It\u2019s 2:30 a.m., and Mr. Phillips is walking the care centre halls, noting which doors are shut tight. He looks over the fire extinguisher attached to the wall, checks to make sure there are no ripples in the entryway rugs, then stops to monitor th e television screen before moving on to examine the locks on the windows. Stopping him and sending him back to bed makes sense at this late hour, but not to Mr. Phillips. Before Alzheimer\u2019s took its toll, he was a night watchman. Disrupting this routine might cause an outburst.<\/p>\n
Knowing as much as possible about a person living with dementia is the key to caregiver-resident communication. That\u2019s because dementia is as diverse as the people it affects. Memory problems can be the result of medications, stroke-induced vascular dementia or even Parkinson\u2019s dementia, in which a disease impairs the brain. The form of dementia people are most familiar with is Alzheimer\u2019s disease, which has different stages and affects thinking and behaviour differently depending on which part of the brain it strikes. In short, not all dementia is created equal.<\/p>\n
\u201cYou can\u2019t see this disease,\u201d says Lisa Misenhimer, MSW, Director of Rethinking Dementia in Grand Rapids, Michigan. \u201cSo it\u2019s hard to know when the brain is causing behaviour or personality changes.\u201d<\/p>\n
If someone has a broken arm, a caregiver expects it will be hard for the person to eat food, but you can\u2019t see brain deterioration until, say, someone has a hard time picking up a fork. It\u2019s also harder for that person to explain why the difficulties are happening. Misenhimer\u2019s nonprofit organization works with care providers to promote communicating with people who have dementia and Alzheimer\u2019s.<\/p>\n
Outbursts of profanity, removing clothes, grabbing, hugging, pushing away, withdrawing into a depression-like state\u2014all of these can be the result of dementia. Each one, Misenhimer says, is the result of an unmet need. Recognizing this is the first part of the equation. Addressing the outbursts is where communication skills matter.<\/p>\n
\u201cThey may be tired, hungry, afraid, in pain \u2026 or they may just need to go to the bathroom,\u201d Mollie Richards says. She and her husband, Ralph, work with the Alzheimer\u2019s Association Greater Indiana Chapter and have devoted much of their lives to studying Alzheimer\u2019s and teaching others its effects, the search for a cure and how to provide care.<\/p>\n
When inappropriate behaviour occurs, Mollie says, instinct tells you to quickly intervene. This is just the opposite of what\u2019s most effective\u2014distraction. \u201cTell them, \u2018let\u2019s go for a walk,\u2019 offer soothing music or a favourite food,\u201d she says. \u201cYou\u2019re not going to win if you argue.\u201d<\/p>\n
The secret to distraction is getting as much personal information about residents as possible. Knowing where the resident grew up, what jobs they held, hobbies, vacations, etc., is a good start. The next thing to do is watch the clock. Humans are creatures of habit, and they eat, sleep, exercise, watch TV and go to the bathroom on a pretty consistent schedule.<\/p>\n
\u201cIt\u2019s like looking at pieces of the puzzle before you know what the answer is going to be,\u201d Alzheimer\u2019s expert Teepa Snow says in a webinar on communication techniques. She emphasizes understanding the person behind the disease to effectively distract them. She also promotes hand-under-hand contact, a much less confrontational approach than putting a hand on a shoulder.<\/p>\n
Another communication tool is language, both spoken and nonverbal. Select words carefully, speak slowly and repeat them\u2014using the same words each time\u2014to help the resident process the message. Look directly into the eyes of the person you\u2019re speaking to, Ralph says. Use concrete terms, not expressions like \u201crun to the store.\u201d Avoid speaking loudly or in an angry tone, and never use baby talk.<\/p>\n
\u201cThese are adults, so treat them like adults,\u201d he says. \u201cThis is a person with a disease, and they deserve dignity. The way we label people is the way we treat them.\u201d<\/p>\n
When it comes to eating, confusion can reign. Selecting a meal can be a challenge, so it\u2019s helpful to give residents a simple choice. At breakfast, offer a choice of eggs or cereal instead of a menu with many options. It may even be helpful, Mollie says, to put food on the table one item at a time or in separate containers to stem confusion.<\/p>\n
Dining rooms, where there\u2019s lots of movement and noise, can add sensory overload. Voices from adjacent tables, music over the speaker system and even the lawn mower running outside the building can be overwhelming.<\/p>\n
It\u2019s important for caregivers to devote their full attention to residents, Mollie says. Sit next to them at an angle so you can make eye contact, and smile with your eyes as you describe what\u2019s on the plate.<\/p>\n
\u201cIt\u2019s a social activity, so ask questions about favourite foods they like to eat or cook,\u201d Mollie says. \u201cThen transition to describing the food on the plate\u2014how good it looks and how great it smells.\u201d<\/p>\n
Environment can be a key to behaviour, Misenhimer says. Overstimulation or understimulation can cause people to act out. It\u2019s up to the caregiver to be aware of the possible causes and responses. Most of all, it\u2019s important to provide individualized attention.<\/p>\n
\u201cJust because people can\u2019t remember a thought or a memory, they don\u2019t lose their identity,\u201d she says. \u201cPeople still care about safety, security and having a purpose.\u201d<\/p>\n
Misenhimer offers these tips to improve spoken communication:<\/p>\n
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What people with Alzheimer\u2019s want you to know:<\/p>\n
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\n\tSource: Alzheimer\u2019s Association<\/p>\n
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Source: Alzheimer\u2019s Disease: Help and Hope, by Jo Huey<\/p>\n
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A personal approach and a human touch make a big difference in reaching people living with memory-care issues. It\u2019s 2:30 a.m., and Mr. Phillips is walking the care centre halls, noting which doors are shut tight. He looks over the fire extinguisher attached to the wall, checks to make sure there are no ripples in […]<\/p>\n","protected":false},"author":19,"featured_media":4606,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[69,111],"tags":[],"class_list":["post-25664","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-running-your-business","category-healthcare"],"acf":[],"yoast_head":"\n