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
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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 As the disease progresses, individuals with dementia may have trouble communicating and may become withdrawn and isolated.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.
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