Tuesday, April 3, 2012

Interacting with a Dementia Patient

Interactions with dementia patients can be challenging.  The person may believe that something has been stolen.  She may be looking for someone who passed away many years ago.  She may be making movements or repeating actions which seem pointless to the rest of us.  The person may be arguing or seeming to not listen to truthful answers from the people around them.

These interactions can be stressful for the person's care provider, especially one, like us, who is not a professional geriatric care provider.  However, these interactions must also be confusing, stressful and isolating for the dementia patient.  From her perspective, she's making a logical conclusion that the item missing has been stolen.  She may not remember that the person has passed.  She may feel there is a purpose to her action or may not be aware that she is making repetitive motions.  While she might hear those around her speaking, her brain may no longer be able to discern the truth or follow the logic within the answer.

The dementia patient cannot stop and reassess her responses or try a different approach.  Her brain no longer has those abilities.  This task, then, falls to the care providers and the others around the dementia patient.

Teepa Snow, an educator who focuses on dementia, advocates that we don't answer a question from the dementia patient with a direct response as we would to another person.  We use the question to redirect the focus of the dementia patient.  For example,  if Lyn were to ask where Grandma is (she hasn't yet), then we would be better served to say "Tell me about Grandma" instead of "You know she died in 2001."  If this happens, then we need to step back and realize that Lyn does not know any longer that Grandma passed over a decade ago.

Another approach when working with a dementia patient is to only give a single instruction at a time.  Dementia patients can no longer keep two or more steps in focus and are no longer able to recall sequences properly.  Saying "Rinse off your plate and put it in the dishwasher" is too complex.  While it might be easiest to say "Just put your plate on the counter", the person with dementia still needs to be included and feel like she is participating in daily life.  So, a better option is to break the first statement into two different steps.  "Rinse off your plate" would be followed with the time the person needs to complete that task before the "Put the plate in the dishwasher" statement is issued.  Mom has already encountered this and adjusted accordingly.

Little changes in how you interact with the person with dementia can make a big difference.  As a change in the person's behavior becomes noticed or more frequently exhibited, the care provider can make little changes in how responses can be given to ease the isolation and unease of the patient.

Additional Information:
How to Interact with Alzheimer's Patients
Interacting with People with Dementia - What You Should Know
Caregiver Tips for Dementia Patients
Talking to People with Dementia

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