Communication Strategies & Managing Difficult Behaviors
All Behavior is Communication
As dementia physically changes the brain, communication is affected—both giving and receiving. Someone with dementia may need to use their behavior as a way to communicate. Some common behavioral symptoms are:
- Anxiety or agitation
- Sleep disturbances
Situations that are often considered “challenging” by caregivers can usually be prevented.
Here are some communication strategies that may help! Call ADRC (920) 448-4300 for more information.
Caring for a Person with Dementia:
Person with Dementia: “I need to call my daughter. She was supposed to pick me up!”
Caregiver: “Oh, you must be worried.”
DO: Begin by validating the feeling and give a word to the emotion.
DON’T: Dismiss the person with dementia.
Why? Validation can reduce stress and agitation. The emotion is more important than the reason behind it.
Person with Dementia: “Where did you put my wallet?”
Caregiver: “I’m sorry, I must have moved it.”
DO: Take responsibility for things even if it wasn’t your fault.
DON’T: Turn the blame back on the person with dementia
Why? An apology is a great way to allow a person to move forward in a conversation.
Person with Dementia: “I’ve lost my purse. I had it right here.”
Caregiver: “Don’t worry, I’ll help you find it.”
DO: Ensure the person with dementia feels that help is on the way.
DON’T: Take the opportunity to orient the person with dementia.
Why? Whether a person has dementia or not, statements of reassurance are naturally calming.
Person with Dementia: “I need to go to the bank and get my money out.”
Caregiver: “Yes, let’s go for a drive this afternoon. Let’s eat lunch first.”
DO: Respond affirmatively, then offer another activity to do first.
DON’T: Reorient the person and explain that they no longer need to go to the bank.
Why? Redirect on or distraction is one of the most effective ways to change the thought process of your loved one with dementia.
Person with Dementia: “I want to go home. This is not my home.”
Caregiver: “You grew up on a farm, right?”
DO: Identify their request as an attempt to connect and communicate an anxiety emotion.
DON’T: Try to convince them that they are “home” and reorient them.
Why? Forcing a person with dementia to accept parts of reality that they cannot understand is harmful.
Bring it all Together
Person with Dementia: “Nobody is going to make decisions for me. You can go now…and don’t come back!”
Caregiver: “I’m sorry (APOLOGIZE), this is a tough time (VALIDATE).
I love you and we’re going to get through this together (REASSURE).
It is important that you make your own decisions (DON’T REORIENT).
You know what? I got a new recipe for banana bread (REDIRECT).
I think you love banana bread.”
The Dementia Care Specialist (DCS) can work one-on-one with caregivers to help understand and manage difficult behavioral symptoms.
The DICE Approach stands for Describe, Investigate, Create, and Evaluate. Its purpose is to manage difficult behaviors to reduce overreliance on medications.
With the support of the Wisconsin Alzheimer’s Institute, the DCS can help walk through this step-by-step, evidence-informed approach that caregivers and loved ones can continue to use to help problem-solve independently.
Interested in learning about the DICE Approach? Call ADRC (920) 448-4300.