Your role as a care staff is significant in ensuring the well-being of people living with dementia. You will be in regular contact with the person and most probably - the first to notice and to notify other specialists about changes in their behavior or aspects of person's health that require their attention. It is a great responsibility that shows that you are an important part of a team of professionals and for what you need to be equipped with appropriated tools such as the skill to communicate with people with deteriorating abilities to voice their needs and understand others.
Dementia is causing the person to feel confused, lost, vulnerable, scared angry... the most basic tasks that used to be self-evident are becoming challenging. The memory is impaired, faces, sounds, objects and places become strange and unrecognizable. The person may understand that irreversible changes are taking place, they might fall into depression or apathy...
Imagine yourself in their shoes. How would you feel?
How would you want to be treated?
Be empathetic and patient at all times. Make sure that all the basic needs are met. Do not do anything that the person can do by herself. Encourage and give positive feedback. Respect the person's rights to voice their opinion, make decisions and be in control over their life. Show respect and make sure that both you and the person with dementia feels comfortable and safe.
Here we offer you a list of communication principles to use when working with people with dementia as well as the rationale of each principle:
1. Always identify yourself and call the person with dementia by name at each meeting.
Because the person’s short-term memory is impaired, it requires frequent orientation to time and environment.
2. Speak slowly.
Because the person with dementia needs time to process in information.
3. Use short, simple words and phrases.
Because the person with dementia may not be able to understand complex statements or abstract ideas.
4. Maintain face-to- face contact.
Because in that way verbal and nonverbal clues are maximized.
5. Be near the person with dementia when talking, one or two arm-lengths away.
Because this distance can help the person focus on speaker as well as maintain personal space.
6. Focus on one piece of information at a time.
Because attention span of person with dementia is poor and they are easily distracted; it helps the person to focus. Too many data can be overwhelming and can increase anxiety.
7. Talk with the person about familiar and meaningful things.
Because in that way self -expression is promoted and reality is reinforced.
8. Encourage reminiscing about happy times in life.
Because remembering accomplishments and shared joys helps distract the person from deficit and gives meaning to existence.
9. When the person is delusional, acknowledge their feelings and reinforce reality. Do not argue or refute delusions.
Because acknowledging feelings helps the person feel understood. Pointing out realities may help them focus on realities. Arguing can enhance adherence to false beliefs.
10. If the person with dementia gets into an argument with another person, stop the argument and separate individuals. After a short while (5 minutes), explain straight forwardly to each of them why you had to intervene.
Because escalation to physical acting out is prevented. Person’s right to know is respected. Explaining in an adult manner helps maintain self-esteem.
11. When the person becomes verbally aggressive, acknowledge their feelings and shift topic to more familiar ground (e.g., “I know this is upsetting for you, because you always cared or others. Tell me about your children.”).
Because confusion and disorientation easily increase anxiety. Acknowledging feelings makes the person feel more understood and less alone. Topics the person has mastery over can remind him or her of areas of competent functioning and can increase self-esteem.
12. Have the person with dementia wear prescription eyeglasses or hearing aid.
Because environmental awareness, orientation, and comprehension are increased, which in turn increases awareness of personal needs and the presence of others.
13. Keep person’s room well lit.
Because in that way environmental clues are maximized.
14. Have clocks, calendars, and personal items (e.g., family pictures, Bible) in clear view of person with dementia while he or she is in bed.
Because these objects assist in maintaining personal identity.
15. Reinforce person’s pictures, nonverbal gestures, X’s on calendars, and other methods used to anchor the person with dementia in reality.
Because when the person loses the ability to articulate themselves verbally and understand verbal communication, alternate methods of communication need to be instituted.
Now we offer you to take a look at a video and analyse how to address challenging situations when caring for people with dementia in a safe and respectful way. However, always follow your local practice regulations regarding care!
In the video below another challenging situation is shown. People with dementia might exhibit inappropriate behavior that can make you feel uncomfortable. However, with tools of communication the cause of it can be understood and their attention - redirected. Always follow your local practice regulations regarding care!