Dementia: Improving Communication with Improv | Mirroring Technique
Kathleen Warshawsky, BSN, RN
For more information about the author, click to view their website: Seniors Blue Book Greater Dallas
Mar 24, 2023
Non-Book Market , Texas - Dallas, Collin, SE Denton & Rockwall Counties
Email US
Click to Email Us
Dementia: Improving Communication with Improv | Mirroring Technique is part of a six-part series. Dementia is a degenerative neurological condition that affects millions of people worldwide. As the disease progresses, individuals with dementia may experience difficulties with communication, including problems with memory, language, and understanding. This can make it challenging for caregivers and family members to connect with their loved ones and provide the best possible care. However, there is a promising solution to this challenge: improv. In this six-part series, we will explore how improvisational theater techniques can be used to improve communication and connection with individuals with dementia. By tapping into the power of improv, caregivers can learn how to communicate more effectively, build rapport, and create meaningful experiences with their loved ones.
Dementia is a debilitating condition that affects millions of people around the world. It is a progressive disease that affects memory, thinking, behavior, and the ability to perform daily tasks. As the disease progresses, individuals with dementia may have trouble communicating and may become withdrawn and isolated. However, with the right approach and support, individuals with dementia can still achieve good quality of life.
One approach to supporting individuals with dementia is to meet them where they are at. This means that care providers should strive to understand the individual's unique perspective, experiences, and needs. This approach can help to reduce frustration, confusion, and anxiety and promote a sense of well-being and connectedness.
To meet individuals with dementia where they are at, care providers can use a range of strategies. One of these strategies is the Mirroring technique. Learning the Mirroring technique can ultimately improve the quality of life for individuals with dementia and their caregivers.
Mirroring technique
The mirroring technique is an improvisation technique that involves reflecting the body language, facial expressions, and verbal communication of another person to build rapport and establish a connection. The goal is to create a safe and comfortable space for communication by demonstrating empathy and understanding.
When using the mirroring technique, the caregiver or healthcare provider closely observes the person with dementia and mirrors their movements, posture, facial expressions, and vocal patterns. This technique can help the person with dementia feel validated and understood, even if they are unable to express themselves verbally.
The mirroring technique involves the following steps:
- Observe the person with dementia: Watch the person carefully, paying attention to their movements, facial expressions, and vocal patterns. Take note of any gestures or expressions that seem to communicate an emotion or a need.
- Mirror the person's body language: Mirror the person's movements, posture, and gestures. For example, if the person is leaning forward, the caregiver may lean forward as well. If the person is using hand gestures, the caregiver may use similar gestures.
- Mirror the person's facial expressions: Mirror the person's facial expressions, such as smiling, frowning, or raising eyebrows. This can help the person feel understood and validated.
- Mirror the person's vocal patterns: Mirror the person's tone of voice, volume, and pacing. This can help the person feel that they are being heard and understood.
- Gradually introduce communication: Once a connection has been established through mirroring, the caregiver or healthcare provider can gradually introduce communication, such as asking questions or making statements that reflect the person's emotions or needs.
By using the mirroring technique, caregivers and healthcare providers can establish a connection with the person with dementia, creating a safe and comfortable space for communication and building trust. This technique can help improve communication and reduce feelings of frustration or anxiety for the person with dementia.
Teaching The Mirroring Technique
Teaching someone to use the mirroring technique can be a helpful way to improve communication with someone with dementia. Here are some steps you can follow to teach someone how to use the mirroring technique:
- Explain the concept: Start by explaining what the mirroring technique is and how it can be used in communication. Explain that the goal is to repeat what the other person is saying, using the same tone of voice and body language. Emphasize that this can help the other person to feel heard and understood.
- Model the technique: Demonstrate the technique by having a conversation with the person and using the mirroring technique. Start by saying something and then repeat what the other person says, using the same tone of voice and body language. For example, if the person says, "I'm feeling confused," you might respond, "You're feeling confused." Make sure to emphasize the importance of using the same tone of voice and body language.
