Use Of Assistive Technology To Enhance Therapeutic Interactions
Murphy et al. ) believe that the progressive, gradual deterioration of a persons ability to remember, understand, reason and communicate is one of the most distressing aspects of the illness, both for the person with dementia and their family, friends and caregivers. This can put pressure and demands on staff in various care settings to improve their communication skills .As we have already established in our previous chapter Communication to enhance therapeutic interaction, communication is a vital component of therapeutic interaction -. We have also explored the effects dementia has on the affected person, such as memory loss, reduced cognition, linguistic and sensory impairments, etc. ,. Considering the above factors, we can assume that modifying these variables by the means of certain ATs, can have an effect on communication, and thus, can potentially enhance therapeutic interactions between the patient and the therapist, which the present section will explore.
Low-tech Tools and Devices Enhancing Communication and Interaction in Dementia
In their study ,, Murphy et al. interviewed 31 people at various stages of dementia about their well-being in order to compare the effectiveness of communication between usual communication methods and Talking Mats ,. The study found that:
High-tech Tools and Devices Enhancing Communication and Interaction in Dementia
To ensure that the patients are getting the most of their touchscreen technology session, it is recommended that ,:
Speak Naturally And Use Gestures
Its important to speak clearly, simply, and in complete sentences, while using a calm and friendly voice to talk to someone with dementia.
Besides using your voice, try to communicate using your body, incorporating subtle movements. Demonstrate your meaning with visual cues or gestures. For example, if you say, Lets go for a walk, use an arm motion with your invitation.
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Identify The Emotional State Of The Response
How is this person feeling? If they have been able to speak, what do the words convey? What does their tone of voice convey? What does their facial expression tell you? What does their body position tell you? What does their respiration rate tell you? Is there any indication that the person is in physical discomfort or pain?
Observing the above will help family members, friends and care staff to achieve better understanding in a conversation. In dementia care you need to listen with your eyes and your ears.
The Role Of Nurses In Providing Care To Patients With Dementia Or Alzheimers
The population pool of older people has steadily increased across the world. The elderly not only have longer life expectancy than ever before, but many live with chronic conditions that require healthcare services provided by geriatric specialists. Consequently, the demand for Alzheimer’s and dementia nursing care continues to grow. Nurses with gerontological specialties and training in these conditions play a crucial role in helping these patients maintain their quality of life and remain independent as long as possible.
Because there is currently no cure for dementia, patients rely on the care management provided by nurses in both clinical and home-based settings. Nurses provide direct care to patients, helping to relieve the burden placed on family members and other caregivers. An important component of Alzheimer’s and dementia nursing care involves education and communication about treatments, progression of symptoms, interventions, and coordination of services with other specialists.
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Dealing With Confusion And Difficult Questions
People with dementia ask some very difficult questions and knowing how to handle that can be tricky. The way to handle these situations is to show you’re listening and that you do care. Do not try to reorient them to reality. For instance, if they are searching for their parents, telling them that their parents are deceased could cause a lot stress and agitation.
Saying they don’t drive anymore and that their car has been gone a long time may cause a violent outburst. The person generally will not remember any of this and it’s distressing to learn something so drastic may have happened and they don’t remember. Often times, they will just sit there and argue with you.
When communicating with a dementia patient, it’s important to remember not to argue with them. Distracting from the questions can sometimes be helpful but can be difficult to do. Offering them a snack, or performing an activity together may help to distract them from some of these distressing issues. Here are some examples of what to do when some of these questions arise.
Dementia Sufferer: “Where’s my mother? I can’t find my mother!”
You: “You’re looking for your mother?”
Dementia Sufferer: “Yes, I can’t find her!”
Here are some possible answers that could be very reassuring to the patient:
- “We will watch for her together. Why don’t you tell me about her.”
- “You miss your mother very much. Let’s have some ice cream while we wait for her.”
- “I haven’t seen her, but let’s have lunch while we wait.”
When In Doubt Remember The 10 Principles Of Communication From Naomi Feils Validation Therapy
Validation Therapy by Naomi Feil was created between the 1960s and 1980s as a set of guidelines for communicating with older adults.
Feil grew frustrated by the focus on reminding people with dementia of everyday reality, rather than working with the person with dementias new reality.
Her answer to this communication issue?
Validation.
As Feil states, validation doesnt cure but it restores their dignity and their feelings of self-worth. Its a way of being with them, of stepping into their world, feeling what they feel.
She found that the more those in later stages of Alzheimers were forced to face reality in the wrong situations, the more they withdrew or became distressed.
