Thinking vs. Knowing
If you’ve heard me speak, followed me on social media, or worked with me, you know I’m in an auto-replay loop (also known as preaching) when it comes to respect, kindness, and love. I say every person living with dementia deserves to be treated with respect, kindness, and love. In every interaction.
I say it so often because I know it to be true. There’s a difference between knowing something intellectually, and knowing it in your bones. When you’re able to synthesize information to a point where it’s a part of you–in your bones–you’re unlikely to forget it.
It’s the difference between thinking and knowing: I’ve never been a millionaire, but I think I’d be darling at it (I’m with you, Dorothy Parker!), versus I know I hate being broke (thanks, life experience!).
I don’t just think we’re more likely to experience success as care partners if we treat people living with dementia with respect, kindness, and love in every interaction. I know it, because I’ve witnessed the difference it makes first-hand.
Behavioral Rehearsal
I’m certain we all agree that people living with dementia deserve to be treated with respect, kindness, and love. But what does that actually look like, in real-life situations?
As care partners, we’re already juggling chainsaws. That makes it difficult to think through scenarios in advance, figuring how we’ll react. We can be all for respect, kindness, and love–but still accidentally drop a buzzing chainsaw in the moment.
Thinking through possible scenarios in advance and determining what you’ll do in a given situation is called behavioral rehearsal. This is where you get to think about what adding respect, kindness, and love looks like in action.
The problem is that we often don’t have any idea what we’d do in a given situation, because we’re often surprised (shocked?) when x happens–it’s beyond our imagination. This is where having a script to work off comes in handy.
Using A (Generic) Script
A generic script looks something like this:
Before beginning the interaction, take a deep breath, be present in the moment, and focus on bringing respect, kindness, and love with you into the interaction.
Gain the person’s attention, get on their eye level, make eye contact.
Create rapport. Use short, concise communication. Smile. Have open body language.
Voila, success!
The generic version is more of a tip sheet, really. A more specific script looks something like this:
Using A (Specific) Script
Scenario: It’s time for Helen’s shower.
All of the generic stuff above +
Hi, Helen. [ ← Acknowledging Helen is an actual human being with a name!]
How are you this evening? [ ← Establishing rapport with Helen]
I saw your daughter was just here for a visit. [ ← Helen has an identity far beyond “person living with dementia;” in fact, she’s kind of a big deal–she’s somebody’s mom]
What’s she up to? [ ← Carer is interested in Helen’s story of the visit]
You must be so proud/That sounds fun/Other appropriate response [ ← Carer acknowledges listening to Helen’s story]
I’m here to help you get ready for bedtime. [ ← Not saying the dreaded ‘s-word’ and also stating the purpose for the carer’s visit]
Let’s go this way, okay? [ ← Carer has a plan, and states it matter-of-factly….Nothing threatening or demanding going on here]
Now imagine if Helen is instead approached with, “It’s time for your shower,” and the reaction that garners.
It probably goes something like, “I already had a shower,” or “I don’t need a shower.”
Watch Out for The Sinkhole
And that turns into an argument before you’ve even finished blinking, before you even realize that you’ve been pulled into the sinkhole of an argument.
Are you meaning to bring respect, kindness, and love? Of course you are! But as we know, things can go sideways so quickly, we’re playing catch up before we fully realized what just happened.
The Helen example is fairly obvious, of course. But what about this story my mom, who worked in long-term care for years, told me this weekend?
Judy & Sparky
A woman living with dementia–let’s call her Judy–reports being upset that her little dog Sparky has run away to Chowchilla. So Sparky has not just run away down the block, not just to another area of Fresno, not just to Madera, but to Chowchilla! Judy is understandably upset–who wouldn’t be when one’s dog takes up two towns over?
My mom listens empathetically and tells Judy she’s so sorry to hear that, that it’s just terrible. Judy seems comforted in the moment and moves on to a different topic of conversation.
My mom also witnesses when Judy’s son comes in later to visit. Judy tells him Sparky has run away to Chowchilla. The son quickly lets Judy know she needn’t worry about Sparky, because Sparky’s been dead for years.
The son leaves soon after, angrily muttering, “What’s wrong with her? Why can’t she remember that?”
Did the son think he was being kind? Loving? Respectful?
Do you think he was?
Time Is A Precious Commodity
I think he was faced with a distressed mom and didn’t know what to do. I think he forgot that people living with dementia have a problem with memory, and that no amount of “reality orientation” in the world is going to fix that–because they have dementia, after all.
I know–in my bones–that he would’ve had better results if he’d handled it differently; if he’d been thinking about respect, kindness, and love; if he’d run through a behavioral rehearsal or two so he’d have an idea of what to say rather than the first thing that popped into his head.
Time is a precious commodity; I understand that. Consider spending some time this week thinking about what respect, kindness, and love look like in your situation. Use behavioral rehearsal, sketch out a script, and practice. Reach out if you need an assist.
Time is finite in this lifetime. Do you want to think you handled difficult situations to the best of your ability and available knowledge at the time, or do you want to know?
Christy Turner is the founder of DementiaSherpa.com and has enjoyed the privilege of working with 1,123 people living with dementia and their families. Follow on Facebook, Google+, Instagram, Pinterest, Twitter, and YouTube. Content varies across platforms.