- Practice the technique: Give the person the opportunity to practice the technique. Start by having them say something and then repeat what they say, using the same tone of voice and body language. Encourage them to focus on the other person's words and emotions and to reflect those back to them.
- Provide feedback: As the person practices the technique, provide feedback and encouragement. Help them to identify areas where they can improve and emphasize the importance of using the same tone of voice and body language.
- Reinforce the technique: Encourage the person to use the mirroring technique in their daily communication. Reinforce the technique by reminding them to repeat what the other person says, using the same tone of voice and body language.
Example of how the mirroring technique can be used with someone with advanced dementia:
Imagine a caregiver is visiting a person with advanced dementia in a care facility. The person with dementia is sitting in a chair, looking down and not engaging with the caregiver. The caregiver wants to try the mirroring technique to build rapport and help the person feel more comfortable.
The caregiver approaches the person and sits down in a chair across from them. The caregiver notices that the person is frowning, so they mirror this facial expression by furrowing their own brow. The caregiver then slowly begins to shift their facial expression to a more neutral one, and they notice that the person with dementia begins to relax their own facial expression as well.
The caregiver continues to mirror the person's body language and facial expressions as they interact. When the person leans back in their chair, the caregiver does the same. When the person leans forward, the caregiver follows suit. As they continue to mirror each other, the person with dementia begins to make eye contact with the caregiver and smile.
The caregiver then uses this positive engagement to begin a conversation with the person, asking open-ended questions and using the "yes, and" technique to build on their responses. Using the mirroring technique, the caregiver was able to build rapport and create a positive and engaging environment for the person with advanced dementia.
Using the mirroring improv technique in caregiving can greatly enhance the caregiver's relationship with their loved one with dementia. By accepting and validating the individual's experience, caregivers can build trust, improve communication, and increase their loved one's sense of safety and comfort. Improv also allows for creative problem-solving and flexibility, which can be crucial in adapting to the individual's changing needs and abilities. Ultimately, incorporating improv as a form of communication can lead to a more positive, meaningful, and fulfilling relationship between the caregiver and their loved one with dementia.
Read all of the articles in this six-part series on Dementia: Improving Communication with Improv
Dementia: Improving Communication with Improv | Overview
Dementia: Improving Communication with Improv | "Yes and..." Technique
Dementia: Improving Communication with Improv | Mirroring Technique
Dementia: Improving Communication with Improv | Storytelling Technique
Dementia: Improving Communication with Improv | Role-playing Technique
Dementia: Improving Communication with Improv | Musical Improvisation technique
Author: Kathleen Warshawsky, BSN, RN | Publisher Seniors Blue Book Greater Dallas | https://www.linkedin.com/in/kathleenwbsnrn/
References:
Alzheimer's Association. (2021). Communication and Alzheimer's. Retrieved from https://www.alz.org/help-support/caregiving/daily-care/communications
Goldsmith, L., & Goldsmith, J. (2019). Communication and dementia. American Family Physician, 99(11), 684-691.
Graff, M. J., Adang, E. M., Vernooij-Dassen, M. J., Dekker, J. H., Jönsson, L., Thijssen, M., ... & Rikkert, M. G. (2006). Community occupational therapy for older patients with dementia and their care givers: cost effectiveness study. BMJ, 333(7580), 1196.
Guzmán, A., & Hegarty, J. (2018). A systematic review of drama therapy interventions for dementia care. Aging & Mental Health, 22(10), 1309-1319.
Hsu, M. H., Flowerdew, R., Parker, M., Fachner, J., & Odell-Miller, H. (2018). A thematic analysis exploring group music psychotherapy for people with dementia in the UK. Journal of Applied Arts & Health, 9(1), 75-87.
Kales, H. C., Gitlin, L. N., & Lyketsos, C. G. (2015). Assessment and management of behavioral and psychological symptoms of dementia. BMJ (Clinical research ed.), 350, h369.
