communication and validation strategies for residents with dementia presented by homecare rehab and...
TRANSCRIPT
![Page 1: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/1.jpg)
Communication and Validation Strategies for
Residents with Dementia
Presented by HomeCare Rehab and Nursing LLC
![Page 2: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/2.jpg)
CommunicationOverview of Abilities
– Common problem is an increase in verbal conflicts as ability to communicate decreases; word finding problems and losing the thread of a story.
– Decrease in ability to censor self leads to more blunt, direct, and socially inappropriate comments.
– Argue to protect pride, act defensive and less cooperative; refuse often.
– Reading to follow directions is not reliable.
Copyright © 2003
![Page 3: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/3.jpg)
CommunicationStrategies
– Get inside visual field (2-4 feet in front).– Keep verbal directions clear and simple; avoid
“conservational speech” while guiding patient through a task.
– Allow time to respond before asking question again- ask again exactly the same way.
– Limit choices and open ended questions: Don’t ask: “What do you want for breakfast?”Ask: “Would you like cereal or pancakes?”
Copyright © 2003
![Page 4: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/4.jpg)
Communication
Strategies– DO NOT EVER ARGUE!– Memory books may be effective with training if
the resident values it.– Can learn schedule of activities if caregivers
consistently remind them to use it.– Communication board may be effective to
make choices- no more than 2 to 4 options.– Don’t hang a sign to improve safety or
orientation.
Copyright © 2003
![Page 5: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/5.jpg)
Communication
Overview of Abilities – Can name familiar items, can state own
name, can say “you and I” appropriately.– Can speak in short phrases.– Talks to self frequently.– Repeats self, asks questions over and over.– Phrases may have meaning only to the
patient.
Copyright © 2003
![Page 6: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/6.jpg)
Communication
Strategies• Get in visual field before speaking or touching
(14 inches in front).• Avoid asking questions that require more than
yes or no.• Show a positive response to all communication
attempts.• Stop what you are doing and make eye contact.• Lower the pitch of your voice.
Copyright © 2003
![Page 7: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/7.jpg)
Communication
Strategies• Use distraction to answer repetitive questions
once you have determined there are no other needs. Reassure often.
• Responds best to demonstrated commands.• Assume that the person understands everything
you are saying- don’t talk about them, talk to them.
• Scolding or lecturing is highly inappropriate and ineffective.
Copyright © 2003
![Page 8: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/8.jpg)
Communication
Overview of Abilities• May speak incoherently but sing a full song
without errors.• Uses one or two random words to communicate.• Able to say “no”.• May be able to identify body parts when
touched.• Uses gestures to communicate until very late
stages (claps, points, waves).
Copyright © 2003
![Page 9: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/9.jpg)
Communication
Strategies
• Keep cues limited to 2 or 3.
• Get in visual field (less than 12 inches directly in front of patient).
• Use all senses to engage patient’s attention.
• Lower your voice.
Copyright © 2003
![Page 10: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/10.jpg)
Validation
What is validation?
1. Letting the patient know that you accept and respect their feelings.
2. Standing in their shoes- empathy.
3. Making them feel important and intelligent.
Copyright © 2003
![Page 11: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/11.jpg)
ValidationHow do we validate a patient?
1. Match the intensity of their emotions with your response.
2. Do not lie or belittle, let them know you hear them.
3. Do not try to orient a confused or frustrated patient.
4. Take opportunity to redirect them if they offer- don’t come up with an unrelated distraction.Yes: “It sounds like your father was very caring.”
No: “Your father is dead. Did you see the weather outside?”
Copyright © 2003
![Page 12: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/12.jpg)
Communication
Absolute No No’s
1. No parenting, disciplining, scolding.
2. No baby talk.
3. No arguing.
4. No negative body language (disgust, frustration, boredom, impatience).
5. No talking about patients in front of patients.
Copyright © 2003
![Page 13: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/13.jpg)
Communication and Validation Strategies for
Residents with Dementia
Presented by Sue Paul, OTR/L
![Page 14: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/14.jpg)
CommunicationOverview of Abilities
– Common problem is an increase in verbal conflicts as ability to communicate decreases; word finding problems and losing the thread of a story.
– Decrease in ability to censor self leads to more blunt, direct, and socially inappropriate comments.
– Argue to protect pride, act defensive and less cooperative; refuse often.
– Reading to follow directions is not reliable.
Copyright © 2003
![Page 15: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/15.jpg)
CommunicationStrategies
– Get inside visual field (2-4 feet in front).– Keep verbal directions clear and simple; avoid
“conservational speech” while guiding patient through a task.
– Allow time to respond before asking question again- ask again exactly the same way.
– Limit choices and open ended questions: Don’t ask: “What do you want for breakfast?”Ask: “Would you like cereal or pancakes?”
Copyright © 2003
![Page 16: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/16.jpg)
Communication
Strategies– DO NOT EVER ARGUE!– Memory books may be effective with training if
the resident values it.– Can learn schedule of activities if caregivers
consistently remind them to use it.– Communication board may be effective to
make choices- no more than 2 to 4 options.– Don’t hang a sign to improve safety or
orientation.
Copyright © 2003
![Page 17: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/17.jpg)
Communication
Overview of Abilities – Can name familiar items, can state own
name, can say “you and I” appropriately.– Can speak in short phrases.– Talks to self frequently.– Repeats self, asks questions over and over.– Phrases may have meaning only to the
patient.
