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Dementia Care Tips: Person-centered approach

Choosing a person-centered approach over a task-oriented one can help you calm, engage, and connect with the older adult you serve.

It’s sometimes hard to know how to help a person with dementia, and for the inexperienced caregiver the process can feel downright daunting. But, as a trained professional there are a variety of tools and approaches you can use to create meaningful connection, positive moments, and greater comfort for the older adult you care for. And, at the end of the day, that makes for a more satisfying caregiving experience for you too.

Creating meaningful moments starts with deliberate, mindful communication. Not the kind of rushed interactions most of us have grown accustomed to in the digital age, but the kind that evolves from careful observation, patience and compassion.

“Good communication skills are very important to redirect and positively intervene with behaviors,” says Megan Carnarius, RN, and memory-loss educator, consultant and the author of A Deeper Perspective on Alzheimer’s and other Dementias: Practical Tools with Spiritual Insights. “This is why we teach about communication first.”

Carnarius helped develop the comprehensive dementia-care education program that is part of the HomeCare 100 Training Curriculum offered to HomeCare of the Rockies caregivers.

Created by Sandi McCann, president of HomeCare of the Rockies, and her sister Maureen McCann, The HomeCare 100 provides caregivers 100-hours of classroom and practical, hands-on training. The training covers a variety of techniques and topics including Dementia Care, Caregiving Basics, End of Life Care, Approaches to Activities of Daily Living, and Caregiver Wellness. Caregivers enrolled in the program are paid during the training and can earn higher pay for credits completed.

But the senior-specific knowledge and practical care techniques that caregivers learn provide the greatest value. Caregivers can use the information immediately to help the older adults.

The HomeCare 100 is part of the larger, three-tiered Caregiver Call to Serve program, led by HomeCare of the Rockies. Caregiver Call to Serve promotes professional caregiver training, fair compensation for professional care providers, and higher standards of care and support for caregivers and the older adults they serve.

This kind of comprehensive training and support means caregivers come away with scores of techniques and approaches to aid clients with dementia by quelling agitation, improving comfort, and preserving dignity.

“So many older adults and families are touched by Alzheimer’s and dementia and our caregivers are dedicated to finding ways to comfort, care, and connect with these older adults no matter what stage of illness they are in,” says Sandi McCann. HomeCare of the Rockies caregivers serve older adults and families living in Boulder, Longmont, Louisville, Lafayette, Broomfield, Loveland, and all surrounding areas. “We give them the tools to help them do that, to help them provide exceptional.”

Providing this kind of quality care to clients living with dementia-related conditions begins with careful observation and personal connection.

Person-Centered Care

One of the biggest things for caregivers to remember is to just slow down, Carnrius says. This can be challenging for a professional who has scores of task-related care responsibilities to tend to each day. Your daily routine may include everything from hygiene and personal care support, to meal prep and household chores. It’s easy to be task oriented and busy every moment. After all, you have a lot to get done! But, a person with dementia will do better – and so will you – when you take time to slow down, notice, and connect.

Every client, including those who appear confused by dementia, needs to feel their caregiver knows and understands them, Carnarius says. That feeling isn’t conveyed when you are busy doing tasks all the time, it’s conveyed through body language, gestures, calm connection.

Before slipping into a task-centered focus, put your attention on the person you are caring for. Take a deep breath, become aware of the present moment and observe the older adult’s behavior and movements. Listen to their speech and tone. Watch for their expressions and gestures. Validate their experience, no matter what it is. Then, adapt your communication style, if needed, to better understand and engage.

Nonverbal Communication

As dementia progresses, our verbal skills diminish. Older adults may find it more difficult – or even impossible – to speak, process, and understand words. This makes nonverbal communication especially important. An older adult with dementia will notice your expressions, gestures, and moods even when they can’t understand your speech. They will also pick up on your emotions, body language, and tone. If you appear angry or agitated, they will respond to that expression. But, a smile, gentle touch, quiet tone of voice, open posture, or slow movements can be invaluable ways to comfort, encourage, motivate, and preserve the dignity of a senior with cognitive decline.

This kind of individualized, person-centered awareness and communication will also help you identify and work with the older adult’s remaining strengths and abilities. It can help build a sense of success and purpose and offset agitation and frustration.

Ready to shift your focus from a task-oriented to person-centered approach? Here are some ways to adapt your communication style to comfort and care or those with dementia.

