Dementia Discussion

Understand the factors that can affect interactions and communication of individuals with Dementia.

How different forms of dementia may affect the way an individual communicates.

  • Dementia affecting visual perception.
  • Dementia affecting structure and ordering eg structure of sentences, order of words and patterns of conversation.
  • Inability to recognise faces and surroundings; inability to recall recent events.
  • Perseveration eg using the same word over and over again.
  • Loss of motivation.
  • Loss of ability to moderate behaviour Physical and mental health factors: sensory impairment eg hearing, sight; age-related degenerative disease eg macular degeneration, cataracts, pain, depression, learning needs.
  • Supporting different communication abilities and needs of an individual with dementia who has a sensory impairment.
  • Awareness of sensory impairment eg for hearing impairment minimise background noise and check hearing aid is functioning and for visual impairment check spectacles are the correct type.
  • Active listening skills.
  • Non-verbal communication eg observation of body language.
  • Clear verbal communication such as clear speech, use short sentences, use simple questions requiring yes/no answers.
  • Appropriate physical contact for reassurance.

The impact of the behaviour of carers:

  • Lack of respect from carer resulting in frustration and anger.
  • Iimpatience from carer and others causing demotivation.
  • Carer assuming they know best resulting in aggression and anger in the individual.

The impact of the behaviours of others.

  • Lack of respect from others such as other individuals or other professionals resulting in frustration and anger.
  • Impatience from others resulting in demotivation in individual.
  • Professionals assuming the individual has no views resulting in aggression and anger from individual.

Be able to communicate with an individual with dementia using a range of verbal and non-verbal techniques.

  • Using different  communication techniques.
  • Active listening skills.
  • Observation and  understanding of individual’s body language.
  • Clear speech using short sentences and simple questions requiring yes/no answers.
  • Aappropriate suggestions if the individual is stuck and checking with them that is what they meant.
  • Nnon-verbal communication including appropriate physical contact for reassurance.

Observation of behaviour as an effective tool in interpreting the needs of an individual with dementia.

  • Observing and interpreting patterns of behaviour eg becoming agitated or undressing when they need the toilet or shouting out or wandering when bored.
  • Responding to the behaviour of an individual with dementia, taking account of the abilities and needs of the individual, carers and others.
  • Verbal and non-verbal support.
  • Enabling, appropriate physical contact for reassurance.
  • Anticipatory response to enable eg offering to help them to the toilet if they indicate such a need.
  • Allowing time for the individual to make choices eg what to wear.

Be able to communicate positively with an individual who has dementia by valuing their individuality.

  • How the communication style of an individual with dementia can be used to develop their care plan.
  • Use of alternative methods of communication eg verbal to supplement visual limitations or visual clues to aid memory such as recent photos of family to help the individual recognise them.
  • Individual care plan allowing time to support communication.

How the abilities of an individual with dementia can be used to develop their care plan.

  • Unique abilities of the individual with dementia are recorded on the care plan and form the basis for their care eg an individual with poor short-term memory but good long-term memory may be helped to compile a life story book around their childhood or an individual with dementia who retains musical ability may be encouraged to play the piano or listen to music.

How the needs of an individual with dementia can be used to develop their care plan.

  • The need to maintain independence for as long as possible using physical aids eg labels on cupboards and drawers, clearly defined environment for sleeping and for eating.
  • The need to maintain independent living by ensuring adequate support at home eg care plan allows sufficient domiciliary care or day centre to meet social needs.

How the individual’s preferred method/s of interacting can be used to reinforce their identity and uniqueness.

  • Use of life story books.
  • Reminiscence sessions.
  • Inclusion in social groups and conversations.
  • Continuance of hobbies and interests.

Be able to use positive interaction approaches with individuals with dementia.

  • The difference between a reality orientation approach to interactions and a validation approach.
  • Reality orientation placing the individual in the here and now, reminding them of the day, place, time and situation they are in.
  • Validation – a non-judgemental acceptance and empathy to show the individual that their expressed feelings are valid and focusing on the feelings rather than the content of speech.
  • The difference between these two approaches and when each might be used.

Positive interaction with an individual who has dementia.

  • An interaction which is positive for the individual who has dementia eg a carer listening and responding appropriately to a person who is distressed and frightened or a carer and the individual working together to arrange flowers.

How to use aspects of the physical environment to enable positive interactions with individuals with dementia.

  • Choice of clothing as a way to express individuality.
  • Walking round the garden to enable individuals to respond to seasons.
  • Care workers clearly define areas so individuals can recognise the dining room or the sitting room.

How to use aspects of the social environment to enable positive interaction with individuals with dementia.

  • Opportunities to meet family and friends.
  • Time to talk about early life, past career, good memories.
  • Engagement with familiar activities ie attendance at church, clubs, playing golf, favourite walks.
  • Engagement with creative or therapeutic activities eg reminiscence, listening to favourite music; continuing social routines, eg going to the hairdressers, out for coffee.

How reminiscence techniques can be used to facilitate a positive interaction with the individual with dementia.

  • Set aside time and resources.
  • Voluntary participation; trained leader able to manage the group or the individual and deal with any negative aspects that arise.
  • Using a range of resources such as photos, old-fashioned sweets, flowers as a talking point for reminiscence.

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