Communication Activity

220px-The_Popular_Educator_Illustration_6_-_Holding_the_Pen In this activity you are required to read the scenario and consider the best ways to responds. You can use the “Reply box below or write your answers on a separate piece of paper.

From: The Best Friends Approach to Alzheimer Care bestfriendsapproach.com

 

1.Coping with forgetting:

Resident states: “I just can’t remember anything! What are my grandchildren’s names?

What are helpful things to say?

 

2.Hallucinating:

A woman with Alzheimer’s disease comes up to her son in the family room looking upset, claiming. “There’s a big cat in my bedroom.  He may hurt me!”

What are helpful things to say?

 

3.Wanting to go home:

A wife is perplexed that her husband wants to go home, even though he is at the house he has lived in for 40 years. He cannot imagine why he feels like a stranger in his own home.

What are helpful things to say?

 

4.Being Overwhelmed by questions

A family who cares for their grandfather at home finds most of the days pleasant and easy.  Yet old friends who are not sensitive to Alzheimer’s disease come by several times a week and often ask a string of difficult to answer questions.  The family notices increased anxiety and restlessness in the grandfather after the friends’ visit,

What are helpful things to say?

 

5.Wanting to stay busy

Many older adults remember a time when the workdays were long and the paychecks were small.  Despite these conditions, the work ethic was strong.  One woman with Alzheimer’s disease always want to keep busy—clean the house, sweep the  porch, .and fold clothes.  The nursing facility activities staff found themselves growing impatient and exasperated at times because their planned activities did not interest her.

What are helpful things to say?

 

6.Confusing past and present

Because of the failing memory and confusion that accompanies dementia, often the person will become confused about past and present.  A mother might say to her daughter, “I’m waiting for Manuel.  I’m sure he’ll be home any minute,” despite the fact that he is long deceased.

What are helpful things to say?

 

7.Coping with inappropriate sexual behavior

One of the most upsetting experiences to a caregiver is when the person makes an inappropriate sexual advance.  What should happen if a man with Alzheimer’s disease makes a sexual advance toward his daughter?

What are helpful things to say?

 

8.Handling angry outbursts

Because of the confusion and frustration that can accompany Alzheimer’s disease, person may sometimes become angry and even strike out at caregivers.  This can be very upsetting, perhaps even placing the caregiver at risk for injury.  However, anger often has an identifiable cause.  If the person is being bathes for example, and becomes angry it might be out of fear (e.g. fear of being undressed by someone the person may not remember, fear of drowning)

What are helpful things to say?

 

9.Coping with repetition

People with Alzheimer’s disease often repeat questions or requests.  This can, of course, be extremely annoying to caregivers and can cause caregivers to lose their temper.  A typical situation might be when the person asks, “When do we have lunch?’   over and over again.

What are helpful things to say?

 

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15 thoughts on “Communication Activity

  1. 1.
    2. “Do not worry, you are safe in here.”
    3.”We can change things around to make you feel more at home”
    4.ask the visitors not to ask anxiety triggering questions
    5. ask her to help around with setting kitchen tables before each meal or folding laundry.
    6. ” How about we do something else while you are waiting for Manual.”
    7. tell the daughter to move from situation asap
    8. tell them you will be quick or allow to do what they can themselves and help when needed.
    9. tell them every time like the first time.

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  2. 1) If I knew the names – I would tell the person the names..perhaps have a photograph to look at. If I did not know the names I would make a point to ask another staff member or ask family when the are in.
    2) Lets go do something together. You are safe.
    3) Suggest to the wife to consult with a doctor.
    4) Educate the family friends about alzheimers. Let them know multiple questions are confusing for their friend to answer.
    5) Give tasks that are meaningful to the person
    6) Tell me one of your favorite things about Manual.
    7) Ask the daughter if she has a moment to talk to help remover her from the situation.
    8) If there is immediate harm to the caregiver, leave the situation, bring someone back with you to assist after a brief cooling off period. If it was a problem with getting dressed or bathing for example…let them help to the best of their ability with and give choice.
    9) Repeat when lunch will be perhaps ask if they would like to sit and have a coffee before lunch.

