May 06,2015
By Sandra Wallace
Dementia is an umbrella term that describes a set of symptoms related to cognitive loss. It is not a disease itself. Alzheimer's is the most common type
of dementia.
Dementia is a shift in the way a person experiences the world around her/him. By managing our own behavior, actions, words and reactions, we can change
the outcome on an interaction. As caregivers, we need to respond, not react.
Being right/truthful doesn't necessarily translate into successful results for both of you.
We must also change our approach and behavior to get the results we want. The focus needs to be on the relationship (big picture), not the individual encounter.
We use communication to interact with others and to get something done. There are five different forms of sensory connections used to communicate with people with dementia. In order to successfully communicate with someone with memory loss, a personal connection must be made before starting a conversation. Let the person connect with you visually. He or she needs to process that you are OK before you proceed with anything else. They understand you mean them no harm.
The next type is verbal communication. However, with dementia, the temporal lobe of the brain, the language center, is affected with word loss. In the early stages of Alzheimer's, most word losses are nouns, names, and relationship references. Think about what this means. You have trouble understanding what the person is trying to say. The person with dementia has trouble understanding all of the words that you speak. Following instructions is difficult. Confabulation is when the brain makes up stuff to fill in the blanks of what they don't remember.
Keep the following in mind:
The Positive Interaction Approach to Someone with Dementia:
People with dementia always comprehend much more than they can express. Don't say anything in front of them that you wouldn't want them to understand. Respect their dignity. The emotional area of the brain is preserved. Feelings are very real. Our words won't be heard until there is an emotional connection…that we have validated their emotion.
When you are having trouble being understood:
When you are having trouble understanding:
How to deal with the person's distress, anger or frustration:
When the person is listening and responding to you, then redirect his attention and actions to something that is positive. Or distract him with other things or activities you know he likes (music, a stuffed animal, a snack).
If what you are doing is NOT working…STOP! Back off and give the person some time and space. When you re-approach, decide on what you will do differently. Then try again. We are the ones who can change the outcome of our interactions. By insisting that the person with memory loss does what we want when we want it is a formula for failure. It only increases agitation in the person and the caregiver.
Many behaviors of people with memory loss have logical explanations that reflect what is happening around them. These behaviors are the person's attempts to cope and communicate their needs. Behavioral expressions are the symptom, not the problem!
Competency concerns will cause people with dementia to withdraw or refuse to participate. They may say they aren't interested. Don't force them to try.
When a person with Alzheimer's disease and limited verbal skills has a problem, figuring out the cause can be challenging. What is the real reason for problem behaviors? The emotional needs of a person with dementia are influenced by their physical environment. You must play detective and look for environmental clues first.
After all of the environmental sources have been reviewed without a plausible answer, consider medical causes:
The manner in which we approach people with memory loss and provide care has profound effects upon their abilities and overall well-being. The world of the person with dementia changes as the disease progresses. We must also change our approach and response to adapt to their evolving needs.
Things to Remember:
The ability to hear sound remains unless they are overwhelmed. Demented people think they can't hear, but really they can't comprehend.
While you base your conversation in logic and reason, the person with memory loss uses feelings to communicate. Listen for the tone of their conversation.
Communication is:
10% WHAT you actually say
30% HOW you say it
60% BODY LANGUAGE
This means that 90% of what you say is non-verbal.
Caregivers, including all family members, need to manage their own behaviors, actions, words and reactions to change the outcome of an interaction with someone with dementia. Caregivers need to join the person with dementia in their journey. The person with dementia can no longer process your reality. Having Alzheimer's (and other dementia's) is like being lost in a foreign country…all you want to do is go home to what is familiar.