Dementia-wise interaction is a specific way to interact with loved ones living with dementia. It places focus on the loved one’s psychosocial needs as they become expressed through actions and feelings.
The benefits of dementia-wise interaction include:
- A calmer, more relaxed loved one
- A less confused loved one
- Allows the loved one to feel as if nothing has changed in their lifestyle
Dementia-wise interaction can best be described as “going with the loved one’s emotional flow.” When a loved one says something illogical, zany, or completely untrue, you will find a happier and healthier interaction can come about simply by focusing on their feelings and emotions. Turns out the validity of the content of their statement is of little importance.
I know, you want to lovingly “set them straight” on the facts. And most often that seems to be the caretaker’s preferred way to handle the moment. But it’s not the best way. Not the best way because it will induce arguments you’re never going to win. You need to switch gears, changing your thinking process around to better interact with your loved one. Yes, it can be difficult to switch gears in life but believe me, you will see a world of behavioral and mood-state differences if you do this.
A person with memory loss can and will share a lot of unique events they claim to have experienced in their life. While in some cases a person may have a history of embellishing, I don’t believe that’s the case here. This behavior is a form of communication, a way to express an unmet need.
May be verbalizing a need
With little if any ability to know just what led up to the fabricated tale your loved one is telling you, your task as caregiver is to find the need behind their words. Remember, the validity of the content of their statement is not the focus, only the feelings and emotions.
Your caregiver brain should start discerning what physical, medical or psychosocial need might be lacking. Cognitive decline is making dialoging more difficult. Yes they can talk all day long, but very often the loved one finds they are not able to express their needs very well.
A common disorder for someone with dementia is word salad. Word salad blends two or more words together to form one word. Similarly, intertwining several stories together to come up with the unmet need may explain some of the chaos.
Brain function
The brain is complex and fascinating. Ever-protecting and vigilant to preserving sanity and life, data is saved and prioritized depending on how necessary and urgent the brain perceives it to be in regards to survival. If data is considered non-consequential, the brain dumps it from its Sensory Memory (SM). SM is a very, very short term memory process lasting up to 60 seconds or so.
When the brain senses the new data may be of value, the information goes into Short Term Memory (STM) where a decision is made to keep or dump it depending on its perceived importance for survival. If it is vital it is sent along to Long Term Memory (LTM) where it becomes part of your working schema which simply means it now plays a part in how you view your world.
This whole process can become grossly unstable in a person with dementia.
Dumping STM
Should the brain assess the new data to be insignificant to survival it dumps it but how? One way is through dreams. It certainly explains why dreams can sometimes be as crazy as they are.
You know how you feel when you first wake up after a bad or scary dream? You just want to shake off those “not feel so good” chemical-induced feelings that are racing through your body. Even in those of us who are still able to express our needs there are times dreams are so ugly we are left “speechless.”
It may be within the dreams our true, undealt with emotions become exposed. Unlike our loved ones however, we can easily get our emotions validated as we share with others, “Wow, I had the craziest dream last night….”
The emotions of dreams
The emotions induced by dreams may well be a collection of numerous mini events that have happened throughout our day. They also could be our concerned reactions to a “what if” style thought pattern. Each one in itself is nothing to shake a stick at until they are bundled together, making the visibility of the emotions more blatant.
For the loved one the brain also takes bits and pieces of leftover sensory data and threads it together in story form. While that story may be confabulated, the feelings it induces are real. It’s those feelings that need a nurturing touch. These feelings may well be the leftover products from the loved one’s daily experiences (or lack of, as the case may be) and need nothing more than validation.
Validation
Validation means you recognize that person’s feelings are valid. You affirm and normalize what they say they are feeling. For example, the loved one says, “I’m scared I might get fired.” You want to shake your head and roll your eyes because you know they have been retired for over twenty-five years. In using dementia-wise interaction however, you ignore that fact and focus instead on the emotions.
“Getting fired is scary dad. I want you to know I’m here for you. We will get through this together.” Right there his feelings were validated. He knows you heard him and calm begins to set in. That’s all that might be needed to alleviate the fears.
Once accomplished, begin redirecting his thought pattern away from “being fired.” Maybe in this example ask what job in his past did dad like best. Then ask about dad’s education level – whether you already know it or not. Continuing to move away from thinking about work you could move on to any subject of interest to him such as favorite books, favorite teachers, favorite vacation…..
To learn more about validation, please read, “Validation and Redirection of Thought.”
Psychosocial Encouragement
- Validate the loved one’s feelings
- Remain nonjudgmental regarding the accuracy of the content of their statements
- Encourage and strengthen their sense of autonomy
- Interact from within their reality, not yours
