Appropriate Communication, Sensory Stimulation Aid Patients with Dementia
November is both National Caregiver’s Month and National Alzheimer’s Awareness Month—an appropriate juxtaposition.
As Americans live longer, more of them become prone to Alzheimer’s or another form of dementia, which tend to increase with aging. Whether they’re cared for at home or in facilities, by professional or family caregivers or both, these individuals benefit from specialized communication and sensory-stimulation techniques.
How to communicate with them, of course, depends on the stage of dementia and on the individual. In general, one can say the way a caregiver—professional or family member—interacts with them is critical, said Barbara Goll, community liaison/education coordinator, Homeland Hospice, HomeHealth & HomeCare, in Central Pennsylvania.
“When you approach someone in the middle to late stages of Alzheimer’s, be sure not to startle that person,” she said. “Call him or her by name, make eye contact, and identify yourself, every time.”
It’s also important to “get on their level, eye-to-eye,” Goll added. “Offer your hand to the person; don’t grab theirs.”
At first a person with dementia may be able to respond to open-ended questions. But eventually, “limited-choice questions” are more effective; even later, one-choice answers, such as yes or no, work better. It’s more effective for you to speak slower and in shorter sentences.
The approach toward speaking with patients with dementia has changed, Goll pointed out.
“Years ago, we used a reality orientation, and would correct them. But now we join them in their reality, which may not be of the here and now. We enter the world of the person—even fib a little—or redirect them by changing the subject.”
Patients with dementia may have moments of lucidity, but the caregiver must acknowledge that these moments will come less and less frequently. The point, Goll said, is that these individuals are slowly losing their identities.
As dementia patients move from the early stage of the illness to the later ones, they may have trouble remembering the names of people they were just introduced to or may misplace things. As a result, they may become socially withdrawn and uncomfortable around people, realizing “they don’t fit in.”
It’s easy for caregivers to become frustrated. So, Goll recommends that they don’t keep trying to “correct” dementia patients.
“It’s better to help them remember by showing them photos and reminiscing. You may also have to tell the patient repeatedly who visiting family members are.”
It’s best to focus on the traits that remain, not on what they’ve lost.
Another guiding principle to remember, Goll added, is that, as dementia patients progress in their illness, they may not be good at group activities, other than listening to music—which can “reorient” a person, if only temporarily.
But you can engage loved ones with whatever abilities they still possess—such as matching socks, folding laundry, dusting, setting the table, or helping to prepare food.
“Always try to keep them involved in the activities of daily living,” Goll suggested. “Some people may be able to sing or play piano from the past better than you’d think.”
The world of individuals with Alzheimer’s or forms of dementia is often circumscribed, lacking in sensory stimulation. They also can’t control their environment, which can engender a feeling of helplessness.
A multisensory room can help ameliorate both situations.
“It’s like the flick of a switch,” said Krissy Koenig, CTRS, community life leader – enrichment at Messiah Lifeways at Messiah Village, in Upper Allen Township.
“These rooms are fairly progressive, but are quickly catching on in senior facilities,” said Koenig. “This kind of environment both relaxes and stimulates individuals with different forms of dementia.
“‘Multisensory’ is a generic description. The technical name of these rooms is Snoezelen therapy, for the man who discovered it.”
The concept, originated in Holland, has existed since the 1970s. It is being used in all stages of dementia, especially in memory-support wings, but also in alternative schools that serve kids with autism and other forms of cognitive impairment.
Among the features you might find in multisensory rooms are fiber-optic lights, which change colors; a color-changing bubble tube; aromatherapy; music; a fan and wind chimes; photo and cloud projections; and anti-gravity and heated massage chairs.
Some rooms contain a portable unit that can move around an entire facility. Messiah Lifeways has two.
What’s also unusual is that the multisensory room is totally driven by the residents. The care provider ensures it is a safe environment but otherwise “allows it to be the individual’s own experience,” said Koenig.
“The first time, everything is initially turned off in the multisensory room, so community life leaders (or other staff) can see what the resident responds to,” she continued. “They can explore things and learn on their own. It may be hard for the care provider to step back, which may not be necessary in more traditional approaches.”
If a person with dementia is experiencing anxiety or is upset, running his or her hands through strands of light can induce relaxation. It can keep residents calm and bring positive results, if not for 24 hours, then for a limited time.
The challenge sometimes is to get the residents into the room initially.
One resident or two—whatever the caregiver considers appropriate—may be in the room at the same time, but caregivers must be mindful not to leave anyone by themselves.
What if you’re caring for a loved one at home? You still can apply some of the same techniques as a formal multisensory room.
“Find a nice, quiet space; turn down the lights; and turn on a color prism to shine on the walls, like a rainbow,” advised Koenig. “You can also use a star projector on a table top.”
Other methods to relax people with dementia include aromatherapy hand massages, adding calming lavender into warm water.
Little lights turned on and off by the top of the hands can give the patient a sense of control.
Amazon.com is a good source of “sensory equipment” if you know what you’re looking for, said Koenig. “They definitely help.” BW