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  3. 1. Don’t say remember, just give straight answers (give the names, or ask for the names from another caregiver)
    2. “I’m here with you, you are safe. It can’t hurt you”
    3. “would you like to make it more like home by changing things around a bit?”
    4. Don’t ask so many questions that are complex that trigger his anxiety
    5. “Can you help me fold the laundry?”
    6. ” would you like some company while you wait?”
    7. Ask her to help you grab some supplies to get her out of the room
    8. Leave if anyone (caregiver/patient) are in danger of harm. If it’s out of fear give them reassurance and get them to help out to the best of their abilities
    9. Repeat when lunch with be ready in different ways (ex. “lunch will be ready shortly”, “I think i smell them cooking it right now so it shouldn’t be long now”)

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  4. 1. Use distraction, but engage in a meaningful activity that evokes positive emotions. I would tell her the names if I knew them. “I don’t know their names, but why don’t we look at the pictures of them in your room?”

    2. “You are safe now, we are here” or “I will go kick that cat outside”

    3.Depending on if this level of confusion is new, and if they presented with other symptoms that might suggest an infection I would talk to the wife about taking him to see a doctor. If not, I would talk to the wife about how this this can be normal for people with dementia, and offer support. Maybe ask the wife to take him on a tour of the house and look at some photos if you think it might be positive.

    4.Explain to the friends why complex and too many questions can be distressing, and offer suggestions like only giving a couple options at a time, and how to use language thats simplified without sounding disrespectful.

    5.Look at their history and choose activities that were relevant to their life that they might enjoy. “Can you help me set the tables please?” or “it would be a huge help if you could fold these napkins fro me”

    6. “OK Mary, why don’t we sit down for a snack while you wait for Manuel” Use distraction while not disturbing her reality.

    7. Comfort the daughter. This would be an extremely upsetting experience. ask her if theres anything you can do to help, or if theres anything she needs. Try to explain that this is part of the illness, and not a reflection of who he is.

    8.Calmly ask why they are upset, offer to listen, ask what you can do to make them more comfortable, but if you feel unsafe, you need to call for help or remove yourself.

    9.Answer the question, then find a distraction. Try different ways of saying the same thing.

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  5. 1) dont ask them to remember!
    2) “Let me get rid of that big cat for you” “Hes gone now, we are safe”
    3) Support both Husband and wife. If this is new or has gotten worst then its time to visit the doc, but if its something that has become a regular occurrence, think about his history. Was there a certain colour in his childhood living room? could it be rearranged differently?
    4) Use this a teaching tool to help his friends connect in a way that better suits him. Let them know of some triggers.
    5) This is a great way for you to learn about the person! Give them meaningful tasks, even if its not perfect. Setting tables, folding clothes, putting away dishes after meals. These are all things they might have been doing since they were young and might being back memories of doing it in their younger years. But this also helps the staff with finding the resident something to do as well as giving the staff a chance to spend 1-on-1 time with them.
    6) Step into her reality. You can always say something to distract and not destroy. “I think he will be a while still, would you like to get a snack while we wait?”
    7) “Hey now, if you keep doing that to the girls they are all gonna run away!” bring in some way to ‘joke’ around while still getting the point across. If that is not very effective, politely separate them. Is the daughter alright?
    8) If there is imminent danger, leave the situation. Talk to them during each procedure so they know what is happening and your voice can distract them. Remain calm and figure out the root of the problem,
    9) Treat each question like its the first time you heard it! try rewording your sentences (not the same answer over and over)

