Change the conversation in dementia care


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Today’s topic is all about how to change the conversation in dementia care.

I’m going to be telling you about how to change the conversation with the person living with dementia to ensure that things go in the right direction. A great example of this is a gentleman I worked with in one of my communities where I was a dementia care director a few years ago, and this gentleman’s name was Jack. He was in kind of an earlier stage of dementia, and really at that point he was great at making an argument as to why you were wrong but was just confused enough to be wrong about whatever the information was himself. That’s a tough spot to be in for most caregivers. So anyway, I remember one time Jack came out of his room and started yelling at all of the other residents.

He was pretty sure that this was his house, and that all of these uninvited people were over at his house. And he was like, why are you all here? And he starts freaking out. He’s yelling at everybody. And so I went over to him and I said, oh, Jack, I’m sorry, this is my fault. I invited everyone here so we could have a dinner party. I really hope that’s okay. I thought that you might like to have some friends over for dinner. This is my mistake. His demeanor changed completely. Suddenly he was like, oh, you, oh, well, that’s okay. That’s fine. Hey, everybody, thanks for coming over. And we ended up all going into the dining room and everybody was fine. I changed the situation. And the way that I changed the situation was by blaming myself, which is always a great tactic.

And then two, I gave him control over the situation or made him feel like really he was in control over the situation, which of course, it wasn’t because we were in dementia care and all of the people who were there lived there, but he felt like coming out of his room, who the heck are all these people? He’s mad. He didn’t feel like he was in control of the situation. I was able to give him back some of that control by gifting him the ability to feel like he’d done everybody a favor. Right? Now, suddenly he’s feeling like, Hey, it was great of me to have all these people at my house, right? Change the conversation. Don’t try to convince somebody living with dementia, oh, Jack, come on. You live here now and all these people live here now, and blah, blah, blah, blah. No, no, we’re not doing any of that. What we’re going to do is we’re going to change the conversation to fit where his reality is.

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Rachael Wonderlin is an internationally-recognized dementia care expert and consultant. She has a Master’s in Gerontology and is the author of three published books with Johns Hopkins University Press. Rachael owns Dementia By Day, a dementia care consulting and education company.

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