Monday, February 6, 2012

What Can Harvey Teach Us About Communicating With Persons Liviing with Dementia


Learning a new way of communicating with the person with dementia is not easy. But practicing these changes, bit by bit over time, can reap great rewards for both the person with dementia and the caregiver.

By Monica Heltemes
Alzheimer's Reading Room

Monica Heltemes
I watched the video of Bob’s mother, Dotty, and Harvey, the repeat parrot, interacting with each other, with fascination.

Their “conversations” seemed so easy and natural, which is often not the case when communicating with the person with dementia.

I viewed their conversation through my occupational therapy lens, analyzing what worked and why it worked.

I think the communication successes I noted between Dotty and Harvey have lessons that we can learn from in our own communication with the person with dementia – with or without the parrot.

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In the moment

A person talking with Dotty would likely talk about one topic then move onto another topic. That is normal conversation for you and I – in fact we probably get annoyed by a person who continues to talk on the same topic over and over!

However, Harvey is “in the moment” with Dotty. Dotty says something, Harvey repeats it back. They are on the same thought together for as long as Dotty wants to stay on that thought.

 To Dotty, this seems reassuring. Harvey is on her level, sticking with her thoughts in the moment. Dotty is leading this “conversation” – which is usually not the case for the person with dementia.

No questions asked

A person conversing with Dotty would inevitably ask Dotty a question. “Are you hungry?”, “Do you want to sit outside”, etc.

The person with dementia does not do well with being asked questions, as they may not know how to answer or may not understand the question. You might hear a lot of “that’s fine”, “whatever you think”, or “NO”.

Unknowingly to us, these all may be inaccurate answers. They are just rote answers that are at least some sort of response. Harvey does not ask questions, so never puts Dotty on the spot to perform (i.e. make a response).

Validation

Harvey hears what Dotty has to say and then repeats it, providing validation to Dotty that what she said was heard and known.

This is so important to people with dementia, so that even if what the person says does not make sense to you or I, it is still validated as is and not corrected. This makes the person feel secure and avoids frustration of not being understood. There is a whole care technique built around this, called Validation Therapy developed by Naomi Feil, MSW, ACSW.

Learning a new way of communicating with the person with dementia is not easy. But practicing these changes, bit by bit over time, can reap great rewards for both the person with dementia and the caregiver.

Thanks to Harvey for showing us how to say just the right thing.

Monica Heltemes is a practicing occupational therapist and owner of MindStart™. MindStart designs hobby-style items, such as games and puzzles, specifically for persons with memory loss. They keep persons with dementia active, while giving support to caregivers, and are quick and easy to use. Visit MindStart (Activities for Persons with Memory Loss) to learn more.


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Original content Monica Heltemes, the Alzheimer's Reading Room