The Story Of Marcella
Marcella was a very frail elderly lady who had to be in a wheelchair for the past few months; she was in early 90’s, had mild dementia and hearing impairment. This was a combination for great miscommunication!
Marcella continually wanted to be independent and do things she used to do on her own when she wasn’t in a wheelchair. For this reason, the staff in the care home monitored Marcella regularly.
Often she would go to her room and close the door and try to carry out tasks such as change her clothes and brush her teeth, which she needed help with. These activities were putting her safety at risk as it increased her changes of falling. The staff needed to prevent this unsafe behaviour, so their solution was to lock her room door so she could not go in.
Being Transparent In Your Approach
One day, I saw her in distress, pulling at her locked door and yelling for someone to open her door so she could enter. I came to find out what was going on. Marcella said that she was very angry that they had locked her out of her room and she wanted to go to bed. It was too loud for her to hear me in the hall where we were so I ushered her gently to a quieter place so she could hear me much clearer. I sat face to face in front of her at her eye level to make sure she could read my lips in the event she missed hearing some of my words.
I asked her, “It’s so early, why are you heading to bed now?” She said to me, “Well, it’s bed time. It’s 9 o’clock.” I looked at my watch and told her the time was only 4 o’clock and that it was too early for sleeping; we’re just about to have supper. It looked like she truly didn’t know it was afternoon and not evening. I showed her my watch for her to see proof. Whether Marcella saw the time or just believed me because of my transparent action of showing her my watch. Marcella took a moment and registered that it was not bedtime.
“Oh, well I don’t need to go to bed now do I!” she exclaimed. With a smile, I explained further that it was suppertime. And that it would be a shame to miss such a good home cooked meal. That was it….all she needed some clarification as to what time it was and what activity needed to be done next. Even though the staff had felt they found the right solution to prevent Marcella from unsafe situations, there was still the need to keep her at peace. She still had some reasoning skills but needed someone to provide the proper communication techniques to reduce her confusion…which took me all of 2 minutes.
Communication Breakdown
When we are caring for someone in the early stages of dementia, it can be difficult to determine what they can and cannot comprehend. We should not just assume they won’t comprehend. That they are not able to reason with; but rather try to communicate to the best of our abilities to avoid unnecessary anger or hostility.
Like Marcella, if someone has a hard time hearing and also has dementia, a communication breakdown can happen easily. It’s important to keep in mind how best to communicate for them. Such as taking them to a quiet place and talking slowly to them face to face. If this has not properly happened, caregivers can become frustrated as they may continue to see the unwanted behaviour.
Frustration from someone with Alzheimer’s disease or other related dementias is a sign that something is not right and that they need help and clarity…even if you need to use Therapeutic Reasoning™. If you’re having difficulty understanding your client/loved one’s actions, please contact us or call me at 778-789-1496 to help with interpreting actions and coming up with solutions to preventing communication breakdown.
Karen 🙂
Karen Tyrell, CDP, CPCA
Personalized Dementia Solutions
www.DementiaSolutions.ca
