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Communication Guidelines for Visiting Dementia Patients

Posted Dec 26 2009 12:00am
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The Family Caregiver

Goals:
Learn and share new approaches, gain confidence, encouragement and motivation for
being effective and compassionate in visits to individuals with dementia.
Turn a difficult conversation into a discovery conversation.
Build strong care giver-care receiver partnerships.
Respond compassionately to patients who are confused, forgetful, unable to speak,
angry, or argumentative.
To find blessings that come from connecting with dementia patients.
To know Jesus Christ and to grow in His image: Love.
Communications Tools: The Do’s
\uDBC0\uDC78 Center yourself with a prayer before entering the building. Focus on the purpose of
your visit. Put on a name tag.
\uDBC0\uDC78 Approach from the front, make eye contact, and say your name. Give a little
description of yourself that the dementia patient might relate to.
\uDBC0\uDC78 Get close enough to have eye contact in order to get and keep the patient’s
attention.
\uDBC0\uDC78 Speak slowly, calmly, and use a friendly facial expression.
\uDBC0\uDC78 Allow the patient to be in control of the visit to the extent of their desires and
capabilities. Remember, you are the guest, they are the host/hostess.
\uDBC0\uDC78 It is your responsibility to ensure a safe environment for the visit.
\uDBC0\uDC78 Use a lot of repetition.
\uDBC0\uDC78 Use short, simple, and familiar words.
\uDBC0\uDC78 If possible, with the patient’s (and roommate’s, if applicable) permission, reduce or
remove distractions (TV or radio on), or move to a quieter location. Try to avoid
complete isolation with patient.
\uDBC0\uDC78 When the patient replies, show that you are listening (by nodding, a few short
phrases such as “yes, that’s nice”, or echo back a few words or phrases) and trying
to understand what is being said.
\uDBC0\uDC78 Be with the person in their own reality (validation principles)
\uDBC0\uDC78 Be aware that the person may want to point or gesture, if at a loss for words.
\uDBC0\uDC78 Sometimes just sitting quietly with the individual is okay.
\uDBC0\uDC78 Take time and look for a response to your voice. A hearing disability may make it
even harder for the patient to communicate.
\uDBC0\uDC78 Ask one question at a time, and allow time for a reply.
\uDBC0\uDC78 If the person seems stuck for a word, you can offer a guess, but act like you have all
the time in the world.
\uDBC0\uDC78 Make positive suggestions rather than negative ones.
\uDBC0\uDC78 Identify others by name, rather than using pronouns (she, he, etc.)
\uDBC0\uDC78 Make suggestions if the person has trouble choosing.
\uDBC0\uDC78 Empathize; have patience and understanding.
\uDBC0\uDC78 If you aren’t quite sure you understood what was said, repeat it back and ask if
you’ve got it right. This does not work in all circumstances.
\uDBC0\uDC78 Try to understand the person’s feelings and emotions, which may be hidden behind
the words. You can ask whether the person is feeling angry or frustrated about a
particular situation.
\uDBC0\uDC78 Give plenty of encouragement and reassurance.
\uDBC0\uDC78 Nonverbal communications, such as shaking hands, touching, or hugging, are
learned behaviors that the dementia individual often easily responds to. Be sensitive
to possible rejection by the patient to these attempts at non-verbal communication.
\uDBC0\uDC78 Bring something to share that the individual might relate to: a photo, sing a song
(bring a songbook), a “memory jogger” (stuffed animal, favorite hat, etc.), a small
keepsake, a Bible passage.
Communication Tools: The Don’ts
\uDBC0\uDC78 Don’t talk about the patient to others in the room as if the patient wasn’t there.
\uDBC0\uDC78 Don’t confront or correct, if it can be avoided.
\uDBC0\uDC78 Don’t treat the person as a child, but as an adult. Don’t speak down to the patient.
\uDBC0\uDC78 Don’t interrupt, argue, or criticize. Remember, you will never win an argument with
an Alzheimer’s person.
\uDBC0\uDC78 Don’t be compelled to fill the quiet spaces in the conversation with talk. Sometimes
being present with the patient is all that is needed.
To take care of others, you must take care of yourself
\uDBC0\uDC78 Be gentle with yourself. You did not create all of the problems you face daily.
\uDBC0\uDC78 You are not a fixer. You cannot change the patient/families, but you can change your
reaction to them.
\uDBC0\uDC78 Time-out. Find a quiet place to use when you need it.
\uDBC0\uDC78 Support each other. Pat other team members on the back for success. Let them
return the favor. Share your successes and your failures with other team members.
Let others know if you have found a strategy that works.
\uDBC0\uDC78 “Debrief” or review your visit with a pastor or team leader, if you encounter a
situation which causes you unusual distress or anguish.
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