Raglio, A., Bellelli, G., Traficante, D., Gianotti, M., Ubezio, M. C., Villani, D., ... & Stramba-Badiale, M. (2015). Efficacy of music therapy in the treatment of behavioral and psychiatric symptoms of dementia. Alzheimer Disease and Associated Disorders, 29(2), 158-163.
Raglio, A., Gianotti, M., Manzoni, V., Bolis, S., Ubezio, M. C., Villani, D., & Stramba-Badiale, M. (2016). Effects of improvisational music therapy vs enhanced standard care on symptom severity among patients with Alzheimer disease: The IMT-ALZ randomized clinical trial. JAMA Neurology, 73(7), 797-805.
Van't Leven, N., Prick, A. E., Groenewoud, J. G., Roelofs, P. D., de Lange, J., Pot, A. M., & Van't Leven, N. (2013). Communication enhancement between dementia care professionals and dementia patients during daily care. Aging & Mental Health, 17(5), 555-568.
Other Articles You May Like
How Spiritual Counseling Helps Families Through Medicare Hospice
In health care settings, the body gets medical attention, but the mind and soul matter, too. Older adults in medical care face a battery of health questions, but too often the most consequential one goes unasked and unanswered: What does a good day look like for you today?Medicare requires people to receive a spiritual assessment within their first five days of admission into hospice. Many states allow a nurse to conduct the initial spiritual assessment, but I think it helps both the person and the health care provider for the assessment to be done with someone who has theological training. Many have been certified in clinical pastoral education, or CPE. Nurses can get so focused on the technical to-do lists of medical work the measurements, the tests, the drug regimens that it can be hard to make time for the issues that matter most to the living human, namely, their happiness, peace and contentment. As a spiritual care provider with 17 years in senior care facilities, and as a chaplain in the Army National Guard and Air Force National Guard, I have counseled hundreds of people in the final days of their lives. For older adults and their families, one of the most valuable resources is also little-known a Medicare option that provides spiritual counseling for people in hospice. Longing for ConversationToo often older adults in care are being talked at, not listened to. Many times, I've found that people in the last chapter of life want to discuss their path to the end more than their medical professionals and, especially, more than their loved ones. It often helps to have that discussion with a professional who is trained to hear them, and, if requested, to comfort and advise them. RecommendedOpinion: Why I Went on Hospice Even Though I'm Not Dying | Personal PerspectivesThe code of ethics for the leading chaplain and spiritual care associations all prohibit proselytizing. A spiritual care provider should be able to work with someone on their own terms, no matter their beliefs. The United States may be turning more secular, but the fact remains that older adults are the most faith-affiliated of any demographic age group.This initial spiritual meeting is likely to be about the basics: Is the person religious? What is their support system? Will a certain faith-based ritual bring meaning or comfort? Do they have a preferred faith leader? Or is a secular discussion a better fit for the person's beliefs?
