28- Apr2017

New Ways To Approach Dementia Communication

At a recent support group, an adult daughter asked, “Is there such a thing as too much information?”  She continued to express her concern about how much information she should share with her father when he asks “How did I get here?”

There are new ways to approach Dementia Communication. First lets review some of the old ways we tried to communicate with Dementia patients.

Reality Orientation Is A Thing Of The Past

The first is based on the torturous manner in which we re-oriented dementia residents 20+ years ago.  We gave them so much information, too much information, we created chaos, confusion and a heck of a lot more frustration for both ourselves and the resident.

We would use reality orientation to bring the resident “kicking and screaming” into the here and now.  We felt that more information was better and eventually they would succumb to our reality instead of their own.

Reality orientation has its time and place, but for the most part, it is not in the world of dementia.  This type of intervention created havoc for the resident, often hearing information they had long forgotten, only to be reminded of their age, loss of family, loss of independence and loss of self.

New Methods Of Dementia Communication Cause Less Stress

Today we encourage the idea that “less is more”.  Consider when broaching the subject of sex with your pre-teen. Once they become curious in the concept and begin to ask questions, I doubt most of us would divulge everything all at once.  Not only could this be harmful to a young person’s psyche, but it becomes difficult terrain for us, as parents, to navigate.

The key to sex and the pre-teen is to answer only what is being asked.  Straight forward answers, no euphemisms, no diagrams needed.  Talk plainly, using the proper anatomical descriptions and answer only what is being asked.  Then wait.  Wait for a follow-up question or a query to more detail. Again, answer only what is being asked.  Let them guide you.

I am in no way encouraging a stunted and strained conversation, rather a cautious approach to a sensitive topic.

The same is true for someone suffering from dementia. When a question is asked, answer only that question.  No euphemisms, no diagrams, no over explanation needed.

Be Creative and Probe

So how do you do this?  Be creative.  In the case of the woman at the support group, I encouraged her to use her father’s dementia to her advantage, leverage his short loop and need to find connection.  When he asks “How did I get here?” answer “In my blue Chevy”.  It is a straightforward answer to only the question he asked.

Then if probed further, use the concept of cars as a jumping off point to conversation.  Explain that you drove your blue Chevy here and it is your favorite car.  Then ask what his first car was.  Was that his favorite?  Was his first car blue, red or black?

Imagine how the dialogue would ensue if you started all the way from the beginning to describe how he arrived there.  Would you start by describing the symptoms you noticed, the doctor appointments, the clinical testing, the diagnosis, the selling of his home, the decision for nursing care?

Not only would you exhaust yourself in that lengthy ordeal, only to relive the difficult days, but you would cause him to do the same.  Anger, frustration, and overwhelming emotions would arise taking the two of you farther away from a brief and joyful conversation of reminiscing but rather immerse you in the strain and heartache of watching him feel loss, deprivation, and defeat.

Less is more.  But the right approach to less can create more and more opportunities to connect.

Learn more about new methods of Dementia Communication at the Dementia RAW website.