We all want to be understood. Knowing that someone is understanding us boosts our self- esteem, helps us connect with others, fosters relationships and can help us grow. So when it comes to communicating with persons living with dementia, how can we make sure we transmit that we are understanding? Charlotte Stafrace shares some practical tips.
When a person senses they are being understood, they feel they can engage in a short conversation and will be empowered to convey their wishes. They can have a say in their own care and even during the later stages when communicating with words is not an option, there can still be occasional moments of recognition.
In order to overcome the difficulties of being understood, a carer of a person living with dementia must primarily recognise the challenges of the condition and then work on achieving adequate communication on a day-to-day basis – anything that works for you, and that can include resorting to unconventional methods.
If you are living with a person with dementia, you are probably in a situation where you know the person you are caring for. If you are a partner, sibling or friend, you have shared a history, a relationship, have explored likes and dislikes, and real-life experiences. What happens with that knowledge if or when that person moves into assisted living is another scenario; and yet, transmitting information and communicating openly with all the new stakeholders can make all the difference in offering better care.
Learn your client’s history. Who are they?
Hand on heart I can vouch for the importance of this. Any known history about a person living with dementia, such as the person’s likes and dislikes, family history, attributes and occupations held should be shared, through consent, and in an ethical way, of course, with that person’s carers.
Armed with such information, people who come across the person living with dementia can create immediate bridges and connections. In the absence of any information being provided, you have to dig deep and try to accumulate as much information as possible, which can be challenging and very time consuming. It can also be frustrating for the person living with dementia – imagine having persons day in day out asking what they like doing?
Discovering social and cultural events of personal significance can help to make a person living with dementia feel better understood
There are various activities, however, aimed specifically at this – especially on a one-to-one basis where you can become a bit of a detective and engage in life-story work, using photos or items, with the sole task of getting a better picture of someone. Discovering social and cultural events of personal significance can help to make a person living with dementia feel better understood with their identity restored.
Acknowledging their behaviour
Their reality is now very different to yours. Their ‘whingeing’ could be getting on your nerves, but they might be feeling hot, cold, tired, or are in pain, or plain bored and lonely. It could also be a direct response to their irritation at not being understood.
As a carer for someone with dementia, anticipating what could be the cause of restlessness or agitation, can often mean pre-empting an escalation of symptoms, as well as reinforcing recognition.
Use prompt cards
This could be helpful in some instances. When communication starts to fail, and even a simple yes/no answer will be hard to achieve, using pictures and prompt cards could be useful to enable the person living with dementia to make a choice, and also to transmit that we are understanding their wishes. Repeating what has just been said also reinforces the importance of your clients’ ‘voice’ and being valued.
Charlotte Stafrace during a session.Keep the conversation flowing
As dementia progresses, conversations can become surprising. Accept whatever is said, and just go along with it. It might be completely random, perhaps part of a long-stored memory, perhaps brought on by a piece of music, or a picture, or perhaps part of a conversation with someone imagined or real. It would be futile to attempt to make sense of it. Rather than trying to get them to enter your reality, try and ‘play’ by going into theirs. You will be appreciated in that moment for trying to connect.
And when words fail or stop…
You can still reach out and convey many emotions through eye contact – just make sure that you are at eye level, and that there are no other vision impairments. Your body language, a calming and friendly touch, or just stopping to connect, are simple but effective tools to share or rejoice in a moment. It says ‘I have understood and I’m trying to help’.
Each person is different but showing a person living with dementia that you can understand, or are trying to understand, ultimately maintains his dignity. And if you don’t find the words, just know that even just by being present in the moment with them, can make a difference.
Charlotte Stafrace is a creative practitioner, running various projects within the elderly community, as well as providing training. She runs Active Age Malta.
This article was published in the June issue of Senior Times.