By Jane Verity ©dementiacareinternational.com
It’s Not What We Say, It’s The Way That We Say It
Remember the old song; ‘It’s not what we say, it’s the way that we say it. It’s not what we do, it’s the way that we do it.’
Once a person has been diagnosed with dementia we tend to think they are no longer capable of being productive or able to contribute in a useful way. Traditionally this is reflected in the type of activity that is provided in formal settings. Many activities aim to fill in time or distract and divert challenging behaviour. For a person with dementia, these kinds of activities can be experienced as meaningless as they do not meet their emotional need to have purpose.
Turning Simple Activities into Meaningful Tasks
Meaningful activities can be any everyday job that needs doing such as the folding of washing or watering the garden. Many staff members are already creative with such ideas though they may not always get the results they had hoped. For example; ‘Rose’ is unsettled, wanders, and tends to go into other residents rooms; rummaging through their belongings. To address the behaviour in a constructive way a staff member, Isabella, places a pile of face washers in front of Rose and suggests she folds them. Rose reacts unexpectedly by pushing the pile aside and going back to wandering. Rose’s reaction does not reflect on the activity but rather on the lack of personal engagement.
For Rose to experience folding face washers as a meaningful activity, she needs to know that the result will make a difference to someone’s life. Isabella could instead ask Rose to help her out personally by saying, ‘Rose, I have this pile of face washers that needs folding, and I have no time! Could I ask you to help me?’ The experience of folding the face washers now shifts from a menial task to an important job that will help Isabella.
Here is another example…
A staff member, ‘Joe’ suggests to ‘Peter’ that it would be good for him to tidy up his own room, as it will help him to stay independent. Peter takes one look at Joe and responds strongly, ‘You are paid to do this job, not me!’ The actual activity was meaningful, but the way in which Joe engaged Peter resulted in him responding unexpectedly. It is helpful to remember that people with dementia are motivated by a strong desire to feel needed and useful. Instead Joe could say, ‘Peter, we have no one to make the beds or put clothes away today. Could I ask you for a hand? Could you help me by making your bed and hanging your clothes in the wardrobe? It would mean the world to me.’
Igniting the Spark of Life
In the Faeroe Islands, a gentleman was living in a small dementia home. Every morning he would get out of bed knowing he had an important job to do; tying large barbed fishing hooks into rows on coarse line for the local trawlers to use. This gentleman had moderate to severe dementia but no one could doubt his ability or safety in carrying out this task. He felt needed and useful, contributing to the community and making a difference in the fishermen’s lives. Every staff member regularly used descriptive appreciation to acknowledge his important work and support his role.
Meaningful activity can also be experienced in more subtle ways. For example, staff had sensed that ‘Jean’s’ unmet emotional need was to have the opportunity to care so they came up with a creative solution. Deliberately, they would turn over their shirt collars or do up their buttons unevenly. As soon as Jean noticed this, she would immediately adjust their clothes and give them a reassuring pat, ‘There you go darling, all fixed up.’ Jean was able to show her love and care and provided staff with an opportunity to use descriptive appreciation to boost her self-esteem.
Try these practical examples of what you can say to engage the person with dementia:
- ‘We are so short staffed. Could I ask you to give me a hand with the dishes?’
- ‘Could you help me? I have no time.’
After any job is completed, ensure you use descriptive appreciation to boost self-esteem and make the person with dementia feel special.
- Routine Chores or Inviting Rituals – Public/Extended Members article – Jane Verity – Learn positive strategies to create successful, meaningful & enriching rituals, special tips for creating evening rituals & encouraging reluctant sleepers, handy tips for stress-free teeth cleaning, showering & toileting. Read practical advice to avoid frustration, tips on trigger words & phrases to avoid & suggestions for overcoming some of the challenges in personal care.
- Validation – Public/Extended Members Article – Jane Verity – Validation is a way of listening and communicating that helps us explore, accept & understand the person with dementia who returns to the past. This approach is positive & non-judgmental as you simply explore further into what they are attempting to communicate.