Dementia: Improving Communication with Improv | Mirroring Technique

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Kathleen Warshawsky, BSN, RN

For more information about the author, click to view their website: Seniors Blue Book Greater Dallas

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 As the disease progresses, individuals with dementia may have trouble communicating and may become withdrawn and isolated.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


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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.

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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.

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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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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 [email protected]

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.