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  6. 1.) If I knew their names I would simply tell him their names and seek other information about them if I could such as facts or pictures, if i didn’t I would ask staff, look at charts, etc.. If that was too much at that situation I would use distraction and say “I”m not sure what their names are but we can go into your room to see if we can find something out or look at some pictures of them ”
    2.) “Dont worry I’ll get rid of that cat, he wont hurt you. Lets go do something together.
    3.)”Is there anything I can change around to make it more comfortable for you?” if not, and this is a common thing I would suggest going to get some help from a physician.
    4.) Educate the family and friends about Alzheimer’s disease and kindly express that asking multiple questions can be very difficult and frustrating and to not take offence when it does happen but find a solution to better everyone.
    5.) ” Would you like to help me fold this laundry ? ” I would love it if your helped me put these dishes away” , “It’d be great if you could help us set the table..”
    6.) ” Why dont we grab a snack and I’ll keep you company while we wait. ..What are your favourite things about Manuel ?”
    7.) Try to get her out of the situation asap. ” Hey .. would you please come with me ,theres something I need to talk to you about and its urgent ” Try to comfort the daughter and ask her if there is anything she needs.Try to explain that this is just the disease not about him or her .
    8.) Ask them if there is anything you can do to make it more comfortable and that it will be quick , tell them they can do it themselves as soon as you get everything ready. If it becomes a dangerous situation , leave the situation, seek help.
    9.) Simply answer the question like its the first time you heard it. Try saying differently each time . Offer a snack .

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  7. 1 do not ask them to think or trying to remember
    2 the cat has left and you are safe now
    3 is there anything that I can do to make you feel better or let you have sense of belonging?
    4 ask his friends stop asking questions and try to talk about something relaxing.
    5 ask they to do something that they can but not too much, something like pass me the cap or fill the cap with water to let them feel there still have something that they can do
    6he may comes over and start another topic to let him distracted
    7ask her daughter to leave
    8leave if fell you are in danger
    9tell them the correct answer each time like the first time

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  8. 1) In this situation, if I knew their names, I would inform the resident of their names. It may also be helpful to create a memory box filled with photos of loved ones and objects that are important to them. This can become an opportunity to reminisce with the resident.

    2) Do not correct her by saying it’s not there. It would be a good idea to redirect her attention by bringing her into another room, so she’ll feel safer away from the cat. Perhaps engage in another activity.

    3) I would suggest seeing a doctor if she is perplexed by his behaviour since this may be a sign of dementia.

    4) I would suggest to those friends that he needs more direct conversation to get their words through. This could be an opportunity to educate them of Alzheimer’s while being empathic to the situation. Perhaps they don’t want to accept his condition. Giving them tips on the best form of communication may help them adapt to this new type of conversation.

    5) This person seems to have been a homemaker. Asking her to help fold clothing-protectors is a great way to keep her busy. Do not force activities she doesn’t enjoy on her; I for one know I wouldn’t want to do something I’m not interested in

    6) It’s best to not correct her and go along with her narrative. It can cause her anxiety since the facts keep changing.

    7) She should leave the situation, preferably have another person with her to take her out of there.

    8) When someone is showing aggression, one needs to step back an assess the situation. Using the acronym P.I.E.C.E.S. (Physical, Intellectual, Capabilities, Environmental, Social) we may target the source of the issue. He could be in pain, unhappy that he cannot wash himself, dislikes the layout of the bathroom, or there are too many people in there at once. After singling out what is causing the issue changes are to be made to accommodate him.

    9) Patience is key. Having a response to say to answer them each time can be helpful. Say the same thing but change the words a bit. Do not linger on the conversation but rather continue doing things with them while they are talking. It will only become more frustrating for the caregiver if they solely focus on getting the information across

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  9. 1. “Well (Clients name) why don’t we go find out” You could make a memory box or label pictures for the future.
    2. :let me see if I can take care of that for you” reassure them and make them feel safe, do not deny the hallucination but do not lie.
    3. Offering support and suggestions. Give resources for education and further support. having an understanding of what’s happening and some education to deal with certain situations could be helpful.
    4. being respectful and listening is the best thing I could do. If they were open to ideas, I could offer to speak with the friends and help them understand the problem while I was there.
    5. Allowing the woman to do as she wishes would be the best way to approach the situation I believe. Advocating for the residents wants and needs to the other staff is what I would do. Try making these types of jobs more accessible for her could be beneficial.
    6. ” Oh alright, how about we wait over here. Would you like to do this activity while we wait”
    7. Make a joke and/or remove her from the situation. Depending on the daughters reaction, changing the subject or allowing her to deal with it s also and option.
    8. Understanding triggers, reading body language/non-verbals, explaining yourself and your actions as well and asking permission can usually help prevent any further incident. Know when to walk away!
    9. Continue to respond, maybe change how you respond, change the situation or surroundings, or change the subject.