Guardianship of an Elderly Parent: Understanding the Process and Responsibilities
Guardianship is a serious legal process that serves as a last resort for caring for an elderly parent who can no longer make sound decisions for themselves. It requires a court hearing and confirmation of incapacity by medical providers.What is Guardianship?Guardianship means an individual is appointed by the court to make medical decisions and manage daily care for an elderly parent. This typically occurs when an elderly parent:Is diagnosed with cognitive impairments like dementia or Alzheimer's diseaseHas suffered brain injuriesExperiences serious health conditions that impair decision-making abilitiesKey Considerations in GuardianshipEmotional ChallengesDeciding to pursue guardianship often involves mixed emotions. Adult children may feel uncomfortable, especially if family members disagree about the necessity of guardianship.Legal RequirementsTo establish guardianship, documentation must be submitted to the court that:Substantiates the degree of cognitive impairmentProvides evidence of poor decision-makingIncludes a medical assessment, potentially a neuropsychological evaluationTypes of GuardianshipGuardian ResponsibilitiesMake medical decisionsManage daily careAdvocate for the elderly parent's best interestsFollow the principle of substituted judgment (making decisions the parent would make)ConservatorshipIn most situations, a conservator is also appointed to manage money and property. This can be the same person as the guardian or a separate individual.Challenges of GuardianshipAdvocacy and Medical InteractionsGuardians must:Navigate complex healthcare systemsCommunicate with medical professionalsUnderstand and research medical conditionsMake thorough, prudent decisionsFamily DynamicsGuardianship can create:Potential conflicts between family membersDisagreements about care and spendingEmotional stress that may damage relationshipsState-Specific ConsiderationsGuardianship laws and terminology vary by state. Some states have:Different definitions of guardianshipVarying availability of professional guardiansUnique legal frameworks for elder careImportance of PreparationRecommended StepsHave early discussions about care preferencesDocument the elderly parent's wishesUnderstand the full scope of guardianship responsibilitiesSeek support and resources for caregiversAs the population ages and chronic diseases become more prevalent, understanding guardianship becomes increasingly important for families caring for elderly parents.
Holiday Check-In: Ensuring Your Loved Ones Well-Being This Season
Check In on Your Loved One During the Holidays The holiday season is a time for family gatherings, traditions, and reconnecting with loved ones. Its a wonderful opportunity to catch up and celebrate, but its also the perfect chance to check in on elderly parents or relatives to ensure theyre doing well. Sometimes, these visits can provide insight into their health, well-being, and overall quality of life that you might not see from a distance.Here are some signs to look for during your visit: Changes in personal hygiene: Noticeable neglect of bathing, grooming, wearing clean clothes, or maintaining trimmed nails. Pay attention to mobility issues, recent falls, or unexplained bruising. Medication management: Look for missed doses, expired prescriptions, or general confusion about their medication routine. These are all signs they might need help managing their health. Living space upkeep: Take note of unkempt homes with piled laundry, misplaced items, spoiled food, or clutter that could pose a fall risk, like throw rugs or poorly placed cords. Emotional or cognitive changes: Watch for signs of depression, forgetfulness, confusion, loneliness, or isolation. These shifts can indicate underlying health issues. Financial management struggles: Keep an eye out for stacks of unopened mail, unpaid bills, or disorganized storage of important documents. Difficulty handling finances is a common red flag. Driving concerns: If theyre still driving, check their car for signs of accidents, such as scrapes or dents.What to Do if You Notice Changes If you spot signs of decline, here are steps you can take to address your concerns:1. Take notes: Write down your observations. Keeping a detailed list of your concerns will help when speaking with your loved one or their healthcare provider. 2. Start the conversation: Share your observations in a compassionate and nonjudgmental way. Use this as an opportunity to discuss their needs and explore support options, such as assistance with daily activities, companionship, or meal services. 3. Consult their doctor: Reach out to their primary care provider to share your concerns and learn about any recommendations. The doctor may already have insights into their health or suggest scheduling a physical or needs assessment. 4. Explore senior living options: If additional support seems necessary, consider visiting senior living communities to understand the available levels of care, such as independent living, assisted living, or memory care. Touring a community can help determine if its the right fit for your loved one.Tips for Having the Conversation Discussing a loved ones needs can be delicate. Here are some tips to make the conversation more effective and compassionate: Pick the right time: Choose a quiet, private moment to bring up your concerns. Avoid discussing sensitive topics during large family gatherings or high-stress situations. Be empathetic: Acknowledge their feelings and emphasize that you want to support them in maintaining their independence and quality of life. Involve them in decisions: Wherever possible, let them take an active role in deciding how to address their needs. This helps them feel respected and in control. Focus on solutions: Frame your concerns around finding practical ways to help, rather than simply pointing out problems.Why the Holidays Are a Perfect Time to Check In The holidays offer a rare opportunity to see your loved ones in person and observe any changes in their behavior, health, or environment. With everyone gathered together, its also easier to have collaborative conversations with other family members about how best to support them.By being proactive during your holiday visit, you can help ensure your loved one gets the care and support they need to stay happy and healthy. Whether that means arranging for extra assistance at home or exploring senior living options, taking action now can make a meaningful difference in their quality of life.