Six Ways Caregivers Can Connect

  1. Introduce yourself. Tell the senior who you are and explain why you are there. Ask for their permission to assist. You may need to introduce yourself several times a day, or each day you come. Be clear and calm, not abrupt and impatient.
  2. Convey calm facial expressions and nurturing gestures. If you are feeling stressed, frustrated, or anxious your client will pick up on that through your frown, look of disgust, or impatient gestures and movements. This can make them feel agitated or unsafe. Take a moment before entering a room to ground yourself, and become mindful of your expressions. A smile, or confident look can go a long way toward soothing an agitated older adult.
  3. Be mindful of your tone of voice. If a caregiver speaks loudly or in a fast, clipped fashion the older adult, who may have difficulty processing language, may feel nervous, impatient, or worried. Keep your voice even, tone gentle, and speech slow. Sometimes, it might be helpful to subtly match the gestures and tone of the older adult in order to help them feel understood. But observe first, then try mirroring his mood or tone, or using a quieter approach.
  4. Communicate clearly. Make sure the senior is wearing glasses or hearing aids if needed, then slowly communicate one point at a time. Use short, simple sentences. Don’t bombard with information. Do, make your statement or ask your question and then pause.
  5. Listen well. Pause for a response after you say something. Don’t interrupt when the older adult you care for is sharing. Watch the nonverbal behavior as well as listening to their speech and validate their communication no matter how their ideas are conveyed. Don’t argue, chastise, point out the repetition or inaccuracies, but acknowledge and respect what they are saying and doing every time.
  6. Get to know the older adult. Understanding an individual’s background, history, concerns, and achievements can give you context and insight that will help you personalize their care. Take time to reminisce, get to know the senior you serve, and recognize that they have lived a big and interesting life long before dementia became a factor. The older adults we care for are so much more than their condition.

How to Get to Know the Older Adult

Every individual is shaped by powerful experiences, distinct preferences, fears, likes, and interests. We all have routines that keep us comfortable and safe and an older adult with dementia is no different, but it can be hard for them to communicate those specific thoughts.

When you take time to get to know the senior as an individual with talents, interests, and a broad life experience – rather than solely a senior with dementia – you can help validate and identify their preferences and needs, provide better care, and create a more satisfying and engaging caregiving experience.

The Life Story practice and technique can be a way into this greater understanding and deeper connection with the older adult you care for, Carnarius says.

“Knowing a person’s life story helps create a good plan of care and inviting environment,” Carnarius says.

By developing a life story with your client and learning details of his experience – you can establish rapport and create a social, emotional, and physical environment that feels familiar and comfortable. With this knowledge, you can also help the older adult feel safe and secure by understanding more about what he might enjoy, or what makes him feel anxious, afraid, or irritated when he doesn’t have the words to describe it.

Learning the Story

Start by asking the older adult about his early life. Who were his parents? Where did he grow up? What did he enjoy doing as a kid? What did he love about his home? Did he go to school?

Reminiscing like this can also be a way to help ease a senior’s agitation, foster meaningful engagement and support cognition. Plus, it’s a fun and fascinating way for you to engage with the older adult.

When piecing together a life story, go slow. Don’t rattle off questions one after the other in some kind of rapid-fire interview. Follow your client’s lead. If they are enjoying the conversation and sharing stories and revealing more information, continue to listen, validate, and ask questions. If they appear tired or upset, distract with another activity or task. Sometimes sharing a simple (and brief) memory of your own, rather than asking a question, can prompt them to recall and share an experience.

Ultimately, all communication must be slow, encouraging, and patient, each interaction building from your careful observations of the senior and his behaviors and gestures in that moment.

The more you get to know your client through practices like the Life Story activity and through observation and nonverbal communication, the easier it will be to connect and understand their needs even when they don’t have the words to express them.

This kind of person-centered approach will help you deliver the kind of customized care that supports a life of comfort, quality, and meaning for the older adult and a more enjoyable work experience for you.

Want to learn how to deliver this kind of person-centered care and make money doing it? Caregiver jobs are now available at HomeCare of the Rockies, 720-204-6083, a family-owned agency where you are paid to participate in the HomeCare 100 Training Curriculum. At HomeCare of the Rockies, you can earn more as you learn more. Apply now, no experience necessary.

Articles for Seniors & Caregivers from HomeCare of the Rockies

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