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  10. 1. I can’t remember anything ever either, it’s OK! But I can go find out for you (if you didn’t know them)

    2.Let’s go see if we can scare him away!

    3. Depends on whether or not this is new confusion. If it is, report and suggest going to see a doctor. If it is not new, suggest a support group or ask if she has moved any furniture around recently.

    4. Explain to the friends that less questions is better and that too many questions makes him anxious and restless – and yes or no questions are best. Let the family know you will try to talk to the friends next time they drop by.

    5. Offer to let her fold some laundry or do some sweeping!

    6.We’re always waiting for men aren’t we?! And then use a distraction method.

    7.Remove the daughter from the situation and explain that he doesn’t recognize her for her. If appropriate make a joke to keep it light! or That’s not ok Bob!

    8. Make sure the water isn’t too hot or cold, hum/sing a song, talk with the resident

    9.Just keep answering the question! Use a distraction method.

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  11. 1. what if we give your daughter/son a call and have her/him tell you how your grandkids are doing
    2. okay I will go take a look and make sure that he is gone so that you can safely be in your room
    3. take out photo albums and gently talk about all the wonderful memories they shared throughout their marriage in that home, also making sure that there aren’t any underlying reasons for his confusion such as UTI, dehydration, lack or rest, etc.
    4. I think the best thing to do in this case would be to have a chat with the friends and make sure they are aware that the person may not remember or not have a clear memory to events that they are trying to speak about, to also make them aware that this person might not be able to answer complicated questions depending on the level of their dementia.
    5. it is not about what makes the staff happy and their job easier. There needs to be a person centred point of view and maybe allow her to sit down at a table and fold the laundry, if she is able to then have her pick up some of the dishes from the tables, maybe make a mix of water and vinegar and put it in a spray bottle and allow her to wipe down the tables or any other furniture that interests her to clean.
    6. invite her to have a cup of tea or coffee while you wait and ask her about Manuel and slowly distract her from that topic but make sure not to interrupt what she thinks is going on at the time as that can be very disheartening and stressful for them to find out.
    7. being that this is a father and daughter situation I can’t even imagine how horrible the daughter might feel if she is not fully aware of how dementia can affect a person and that some of their actions are out of their control. I would maybe make a comment such as “oh mr. mike lets keep our hands to ourself” in a nice way but still get the point across and separately ask daughter if she is okay and try to explain to her how dementia can affect a persons decision making.
    8. I think one of the best phrases to use is “you are safe” to assure them that you are there to help and not to harm. if situation gets too out of control I would make sure resident is safe and maybe step out to give them a few minutes and make someone aware of the situation I am finding myself in.
    9. If someone is asking over and over again they clearly do not remember anything you said. so to make things better trying giving different responses such as pointing at clock and telling them when big line hits two or in twenty minutes or when the cafeteria staff comes

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  12. 1. I would tell them not too worry about it and if I knew the names I would tell her them.
    2.”Is there? Why don’t we go take a look together and see if we can get him out of there?”
    3.Help explain to her that he may not remember that as his home anymore which is very normal and help provide emotional support for her.
    4.Speak to the friends in private and explain his situation and let them know that those questions are causing him anxiety and give examples of questions that would be better to ask.
    5. Explain to them that those are things that she enjoys and if they are keeping her busy let her continue to do them as long as she isn’t causing any harm.
    6. Make sure the daughter is aware that her mother will probably forget that he is deceased no matter how many times you tell her and suggest that she can let her know that if she sees him she will let her mother know right away.
    7. Make sure the daughter is aware that he doesn’t understand some boundaries now due to his Alzheimer’s and let her know that this is quite normal and to give herself space and try to distract him from the situation.
    8. Let the person know that we are there to help them and try asking them if there is anything we can do to make it more enjoyable ex. music, warmer or colder water, less people in the room, etc.
    9. Try giving them the answer in different ways and take a deep breath if you are beginning to become annoyed and remember that is not their intention.

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