There really is no good excuse for them to not listen to you and make some changes that will improve the relationship with their patient and family.
By Cindy Keith
They just don’t know how to respond to, or talk to a person with dementia.
They end up making that elder feel angry, hurt or insulted when they talk over them as if they aren’t there, or speak to them as if they’re not capable of understanding anything being said, and have no feelings either.
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I recall a very feisty little elderly woman in the dementia facility where I was working.
She was in a great mood one morning, kissing everyone and enjoying the return hugs and kisses. The psychiatrist came in to see her and the following dialogue took place when she immediately hurried over to him, grabbled him around his waist and ordered him to:
“Bend down here!”
“Why do you want me to bend down?”
“She wants to give you a kiss.” I said to him.
“Oh no! Thank you very much, but we’re not going to do that now, I would just like you to sit down here and talk with me a little bit.”
I’m thinking to myself as I observe the surprised and hurt look on her face “Why not just let her give you a kiss and she would be much more cooperative.” She was starting to look like a small thundercloud at this point, but the psychiatrist forged ahead.
“Do you remember who I am?”
“Of course I remember you!” This response was made in an insulted tone.
“Okay, what’s my name?”
This woman knew her loving offer of a kiss had been dismissed and she was not happy, so her responses to the doctor reflected that. He was quite surprised to elicit that reaction from her, but I was not at all surprised by her response.
I have had countless family members tell me that the healthcare provider never once spoke directly to the elder, and that elder was furious when they left the office.
They may not be able to form an intelligible sentence, but they still know when they’re being treated like a child, like an invalid (which they certainly don’t feel like), or worse, like they can no longer make their own decisions. They probably cannot make their own decisions but most caregivers know that it’s best if you can always give them the illusion of control.
I believe more and more healthcare workers are learning the lessons they need to learn about people with dementia, but we still have a ways to go. Unfortunately, it will be up to the caregivers to add this to their list of things to do:
Be pleasant at all times to healthcare providers who seem clueless—remember that now you’re in the “teacher” role;
- Gently redirect them to speak directly to your loved one if they are ignoring them and addressing all comments and questions to you.
- Possibly saying something like “Mom would like to answer your questions directly. I’m just here for some support.”
- You can always request a private meeting with them after the visit or via phone in order to discuss touchy issues.
- In fact, letting the office know in advance that this is your desire, would be beneficial.
Thank them when they get it right—we all like positive reinforcement!
Prepare the healthcare provider in advance by letting the office know a few things about your loved one. Remind them this loved one does not need to be told (again) that they have Alzheimer’s.
Provide some alternative words you know your loved one will accept such as “memory problems” instead of Alzheimer’s or dementia.
Let them know they will achieve more success with your loved one if they give them the illusion of control over some decisions such as “I’m thinking we need to adjust your vitamins right now because I think it will help with some of your memory problems—would you prefer the pills or the liquid?”
Remind the healthcare provider to always tell your loved one something positive. This will go a long way in gaining trust.
Try to inject some humor into the situation so the healthcare provider knows it’s okay, and it will help put everyone at ease.
Sometimes, you just need to find another healthcare provider if the one you’re using seems to make everything worse.
I would advocate for letting the office know exactly why you’re choosing to seek care elsewhere.
At the very least, if you try to initiate some changes, your visit can be made more pleasant and productive if they are willing to listen to you, and you’ve done a great thing by educating that provider so they improve the way they’re interacting with elders with dementia.
Having worked in the medical profession for over thirty years, I know both sides of this story. I know the healthcare providers are stressed for time—but then, so are you.
There really is no good excuse for them to not listen to you and make some changes that will improve the relationship with their patient and family. You know what makes your loved one calm and happy, and you know what pushes their buttons. When you can relay that information, and it’s received and incorporated into the visit, everyone benefits.
M.I.N.D. in Memory Care
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Original content Cindy Keith, the Alzheimer's Reading Room