What is it?
Communication is used to transmit ideas and influence people. Communication between a person living with dementia and others risks breaking down because of differences in their understanding of what is meant.
Carers can inadvertently inflame a situation when the wrong cues have been picked up or when their desires are unwittingly in conflict with those of the person with dementia.
Recognising common difficulties and developing appropriate responses helps to make everyone involved aware of possible misunderstandings so that they can be addressed.
Why is it important?
‘Behavioural disturbance’ in a person living with dementia can be thought of as an expression of their ‘unmet needs’.
It might look incoherent or aggressive to those not familiar with such methods of interaction, and might result in inappropriate behaviours being reflected back at the person living with dementia.
Such ‘unhelpful behaviours’ on the part of well-intentioned carers can be reduced through engagement in different ways.
Reducing behavioural disturbance in people living with dementia is vital to improving their quality of life: it will help to reduce institutionalisation and lower the need for potentially harmful psychotropic medications. Care-giver skill and improved social interaction have been shown to help this to happen.
A common example of behavioural disturbance is aggression towards others, which often indicates fear or frustration.
This can be helped by leading the person concerned into a calmer or more interesting environment.
- Always try to understand the cause of behaviour, using whatever clues are available. Listen carefully, and try to understand by drawing on your knowledge of the whole person.
- Try to avoid being overly judgemental of ‘bad’ behaviour, and also try not to take it personally.
- Consider if something you are doing or saying might be the cause of the distress.
- Try to balance the needs of everyone involved. Safety (for example, with gas) is an issue, but so is personal freedom for the person living with dementia.
- Be aware of the possible cultural reasons behind behaviour. What is normal for them? What do they expect to happen? What boundaries are there (in relation to touch, or to gender, for example)?
- Be creative and flexible in the solutions you offer. Think of alternatives: try to work around the problems of the person living with dementia.
- Avoid escalating bad situations. Don’t force issues.
- Is there an unmet need? Offer suggestions.
- Take your time. Allow the person as much time and space as possible.