To improve this area of dementia care and communication in what she calls old-old age , she came up with 10 principles that can be helpful to refer to as guidelines:
- There is a reason behind the behavior of disoriented old-old people.
- All people are unique and must be treated as individuals.
- Painful feelings that are expressed, acknowledged, and validated by a trusted listener will diminish. Painful feelings that are ignored or suppressed will gain strength.
- Behavior in old-old age is not merely a function of anatomic changes in the brain but reflects a combination of physical, social, and psychological changes that take place over the lifespan.
- All people are valuable, no matter how disoriented they are.
- Old-old people must be accepted non judgmentally.
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How To Effectively Talk To A Parent With Dementia
Communication is a big challenge for many individuals when dealing with loved ones suffering from dementia. Because of the inability to focus and remember, dementia patients experience feelings of anger and confusion, which may result in oppositional and aggressive behavior toward family caregivers in contact, like a family member or a spouse. This is why family caregivers often feel lost and helpless when talking to ageing parents with dementia.
However, communication doesnt have to be the barrier that stands between you and your parent. By understanding the condition of dementia better and practicing strategies to deal with dementia behavior, you too can effectively communicate with a dementia patient.
Dont Infantilize The Person
Dont talk down to the person or treat them like an infant. This is sometimes called “elderspeak” and it’s got to go.
Have you ever observed how people talk to babies? They might use a high pitched tone and get close to the babys face. While this is appropriate for infants, its not fitting for communicating with adults. Regardless of how much the person with dementia can or cannot understand, treat them with honor and use a respectful tone of voice.
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Dont Just Talk Loudly
Not every person with dementia has a hearing impairment, and using a loud tone can make them feel like you are yelling at them. Use a clear, normal tone of voice to start a conversation with someone.
If the person doesnt respond or you become aware that they have a hearing problem, you can increase your volume. Speaking in a slightly lower register can also help if someone has a hearing problem.
Show Love And Affection
While some people might get defensive if you break their bubble of personal space, many appreciate a gentle touch. Take the persons hand, or give them a hug or kiss if you are comfortable. Physical touch has been shown to have many positive benefits for people in all stages of dementia.
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Strategies For Caregivers: Communicating With Family Members
Care facilities should provide family members with written information about the specific types of dementia affecting their loved ones and counsel family members on what they might expect in the coming weeks and months, especially for new residents of a long-term care facility . Care facilities should:
- Help family members understand that dementia is not a normal part of aging and that their loved ones require special care.
- Remind family members that their loved ones are not playing games, being contrary, or pretending, and that they have no control over their condition.
- Reassure family members that their loved ones will undergo a period of adjustment and that upsets are likely during this time.
- Explain ways family members can make the end-of-life stage more tolerable for their loved ones.
- Provide family members with information about self-care and stress management.
Maintain A Sense Of Humor
The comic actor, Charlie Chaplin, once said, âA day without laughter is a day wasted.â It makes sense. Apply humor when dealing with your dementia patient whenever appropriate. But, of course, humor should not be at his expense. After all, laughter is said to be the best medicine.
To sum up all these, I should say it takes both expressive and receptive communication to make caregiving stress-free. A healthy relationship between the person with dementia and the caregiver is founded on trust.
Here are some more ways to improve your communication with your dementia patients:
- Check their hearing levels. Make sure they hear you well. Majority of your patients/dementia will have hearing problems. Check their hearing aide. Talk a little bit louder, but not too loud that they think you are shouting at them.
- Talking about talking loud, make sure to talk in a nice low tone. A raise tone is a nonverbal sign that make dementia patient upset. I dont like being shouted at either.
- Use short phrases, simple sentences. Avoid or minimize complex explanations. Instead of saying, âWe will go to the doctors office tomorrow when i am not busy and probably after having my car fixed.â Say this instead, âWe will go to your doctor tomorrow.â
- Last but not the least, i have learned this in a hard way, make sure to speak slowly and wait for the patient to respond. Wait. Wait. Wait.
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Alzheimer’s Caregiving: Changes In Communication Skills
Communication is hard for people with Alzheimers disease because they have trouble remembering things. They may struggle to find words or forget what they want to say. You may feel impatient and wish they could just say what they want, but they cant.
