Empathetic Communication

For years, loving caregivers have searched for gentle ways to respond to people with dementia. What do you say when your 90 year old mother is looking for her mother? Or when your husband says he wants you to take him home when you leave the facility?

Initially we tried reality orientation, trying to force the person's brain to come back into our world. For example, telling the mother that her mother is dead and telling the husband that he's never going home again. This strategy led to accusations of lying, confrontations and tears, plus, it didn't work.

Next we tried therapeutic lying or "fiblets", responding with misinformation in attempts to comfort the person. Statements like "Your mother's gone to the store" and "Of course I'll take you when I leave" followed by slipping out the door are examples of this strategy. However, most of us aren't good at lying and people with dementia can be very good at picking up on non-verbal communication, as well as our discomfort so these attempts were met with suspicious acceptance, outright challenges or breaking of trust.

Empathy is the Answer

So what is the answer? Empathetic communication is the best approach to meeting the needs of the person with dementia. First, start by addressing the underlying feeling or need by using the phrases "looks like," "sounds like," "seems like" or "feels like" and then label the feeling.

For example, "sounds like you really miss your mother" or "looks like you're angry that you aren't at home." Second, help the person express the feelings while guiding towards reminiscing: "Tell me about your mother/home etc.," or "Was she a good cook?"

Lastly, guide the person to an activity that is related to the conversation, getting something to eat or looking at familiar pictures or household items.

Using this new approach takes time and practice. Initially, you may feel awkward and find yourself going back to previous strategies. Be patient with yourself and call the office for additional help and problem solving.


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