If you are caring for a client with dementia at home, you know how difficult it can be to communicate with him or her. This information will give you some insight into techniques that can improve communications and care.
Start by putting yourself in the person’s shoes. Example #1: Imagine that you’re a person with dementia and you’re getting dressed. In your mind, you may be getting dressed for work – like you have done for the past 35 years. Today you struggle getting your tie just right, but wonder if your daughter is home because she’s great at fixing your tie. You call out her name and although she’s not home your live-in caregiver comes to the room to ask if she can help. You try to explain that you can’t get your tie on and you have to hurry to catch the train or you will be late for work. Your caregiver says “There is no train, you don’t work, you’ve been retired for 20 years.”
Mistake! It used to be common and acceptable to “reorient,” “correct,” or give “gentle reminders.” However, research has shown a much better way. You should not force a person with dementia to accept aspects of reality that he or she cannot comprehend. This person still has feelings and an ego that must be respected. Don’t shatter their reality. In this example it would be better to say “let me help you get that tie looking nice, then we can have the nice breakfast I made for you and I’ll bring you to work – you won’t be late.” Validate and redirect. Obviously, techniques and their usefulness depend on what seems sensible in the situation. You need to be creative and experiment to see what works and what doesn’t. Sometimes people with dementia get very agitated because of delusions or hallucinations. These can be very stressful to them (and you). Redirection techniques can divert their attention and emotions away from the stressful event.
Example #2: The person with dementia starts yelling in the kitchen. She is hallucinating and sees a cat on the refrigerator and says “get that cat out of here!” You say “what cat – there is no cat.” Mistake! Instead, validate the person’s feelings by showing your concern. Be warm and caring because they can pick up on your facial expressions if you don’t. Use phrases that show your support (validate) like “I would be upset too,” or “I understand why you feel that way, I don’t like cats either.” Then say, “How about we take a walk to your living room and do a puzzle together” (redirect).