Involving a Person with Dementia in Conversations
As a Gerontologist and Dementia Expert, I often cringe when others talk around someone with dementia.
Talking around the person with dementia happens when the person with dementia is standing in the room and the caregiver, doctor, family member, etc. is talking about them as if they’re not there.
Here is a scenario: Mary has dementia. She is sitting in a chair and her doctor is standing against the wall. Mary’s daughter, Sue, is sitting on the other chair.
The doctor looks right at Sue and asks “How has Mary been feeling?” and Sue responds “Well, she has been tired more lately, at night she fights me when I try to help her get dressed.” The doctor and Sue continue to have a conversation about Mary but never address Mary. This occurs with doctors, friends, family members, hired caregivers, everyone! I see it a lot.
It frustrates me and I want to shout “OH MY GOSH! DO NOT DO THAT!” but, I also know that won’t fix anything! I have seen others with my credentials react with anger, but I’m here to tell you: That won’t correct the negative behavior.
It is human nature to become defensive when someone tells you what you did wrong. Most people will jump to defend themselves or explain why their behavior is OK. This ruins a learning opportunity.
Much like when we are working with families, it is important to assume that the person is not coming from a bad place. It could be ignorance or perhaps they really think they’re saying or doing the right thing. I will give you some of my techniques on correcting someone and avoiding this pit fall yourself.
How to avoid the pitfall:
- Make sure you’re not doing this yourself. Pay more attention to how you respond when someone starts to do this.
- You can turn to the person with dementia and repeat the question for them.
Doctor: “How has Mary been feeling.”
Sue: “Mom, how have you been feeling?”
Although, the person with dementia may not be able to answer appropriately, it is still important to include them and give them the opportunity.
- If the person with dementia does not answer correctly, you can provide the answer for them and ask them to confirm
Sue: “Mom, the other day you seemed like you were very tired. You weren’t eating very much and had trouble getting out of bed. Would you say that’s correct?”
- If this still presents a challenge, you can leave out the confirmation but still address the person with dementia by using “you” statements.
Often times, the other person in the room will continue to address the more cognitively healthy person rather than the person with dementia. It can be awkward and frustrating. Here is a phrase I suggest using:
“Could you please speak up, _________________________ can’t hear you.”
After this, repeat the other steps continuously. You may have to use this phrase several times throughout the conversation. Leading by example can be very powerful. The more we do this, the better the response will be.
Considering both sides
It is important to add that I recently met with a doctor and discussed this topic exactly. You may be surprised to hear that they experience the same frustration. Sometimes, there is a spokes person (a daughter, son, or spouse) who speaks around the person with Dementia. So, the provider or the spokes person can use these tips. If you’re reading this- use these techniques!
I would like to leave you with this thought for when you may be in this situation:
“Perhaps the greatest charity comes when we are kind to each other, when we don’t judge or categorize someone else, when we simply give the benefit of the doubt or remain quiet. Charity is accepting someone’s differences, weaknesses, and shortcomings; having patience with someone who has let us down; or resisted the impulse to become offended when someone doesn’t handle something the way we might have hoped. Charity is refusing to take advantage of another’s weakness and being willing to forgive someone who has hurt us. Charity is expecting the best of each other.” – Marvin J. Ashton