain calm *Think about the feelings of the other person *Only speak after the other person has completely finished speaking

15. Active Listening does NOT mean: Doing something else while the person is talking Thinking about what you will say while the person is talking Getting upset or defensive Reacting to what you think you heard Offering suggestions or advise unless asked for

16. Non-Verbal Communication As the person with dementia loses the ability to speak and understand words, they will still be able to sense the feelings of others. Non-Verbal communication is more accurate that the spoken word. Body language and gestures become more important than words as dementia progresses. The person with dementia will sense and pick up on anxiety, fear, and happiness.

17. Non-Verbal Communication continued Eye Contact: In America, eye contact is considered a sign of respect, but in some cultures direct eye contact is disrespectful. Posture: Sit next to across from the person you are speaking with and lean forward. If you are both standing, stand straight, and slightly lean forward-this shows interest in what is being said. Facial Expression: Smiling and maintaining eye contact shows interest. A furrowed brow shows worry. A frown may mean anger or disagreement.

18. Gestures Gestures are important when talking to people with dementia. For example, patting the chair helps the person understand you want them to sit down. Holding up the fork can indicate it’s time to eat. Taking off your own jacket shows them to take off theirs. They will typically mirror your actions.

19. Positive Gestures *Nod your head to show you understand and are interested in what is being said *Smile *Have open arms *Slightly lean forward

20. Negative Gestures Clenched fists can mean anger Pointed fingers can mean blame or dominance Fidgety hands can indicate nervousness Folded arms across the chest can indicate fear, disinterest, nervousness, etc. Looking way may show boredom or not understanding what is being done or talked about

21. Tone of Voice *What we say can be changed by how our voice sounds. These include pitch (how high or low we speak), speed, volume, and articulation (how clear we speak). *Our voice changes when we are angry, annoyed, distracted, anxious, surprised, bored, distracted, or in a hurry.

23. Communication in the Early Stage of Dementia Forgetful of recent events They may start to misuse words They may start to forget names of people They may start to misuse pronouns They may start to lose the “proper” name of an object, but still knows it’s use. For Example: I need that thing that writes. If English was their 2nd language they will start to revert back to their original language

24. Communication in the Middle Stage of Dementia Both speaking and understanding become more difficult Speech begins to make no sense. They may have trouble remembering even close family members names, but may know their relation. They will have trouble naming objects.

25. Communication in the Late Stage of Dementia Severe language breakdown occurs. Most people develop “word salad.” May have less than ten word vocabulary. Difficulty in making needs known. Difficulty understanding speech. They may completely lose their language. Actions become their communication.

26. Communication Tips Call the person by name-do NOT use “Mama” or “Honey” You may say Ms. Mary or Mr. Richard Allow time for a response. People with dementia need extra time to think about the message and respond. Do not rush the person! Learn the person’s story-this helps you understand and communicate with them better

27. More Communication Tips People with dementia need to remain self-confident and feel that their opinion still counts. Decrease distractions so the person can listen more carefully. Turn off the TV and move the person to a quieter area while trying to communicate. Use short sentences without a lot of adjectives (descriptive words)

28. Validation Therapy A way to approach adults with empathy and understanding. It is used to comfort and reassure people who are living with dementia. It is proven to reduce stress and enhance dignity and happiness. It is all about accepting the feelings of another person and reaching out to them with empathy.

29. Validation Therapy The resident cannot accommodate the disease, but we can. Do not try to bring them into our reality, we go to theirs. Examples: Don’t reason. Patient: “What doctor’s appointment? There’s nothing wrong with me.” Don’t: (reason) “You’ve been seeing the doctor every three months for the last two years. It’s written on the calendar and I told you about it yesterday and this morning.” DO: (short explanation)“It’s just a regular checkup.” (accept blame) “I’m sorry if I forgot to tell you.”

30. Compassionate Communication DON’T Don’t reason. Don’t remind them they forgot. Don’t argue. Don’t question recent memory. Don’t confront. Don’t take it personally. DO Give short, one sentence explanations. Allow plenty of time for comprehension, then triple it. Repeat instructions or sentences exactly the same way. Avoid insistence. Try again later. Agree with them or distract them to a different subject or activity. Accept the blame when something’s wrong (even if it’s fantasy.) Leave the room, if necessary, to avoid confrontations. Respond to the feelings rather than the words. Be patient and cheerful and reassuring. Do go with the flow. Practice 100% forgiveness. Memory loss progresses daily.

31. Appropriate Terms Preferred Terms Words Not Used Facility Patient Locked Feeder Unit Diapers REMEMBER Victim Crazy • Center • Resident • Secure • Assist with Dining • House • Briefs

32. Until there’s a cure, we’re here to care.