As we have written before; people with Dementia at times ‘live’ in their own reality, one which at times can be subtly or dramatically different from our own. This ‘inner reality’ they live in from moment to moment can cause them to perceive their surrounding environment differently than one normally would. As a result they may react unconventionally or inappropriately to the world around them. Read: Does Your Loved One Live In a Different Reality?
Those who have loved ones with Dementia may agree with me when I say that they at times seem absent-minded, like they are not there, not present… Like they have checked out and are in a different world. Perhaps they are simply more quiet than usual, perhaps they are more withdrawn. One of the early behavioral responses to ‘dealing’ with Dementia as a ‘victim’ is to withdraw more and more from social contact. Why does this happen?
It could be a strong fear the person with Dementia has towards others. Will they realize that something is wrong with me, with my brain? Will they think I’m going mad? Will they begin to pity me? Will they take advantage of me? Will I lose my social control? This tormenting fear could be enough to cause them to withdraw, or do whatever it takes to appear normal. Someone who has substantial experience interacting with someone with Dementia will know that they make use of various vices to curb the numbing realization to the fact that they are loosing control of their cognitive faculties. Ex, he/she may make use of verbal phrases to avoid certain questions. When asking factual questions like how old they are, how many children they have, what day it is today, etc; they may avoid them by making a joke, or abstract response. Ex, I’m older than the mountains, ooooh I have too many children you know, today is just another day, etc.
These types of factual questions that only have one correct answer could be enough to cause the person to withdraw into silence simply because saying nothing at all may be better than giving the wrong answer. They can also cause emotional discomfort such as irritation, anxiety and aggression.
So! One of the most meaningful tips we at the Jura Care Village can share with you is this: Keep your angle of conversation abstract. And by this we mean that you keep questions to a minimum, but when you do ask questions to try and keep them open-ended questions.
| Factual Questions | Abstract Questions |
|---|---|
| How old are you? | You’ve got a couple of years under your belt hey? |
| How many children do you have? | I think you were a very good mother/father. |
| What work did you do? | You look like you were a professor? |
| What did you eat today? | I heard you like eating ………. |
| Where do you come from? | I come from …….. Are you from here? |
| What day is it today? | We are having such great weather today. |
And so it is fundamental that we learn how to effectively communicate with these people we love so much. And learn how we can facilitate the opportunity for them to communicate effectively. That is why the Jura Care Team has created an insightful guide titled: Effective Communication – How To Engage People With Dementia Through Effective Interaction (pdf: 1.15MB)
Click Here To Open This Document
Also Read: How To Effectively Communicate With People With Dementia
Also Read: Just One Hour a Week of Social Interaction Helps Dementia Patients
My experience is that aged care staff delivering care to my Mother who is living with dementia are not providing adequate oral hygiene services to her. I am also aware of other carers and advocates with the same experience.
A common excuse is that it is difficult to attend to oral hygiene of a person living with dementia as they can become agitated and non compliant. My mother is a very compliant woman. A a result of poor oral hygiene, she has had to undergo teeth extraction by a mobile dental service which attends monthly at her facility.
We need comprehensive training in oral health for aged care staff and supported in full by care managers and boards of management. Training in managing changes in behaviour also need to be addressed. It is not good enough to simply place the responsibility back on the person with dementia. For family who are not living in close proximity to the facility, it is imperative that care staff look after this daily health requirement as family are unable to assist.
I understand the pressures on care staff and in reality my issue is not with them but with the organisational lack of understanding of the needs for increases in staffing ratios, particularly in facilities where the clients are vulnerable and frail and in need of extra support. Boards of Management need to realise what the staff at the coal face are tasked to do and the importance of their rolescaring and supporting our wonderful older generation.
Good day, we thank you for speaking out regarding the troubles experienced with the care of your mother and the challenges faced in the care industry. We fully agree with you regarding the importance of the elderly’s oral hygiene and the regular and proper attendance to their oral hygiene.
This boils down to training, training and more training. Here at the Jura Care Village we constantly train our carers both through monthly workshops and daily one-on-one programs.
We wish you and your mother all the best and hope that by voicing your troubles to the care home, they will understand and take appropriate action.
Kind Regards,
Johannes van Niekerk
Marketing Director
Thanks For your valuable videos.