Distressing situations can occur for people with dementia where for a variety of reasons the person can find it difficult to manage the situation that is facing them. But you can help, and how you communicate with the person is crucial at these times.
Responding to distress and frustration
- You don’t have to disagree or argue with the person – instead, focus less on the factual content of what is being said and more on how the person is feeling.
Further learning
This link will take you to the SCIE e-learning programme Module 7 ‘Positive communication’. Go to section 4/page 5’Understanding and responding to a different reality’ to hear a dementia expert talking about this point: http://www.scie.org.uk/publications/elearning/dementia/dementia07/resource/flash/index.html
- Accept that the person is distressed, and don’t blame them for how they are feeling and what is happening.
- Try not to take it personally if the person displays angry behaviour towards you.
- It may help to try and distract the person with everyday routines such as meals/drinks/walks.
- Consider the person’s sense of ‘reality’ and respond to this – using reminiscence to link to past stories in the person’s life and asking questions to engage the person.
- Look to identify how the person is feeling and respond to this.
Any of the above may be helpful and sometimes a combination of responses or different approaches may be required, at different times, depending on a variety of factors. It can be helpful to think of having a ‘toolbox of approaches’ to use when trying to work out what might work best in any given situation.
However it is also important that the person with dementia receives a consistent response as this will help to lessen distress with mixed messages being received.
Positive communication
Therefore once an approach has been agreed this should be shared with anyone who may know the person, for example with other staff members and this can also be noted on their care plan. Whichever response / approach is used, the verbal/non verbal communication guidance as outlined in Workbook 1 will be helpful.
Verbal communication:
- Speak in a calm way; notice the tone of your voice.
- Use short sentences giving small amounts of information.
- Give time for the person to answer.
- Don’t argue about facts or try to ‘correct’ the person.
Non-verbal communication:
- Move to the person’s level.
- Maintain eye contact where possible.
- Use gestures, objects or signals as well as words, for example show the person an object that relates to what you are saying.
Further learning
Look at section 4 / page 5 of this SCIE programme to see how the staff are using some of these communication skills: http://www.scie.org.uk/publications/elearning/dementia/dementia06/resource/flash/index.html
Mr Porter has an Alzheimer’s type dementia and was diagnosed four years ago. He was a builder by trade and retired seven years ago. He has been living at home with his wife and she is his main carer. Mrs Porter has a chronic back problem and Mr Porter has a care worker who comes daily to support him with washing and dressing.
One day when the care worker visits, Mrs Porter is looking distressed and says that her husband is constantly talking about ‘getting to the job on time’. This is happening particularly in the evenings and at times she is finding it very difficult to encourage him to settle and go to bed. On two occasions she has locked the door and left him to walk around the house and eventually sleep in his clothes downstairs.
Mrs Porter is very distressed and asking what should she do.
Think about what you can do to help?
In your notebook write down the advice and support might you give to Mrs Porter. Make a note of the approaches might be helpful in communicating with Mr Porter.