Local Services By This Author
STAP (Specialized Telephone Assistive Program)
Hearing/Deaf Products , , Texas,If You Have A Hearing, Vision Or Mobility Problems Accessing Or Using A Telephone - You May Qualify For A Free Telephone! 4 out of 5 Americans over the age of 60 have some hearing, vision or mobility loss. There is help however and it is paid for by you through a government program called STAP, Specialized Telecommunications Assistance Program, by a small charge each month on your telephone bill. Why not take advantage of a benefit youre paying for already? Contact Laura Carr, STAP to learn more about this program and show you what equipment youre eligible to receive FREE OF CHARGE! To qualify, you must be a Texas resident with a problem with vision, hearing or mobility. You are entitled to one FREE phone every 5 years. You can get a cell phone, landline, smartphone or tablet, depending on your disability. Must provide proof of residency. Acceptable forms of residency include:* Texas Drivers License* ID card with address* Voters Registration card* Letter from facility on their stationery* Utility Bill (current - showing address)* Vehicle registration card* Medicaid ID* Medicare Summary This program is for any Texas Resident that has a Vision, Hearing, Mobility- including cognitive problems. They are entitled to FREE telephone equipment (just the device) and they have to pay their monthly charges to their telephone service provider. Depending on their impairment, they may qualifiy for a Landline Telephone with a medical alert system; a Regular Cell Phone (where they can make calls, text, take photos including a medical alert button on the back. If they have a hearing problem, they can receive a 2-way texting device - an Android Smart Phone or Android Tablet. They have to provide their proof of residency for the State of Texas: a current drivers license, Texas ID, Voters Registration Card or a Utility bill showing their name & current address & date. Laura can assist with completing an application, take a photo of their proof of residency - attach to their signed application & send it to STAP headquarters in Austin, Texas. The State processes their application & mails the Voucher for the equipment, directly to the Resident. Once they receive the Voucher, they contact Laura and she will deliver the equipment that is authorized on the voucher to the Resident. NO MONEY CHANGES HANDS. Laura Carr, STAP Specialist has worked with this program for 16 years.Contact Laura at 214-388-0088 or LauraCarr@prodigy.net
Lifeline Screening
Medical & Wellness , , ,Dont Let a Stroke Ruin Your RetirementYour risk of stroke and cardiovascular disease increases as you age. But the good news is 80% of stroke and cardiovascular disease CAN be prevented.1 If you are age 50 or older, you should be screened.Often there arent any symptoms of a stroke before it occurs, in fact for 4 out of 5 people who have a stroke the first symptom of any illness is the actual stroke.2 But, you can take steps to find out if youre at risk.Life Line Screening is a premier provider of preventive screenings for stroke and cardiovascular disease risk. A simple appointment can identify your risk factors and provide peace of mind or early detection.Screenings are easy, painless, non-invasive and dont require any messy prep work.Life Line Screening has over 14,000 locations across the United States so you can find one close to you.Getting screened is affordable. The most popular package at Life Line Screening includes 5 screenings in 1 appointment for $149.Get the most out of your life! Find out your stroke and cardiovascular disease risk with Life Line Screening so you can be in control and do something about it.***CLICK HERE*** to schedule your appointment! A simple screening can be worth a lifetime.1 American Heart Association https://www.heart.org/en/get-involved/advocate/federal-priorities/cdc-prevention-programs2 Hackam DG, Karpral MK, et al. Most stroke patients do not get a warning, a Population Based Cohort Study. Sept. 2009. Neurology, 73, 1074-1075.