The person with Alzheimers may have problems with:
- Finding the right word or losing his or her train of thought when speaking
- Understanding what words mean
- Paying attention during long conversations
- Remembering the steps in common activities, such as cooking a meal, paying bills, or getting dressed
- Blocking out background noises from the radio, TV, or conversations
- Frustration if communication isnt working
- Being very sensitive to touch and to the tone and loudness of voices
Also, Alzheimers disease causes some people to get confused about language. For example, the person might forget or no longer understand English if it was learned as a second language. Instead, he or she might understand and use only the first language learned, such as Spanish.
Recognizing The Warning Signs And Symptoms Of Dementia And Alzheimers
Because the early warning signs can be mistaken for normal age-related behaviors such as forgetfulness or misplacing items, family members and caretakers may not know how to recognize the symptoms.
Kriebel-Gasparro emphasizes that nurses who have training in dementia and Alzheimer’s disease with gerontological patients can provide quality medical care to help track and manage symptoms. Early detection of dementia and treatment of other health issues can help people maintain their independence longer and slow the progression of symptoms.
Dementia and Alzheimer’s share many of the same symptoms in the initial stages. These are among the most common warning signs.
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Top Communication Tools For Seniors With Dementia
Although dementia signs and severity vary, there are many communication tools for dementia and support techniques to improve conversations with your loved one. In general, its best to remain patient, clear, and understanding. Here are 10 Alzheimers communication strategies to help boost your bond with your loved one and improve communication.
Give One Instruction At A Time
Granted, this is sometimes easier said than done when life gets busy and youre in a rush!
Still, giving one instruction at a time can make communication much easier.
Multi-tasking is hard enough for adults without cognitive impairments, so you can imagine what it might be like for those living with dementia.
It may take your parent a while to get their words out, so hold back from asking further questions before theyre able to answer.
Repeating the question or rephrasing it slightly differently can help move the conversation along.
Try to give your loved one at least 20-30 seconds to respond.
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How To Finish The Conversation
Just as you prepared to start a conversation, so you must think about how you will bring it to a close. If you are leaving the persons home, make sure you say goodbye. You should not leave the person thinking you are still in their home, perhaps in another room. This may cause confusion or anxiety.
Ensure you have their attention, smile, and let them know you enjoyed your time together and the conversation. Shaking their hand or touching them is a common gesture which gives them a strong clue you are leaving. Leave them reassured and let them know you look forward to talking again. If you are likely to be speaking to them very soon, for example later that day, say when you will return and leave a note close by indicating when the next visit will be.
Solutions For Improving Social Interactions For Persons With Dementia
At Home
Like so much else in caregiving, understanding and planning are key. What follows are tips for making socializing easier and beneficial for your loved one.
Stay YourselfLiving as normally as possible, for as long as possible, is important for people in the early stages of Alzheimers. Maintain a social calendar, things like lunch dates or game nights, until your loved one is no longer able.
The Right TimePlan social visits for the time when your loved one feels best, not when its best for the visitor. A common phenomenon for people in mid- to late-stage Alzheimers is sundowning, or late-day confusion. If your loved one experiences sundowning, dont have visitors late in the day.
The Right PlaceBusy settings full of noise and people are often stressful for someone with dementia. Visits should occur in environments that are calm, quieter, and uncluttered.
Be PreparedMake sure that friends and family have appropriate expectations. Explain the nature of the disease and what changes to expect. Prepare an activity that can be shared during a visit, like singing a song , looking through old photo albums, or taking a walk. This can give your loved one something to focus on. Show your loved one pictures of whomevers coming to visit, to prepare.
Say Thank YouRemind visitors they remain important and vital to your loved one, even as the symptoms of dementia make interactions more difficult. Taking time to visit is always appreciated.
Adult Day Care
Memory Care
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Should You Keep Trying To Communicate
Family members may frequently ask, How often should I visit?, or, Should I visit at all, because they dont seem to be understanding what were saying, most of the time they dont seem to recognize me, etc. Caregivers can encourage family members to visit because its important to them. Also, the person with memory loss may catch some things on some days, and if family members can make the interaction a pleasant moment, it can be rewarding for both.
Communication amongst family becomes particularly difficult when the person with dementia and/or Alzheimers doesn’t recognize family members anymore. In this situation, a spouse or children can think that it doesnt do any good to go talk to the personthat anyone could talk to him/her because they dont remember who they are. But there is a richness that happens because of family history together, something that can only come from people that have been family or friends for a long time.
The type of communication families can get out of visits can be pulled from the strength of the patient and/or loved ones long-term memories. They can still talk about the past, and for family members, to hear those things are perhaps a worthwhile gift.
Even though the patient and/or loved one can no longer communicate the way they used to, there are still other ways to enjoy time together. There is beauty and simplicity in being in the present moment.