Two of the best ways to respond to dementia who think they are at a different time or place

About One quarter of the hospital beds On acute totems – departments for patients who need strict care for sudden or severe diseases – are occupied by a person living with dementia in Great Britain.

Views, sounds and smells of the hospital environment and the lack of friends of guardians can be A significant challenge For people with dementia. Many healthcare employees think they don’t have Sufficient training for care Well, for them.

This can lead to some employees using less effective communication methods to reduce stress and anxiety in patients with dementia. For example, some carers can try to “improve” patients with dementia who seem confused with their surroundings or can employ a therapeutic lie – When lies are to alleviate the patient’s anxiety with dementia – to further avoid patients. Our research shows that there are two approaches that are more effective.

Management of competitive reality

Dementia affects people’s skills Employ the language, understand the employ of language by other people and remember things. One of the common challenges is the presence of competitive reality, in which a person with dementia is oriented for a different time or place. These competitive reality is often based on the previous experience of this person in a career or family role. For example, they can believe that the parent will come to take them home or that he must urgently leave to pick up his own child from school.

Managing these competitive reality can be challenging for carers in any environment. This is particularly challenging in a pointed ward, in which staff may not know much about the origin of the patient accepted for treatment for urgent medical needs, such as fracture or infection. Competitive reality can be the main source of stress for a dementia that may not recognize where they are or that they have any medical needs, and cannot understand why they are unable to leave when they ask.

We have been using my colleagues in recent years Video recordings of daily interactions of the branch To identify communication challenges that occur during care for people with dementia.

We developed Training in the field of communication skills focused on specific challenges. For example, coping with refusal of the necessary medical careAnswering It is hard to understand AND Effective closing of interactions. Recently, we focused on dealing with competitive reality and despair that they can cause.

Responding effectively

We found that there are four ways to respond to employees, but only two of them are effective in solving stress.

The first way is to confront or question the patient’s reality. For example, telling a person who thinks he is at home that he is really in the hospital. It is understandable why staff can do it, but we found that this usually does not lead to an agreement, and instead it can worsen suffering.

The second way is to deteriorate the patient’s reality. For example, agreeing that a deceased family member, such as a parent or spouse, will come to visit or pick up the patient later. Although this may work as a compact -term strategy, it is temporarily circumscribed because the promised event will never happen. This can ultimately worsen suffering. Wider debates on the subject “Therapeutic lie” People with dementia suggest that this should only be done if they are carefully thought out and planned, and only then as a last resort.

Read more: Can you lie to someone with dementia?

The third way is to find a certain aspect of the reality of a patient who can be divided without entering it. For example, if the patient claims that their (deceased) father arrives to pick them up, a member of healthcare workers may ask “Will you miss your dad?” It avoids lies, but reacts to the emotional tone of the patient and allows you to share feelings.

For a person who was worried that she had left a child or a pet at home, a health care worker can say: “Your neighbor looks after everything at home.” This ensures general assurance without confirming or questioning details. For a patient who repeatedly asks for a return home because he does not recognize their medical needs, asking: “What would you do if you were at home?” It can identify the need or desire – for example, download tea, walking or watching a TV – which can be found in the hospital environment.

Alternatively, the staff used diversion. The topic of the conversation can be moved away from the problem that caused anxiety towards something else that a person could involve.

Sometimes it attracted a direct environment – for example, view of the window. Sometimes they offered alternative activity, for example, going to a room or a drink. When no other possibilities were available, they sometimes asked a dementia a question that could lead to another conversation.

These approaches are critical for carers in any environment. Even in the context of a busy, environmental pressure, in which carers may not know much about the person, slight differences in the way they communicate can have a deep impact on the care and well -being of people living with dementia.