Copyright © 2003
![Page 18: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/18.jpg)
Communication
Strategies• Get in visual field before speaking or touching
(14 inches in front).• Avoid asking questions that require more than
yes or no.• Show a positive response to all communication
attempts.• Stop what you are doing and make eye contact.• Lower the pitch of your voice.
Copyright © 2003
![Page 19: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/19.jpg)
Communication
Strategies• Use distraction to answer repetitive questions
once you have determined there are no other needs. Reassure often.
• Responds best to demonstrated commands.• Assume that the person understands everything
you are saying- don’t talk about them, talk to them.
• Scolding or lecturing is highly inappropriate and ineffective.
Copyright © 2003
![Page 20: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/20.jpg)
Communication
Overview of Abilities• May speak incoherently but sing a full song
without errors.• Uses one or two random words to communicate.• Able to say “no”.• May be able to identify body parts when
touched.• Uses gestures to communicate until very late
stages (claps, points, waves).
Copyright © 2003
![Page 21: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/21.jpg)
Communication
Strategies
• Keep cues limited to 2 or 3.
• Get in visual field (less than 12 inches directly in front of patient).
• Use all senses to engage patient’s attention.
• Lower your voice.
Copyright © 2003
![Page 22: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/22.jpg)
Validation
What is validation?
1. Letting the patient know that you accept and respect their feelings.
2. Standing in their shoes- empathy.
3. Making them feel important and intelligent.
Copyright © 2003
![Page 23: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/23.jpg)
ValidationHow do we validate a patient?
1. Match the intensity of their emotions with your response.
2. Do not lie or belittle, let them know you hear them.
3. Do not try to orient a confused or frustrated patient.
4. Take opportunity to redirect them if they offer- don’t come up with an unrelated distraction.Yes: “It sounds like your father was very caring.”
No: “Your father is dead. Did you see the weather outside?”
Copyright © 2003
![Page 24: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/24.jpg)
CommunicationOverview of Abilities
– Common problem is an increase in verbal conflicts as ability to communicate decreases; word finding problems and losing the thread of a story.
– Decrease in ability to censor self leads to more blunt, direct, and socially inappropriate comments.
– Argue to protect pride, act defensive and less cooperative; refuse often.
– Reading to follow directions is not reliable.
Copyright © 2003
![Page 25: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/25.jpg)
CommunicationStrategies
– Get inside visual field (2-4 feet in front).– Keep verbal directions clear and simple; avoid
“conservational speech” while guiding patient through a task.
– Allow time to respond before asking question again- ask again exactly the same way.
– Limit choices and open ended questions: Don’t ask: “What do you want for breakfast?”Ask: “Would you like cereal or pancakes?”
Copyright © 2003
![Page 26: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/26.jpg)
Communication
Strategies– DO NOT EVER ARGUE!– Memory books may be effective with training if
the resident values it.– Can learn schedule of activities if caregivers
consistently remind them to use it.– Communication board may be effective to
make choices- no more than 2 to 4 options.– Don’t hang a sign to improve safety or
orientation.
Copyright © 2003
![Page 27: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/27.jpg)
Communication
Overview of Abilities – Can name familiar items, can state own
name, can say “you and I” appropriately.– Can speak in short phrases.– Talks to self frequently.– Repeats self, asks questions over and over.– Phrases may have meaning only to the
patient.
Copyright © 2003
![Page 28: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/28.jpg)
Communication
Strategies• Get in visual field before speaking or touching
(14 inches in front).• Avoid asking questions that require more than
yes or no.• Show a positive response to all communication
attempts.• Stop what you are doing and make eye contact.• Lower the pitch of your voice.
Copyright © 2003
![Page 29: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/29.jpg)
Communication
Strategies• Use distraction to answer repetitive questions
once you have determined there are no other needs. Reassure often.
• Responds best to demonstrated commands.• Assume that the person understands everything
you are saying- don’t talk about them, talk to them.
• Scolding or lecturing is highly inappropriate and ineffective.
Copyright © 2003
![Page 30: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/30.jpg)
Communication
Overview of Abilities• May speak incoherently but sing a full song
without errors.• Uses one or two random words to communicate.• Able to say “no”.• May be able to identify body parts when
touched.• Uses gestures to communicate until very late
stages (claps, points, waves).
Copyright © 2003
![Page 31: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/31.jpg)
Communication
Strategies
• Keep cues limited to 2 or 3.
• Get in visual field (less than 12 inches directly in front of patient).
• Use all senses to engage patient’s attention.
• Lower your voice.
Copyright © 2003
![Page 32: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/32.jpg)
Validation
What is validation?
1. Letting the patient know that you accept and respect their feelings.
2. Standing in their shoes- empathy.
3. Making them feel important and intelligent.
Copyright © 2003
![Page 33: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/33.jpg)
ValidationHow do we validate a patient?
1. Match the intensity of their emotions with your response.
2. Do not lie or belittle, let them know you hear them.
3. Do not try to orient a confused or frustrated patient.
4. Take opportunity to redirect them if they offer- don’t come up with an unrelated distraction.Yes: “It sounds like your father was very caring.”
No: “Your father is dead. Did you see the weather outside?”
Copyright © 2003
![Page 34: Communication and Validation Strategies for Residents with Dementia Presented by HomeCare Rehab and Nursing LLC](https://reader030.vdocuments.net/reader030/viewer/2022032517/56649c9e5503460f9495d5cd/html5/thumbnails/34.jpg)
Communication
Absolute No No’s
1. No parenting, disciplining, scolding.
2. No baby talk.
3. No arguing.
4. No negative body language (disgust, frustration, boredom, impatience).
5. No talking about patients in front of patients.
Copyright © 2003