Promoting a positive environment for a person with dementia or Alzheimer’s disease is ALWAYS possible; it’s all in the approach and by applying the basic “do’s and don’ts” for memory care.
- Do talk in short, simple sentences of seven words or less.
- Don’t ask too many questions. Keep it to minimal choices: “Would you like coffee or juice?”
- Facial expression is important. Do smile, but not in a mocking way.
- Calmly wait for a response, don’t talk, let the resident think.
- If the resident is hard of hearing, do lower your tone of voice as you talk louder and speak clearly. Our voice tones tend to get higher when we talk louder, which makes it harder for that person to hear or they may think you are yelling at them.
- Don’t stand over the individual in dominance. Instead, talk at eye level.
- Do offer food, drinks, or activities according to that person’s liking.
- Don’t invade their space, but also don’t be afraid of touch. A light hand over theirs is reassuring.
- Do reminisce with a resident.
- Don’t disagree, argue or correct.
Dementia caregivers know that the resident with dementia who woke up in the morning refreshed and ready for the day may not have the same mindset in the afternoon or evening. Getting to know each individual is important to recognize the causes of their change in mindset throughout the day. Each person has their own triggers, and in some situations the triggers are unknown. The focus then becomes communicating through redirecting, not reprimanding.
The main goal is to keep a calm atmosphere within a memory care facility. If one resident is upset, which happens occasionally, the situation often turns into a domino effect, causing others to act the same way. This usually happens mid-to-late afternoon through the evening hours. This is called “sundowning”. Looking for a loved one or family member is often a main indicator of sundowning. This is especially true when they are exit seeking, which means looking for a way out. Usually, this loved one is deceased, but the resident remains adamant about finding them. Caregivers must then work to redirect the conversation. An example response may be, “Your husband called and he will be here in an hour. Come over and have a seat, I have a cup of coffee and a cookie for you while you wait.” Going along with their mindset is much less agitating to the resident than contradicting what they are saying. Some may say this is lying, but it is not. Instead, we are “joining their journey”.
As a memory care nurse at Friendship Haven, I have the opportunity to observe and learn the methods of communication with our residents with dementia and Alzheimer’s disease. Friendship Haven has a staff of patient, caring, nonjudgmental people, who strive to help all residents feel comfortable.
Contributed By: Sherry Grady (Journeys Charge Nurse)