ACT on Alzheimer’s Disease Curriculum

Module IV: Effective Interactions with Dementia Patients

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Effective Interactions

• These slides are based on the Effective Interactions text from Module IV

• Please refer to the text for all citations, references and acknowledgments

Learning Objectives

Upon completion of this module the student should:• Develop an understanding of person-centered care

and recognize each person as a unique individual.• List types of verbal and non-verbal communication

that people with cognitive impairment may display.• Gain insight into common behaviors, understanding

why they happen and what they mean.

Dementia Care Overview

Suggestions for Dementia Care

• The patient is a person, respect that individual’s humanity

• The changes in this person are a result of a brain disease over which the person has no control

• Different or challenging behaviors may be the only way for this patient to communicate

Three Keys to Quality Interactions

• Affirm the person’s feelings, show empathy• Solve the problem whenever possible• Distract and/or relocate

Person-Centered Care

• Patient care should be personalized, so a caregiver needs to understand:– What makes this person unique– His or her personality– What core qualities define this person

• Caregivers can use these core personal qualities to develop suitable, personal care

Effective Communication

Communication Overview

• A dementia patient’s communication patterns will change over time and a caregiver’s communication techniques need to change as well

• The best way to support a person with dementia (and to communicate effectively) is to build a relationship with that person

Communication Challenges

• Word-finding difficulty• Repetition• Loss of reading and writing ability• Revert to native language• Loss of ability to speak in clear sentences• Loss of ability to understand• Inability to use words

Communications Tips

• Talk to the person in a place free of distraction• Begin conversation with orienting information• Look directly at the person• Make sure you have the person’s attention• Be at eye level with the person• Speak slowly and clearly

Communications Tips

• Use short, simple sentences• Ask simple yes/no questions• Use concrete terms and familiar words• Talk in an easy-going, pleasant manner• Allow sufficient time for the person to respond• Break up tasks into smaller steps

Having Trouble Being Understood?

• Be sure that you are allowing enough time for the person to process and respond

• Demonstrate visually what you are saying• Think about the complexity of what you are

saying• Try a hug and change the subject

Having Trouble Understanding?

• Listen actively and carefully• Try to focus on a word or phrase that makes

sense• Respond to the emotional tone of the

statement• Stay calm and be patient• Ask family members about possible meanings

Things Not To Do

• Don’t argue with the person• Don’t order the person around• Don’t tell people what they can’t do• Don’t be condescending• Don’t ask questions that rely on good memory• Don’t talk about people in front of them

When Verbal Communication Fails

• Try distracting the person• Ignore a verbal outburst if you can’t think of a

positive response• Try other forms of communication• Learn your own body language• Learn the other person’s body language

Physical Interaction

Making a Positive Physical Approach

• Come from the front• Go slow• Get to the side• Get low• Offer your hand (palm up)• Use the person’s preferred name• Wait for a response

Assessing Behaviors

Common Behaviors• Walking about• Exiting or trying to leave• Wanting to go home• Showing fatigue as the

day progresses• Sleep disturbances• Looking or searching for

things

• Gathering • Shopping• Expressing discomfort• Having hallucinations or

delusions• Being suspicious or

paranoid• Repetitive actions• Loud verbalizations that

may not be coherent

Why Challenging Behaviors Occur

• Change in environment• A caregiver’s approach to communication• Past history and behaviors• Internal needs of the person• The task that the person is doing• Inability of the person to express needs or

desires

A Different Way to View Behaviors

Wandering Demonstrating mobility

Sundowning Tired at end of day

Rummaging Gathering / Exploring

Hoarding Shopping

Resistance to care Feeling uncomfortable

When Is Behavior a Problem?

• It violates the rights of others• It poses a threat to someone’s health and

safety (including one’s own)