Alternative communication methods for dementia
While short-term memory is what is affected relatively early in a dementia disease, procedural memory is the one that is affected last. The procedure memory includes things that have been learned through training, such as cycling and swimming, but this also includes learned word sequences, such as the order of the months and many children's rhymes.
Since the knowledge and abilities learned early in life tend to be those that remain the longest in people with dementia, they can also form a basis for communication. And depending on the person's conditions, various alternative communication methods, such as music, song and dance, can be a substitute or complementary way of communicating with him. Music is often associated with memories and affects both the body and the senses in many different ways, and since music evokes memories, it can also help to emphasize remaining functions when expressed through song and dance.
Many of us prefer a certain type of music over another and the music can, in addition to giving joy, peace and security, also help to preserve a sense of self. But music, song and dance can also be a way to promote or support verbal communication. Studies have shown that singing and music can be an alternative and fruitful way to reach out and communicate with a person who has gradually lost the ability to understand the spoken language. This seems to work best with music performed live, and even more so when the staff (or someone else) sings along with the dementia sufferers.
A phenomenon in the Swedish context is known as "caregiver song". Caretaker singing is performed by the staff and often includes both singing and dancing for a specific purpose. By involving the dementia sufferer in song and dance, it is possible to calm and distract in situations that may be perceived as violating privacy, for example in connection with morning hygiene or when dressing and undressing.
In accordance with a person-centered approach, however, it is important that the activity with music, song and dance is adapted to the person or persons with dementia who participate. The staff therefore needs to be sensitive to the dementia patient's needs as well as acquire knowledge about that particular person's taste in music and the importance music has previously had in the person's life. It is also important that music, song and dance are not used routinely, but the measure must be well thought out.
The video below shows how the experienced staff, Britt-Marie, uses singing in a problematic situation when a patient with dementia, Berta, does not want to take a shower.
Reflection questions
* Reflect on what the reasons may be that Berta does not want to take a shower.
* Reflect on Britt-Marie's actions and why it helped resolve the situation.
* Give suggestions for other solutions to the situation that has arisen.