A New Year; A New Approach

Excerpts from The Dementia Concept by Joshua Freitas

The way we approach people, guide them, listen, and respond to them influences the success of our conversations and interactions. Challenge yourself this year to use a new approach that will improve connection with your loved one.

7 Steps for Mindful Communication

1. Introduce yourself to the person, and provide prompting information.“Hi, I’m Joshua, and I will be your caregiver today.” Or, "Hi, Mom; it’s your son, Josh. I’m here to visit you."
2. When communicating, make eye contact and communicate at the person’s eye-level.
3. Give a compliment, and then invite the person to help or participate. “I bet you’re great at this activity. Would you like to join us?” Or, “I could really use your help with this; will you help me?”
4. When offering choices, provide no more than two or three options. “Would you like to join us for morning exercise, or would you rather read the newspaper?”
5. Provide the person with something to hold for comfort. Holding an object can also improve focus and concentrations. While communicating, try offering a small pillow or another favorite object.
6. Sit on the dominant side of the person with dementia. A person with dementia will be more receptive to you if you approach them on their dominant side.
7. Provide a clear ending to activities by thanking the person and creating an emotional and physical connection. “Thank you for singing with me today!” Offer the person a handshake or a hug.

The following approaches offer more methods for achieving successful interactions.

Give More Compliments: Compliment Therapy is the act of pointing out the positive attributes that you see in someone. When someone receives a sincere compliment, it reinforces positive self-esteem and increases positive behaviors. Compliments can cause endorphins to be released in the recipient’s brain. You will see a brightening of the expression, a lightening of the spirit, and an increase in energy. Even after a specific compliment is forgotten, an emotional bond endures.

When you initiate interaction by giving a compliment, you instill a sense of confidence, belonging, and trust. Start conversations with statements like, “Mrs. Smith, what’s your secret to staying so beautiful?” or “Joe, you have a handshake like a president!” Human beings are more likely to agree and comply with those who compliment us, even if that compliment is as simple as someone remembering our name. Giving compliments makes it easier to manage difficult behaviors that might arise during an interaction.

Listen compassionately and validate feelings: We all have a desire for our feelings to be validated by others. When connecting with someone with dementia, it is important to validate how he or she is feeling.

Start conversations by acknowledging the person’s countenance, for example, “Hi, Mom; it’s me, Josh! You seem happy today.” Or, if someone seems markedly upset, validate that by saying, “Hi, Mr. Smith; you seem sad. Would you like to talk to me?” Let the person know that you are there to help.

Validating another person’s feelings is a way of establishing a meaningful connection with them. Show the person that you care and are willing to listen. Use this connection to direct the conversation toward assessing what support they need and attempting to provide it.

Match emotion to emotion: If someone is feeling sad, you should match your emotion with theirs. Put yourself in their shoes. If you were visibly upset and a friend approached you with smiles and laughter without asking you what was wrong, might you feel disregarded and invisible? The same is true for someone with dementia, and sometimes even more so, because verbal and cognitive obstacles can make it more challenging for them to express their feelings. We must match and mirror their emotional state: sad with sad and happy with happy. Connecting with their emotional experience is a form of empathy that gives you a chance to help redirect the emotion.

If Mr. Smith seems sad and lonely, walk over to him and validate his feelings. Ask if you can sit with him for a few minutes. Mirror his emotional demeanor when you speak to him. This will comfort him and enable you to begin asking more questions about how he feels and what might make him feel better. Throughout the conversation, you will notice that Mr. Smith will also start to mirror your emotional demeanor. Use this opportunity to lighten his mood and slowly bring the conversation to a happier place. Redirect the topic to something other than loneliness, and see if you can engage him in a connected social activity.

The 15-minute rule: Have patience. It takes a person with dementia about 15 minutes to become acclimated to his or her surroundings, after which the windows of opportunity for meaningful interaction will begin to widen. The average brain tends to process information differently about every 15 minutes, and interestingly, the average attention span of a person with dementia is typically about 15 minutes. Remember to give people 15 minutes to acclimate to new surroundings and another 15 minutes to begin to participate. Your patience during transitions will truly help them engage with the next activity.

If a person with dementia starts to exhibit a concerning behavior, give him or her about 15 minutes before attempting to redirect the behavior. This allows the brain to process the information you are giving them with a different set of neurotransmitters.

With a good approach we can help support the needs of our residents, loved ones and friends who have dementia. Challenge yourself this year to implement these approaches and see what a difference they can make.