Dementia: Improving Communication with Improv | Overview
Kathleen Warshawsky, BSN, RN
For more information about the author, click to view their website: Seniors Blue Book Greater Dallas
Mar 22, 2023
Non-Book Market , Texas - Dallas, Collin, SE Denton & Rockwall Counties
Email US
Click to Email Us
Dementia: Improving Communication with Improv | Overview 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 As the disease progresses, individuals with dementia may have trouble communicating and may become withdrawn and isolated.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. These may include:
Communication: Communication can be challenging for individuals with dementia. Care providers should use clear and simple language, speak slowly, and allow time for the individual to process information. They should also use non-verbal cues, such as facial expressions and gestures, to convey meaning.
Activities: Activities that are meaningful and engaging can help individuals with dementia to stay connected and maintain a sense of purpose. Care providers should focus on activities that the individual enjoys and are tailored to their abilities and interests.
Environment: The physical environment can have a significant impact on the well-being of individuals with dementia. Care providers should create an environment that is familiar and comfortable, with minimal distractions and noise.
Personalized care: Personalized care can help individuals with dementia to maintain a sense of identity and autonomy. Care providers should take the time to get to know the individual and their preferences and involve them in decision-making as much as possible.
Emotional support: Individuals with dementia may experience a range of emotions, including fear, anxiety, and frustration. Care providers should provide emotional support and validation, acknowledging the individual's feelings and concerns.
Meeting individuals with dementia where they are at requires a holistic and person-centered approach. By understanding the unique needs and experiences of the individual, care providers can support them to maintain a sense of dignity and quality of life, even as the disease progresses.
Communication is a complex process that involves sending and receiving messages, both verbal and nonverbal, between individuals. Effective communication requires the ability to understand and interpret messages, express oneself clearly, and respond appropriately to feedback. For people with dementia, communication can become more challenging as the disease progresses and affects their cognitive and language abilities.
Communication in people with dementia can be impaired due to a variety of factors, including memory loss, difficulty finding the right words, and impaired processing and comprehension of language. This can lead to frustration and anxiety for both the person with dementia and their caregivers. It is important to understand how communication can be affected by dementia and to develop strategies for effective communication.
It is also important to remember that communication is a two-way street, and caregivers and healthcare providers must also be good listeners. Active listening, which involves paying attention to the person with dementia, acknowledging their feelings, and responding appropriately, can help build trust and understanding.
Improved communication with individuals with advanced dementia can lead to several benefits, including better social interaction, reduced feelings of anxiety, and improved quality of life. It can also help caregivers better understand the needs and preferences of the person with dementia, resulting in more personalized care and enhanced well-being for both the caregiver and the person with dementia.
Several studies have explored the benefits of improving communication with individuals with advanced dementia. For example, a systematic review of communication interventions found that these interventions can lead to reduced agitation and aggression among people with dementia, as well as improved quality of life and social engagement (Van't Leven et al., 2013). Another study showed that individualized communication training for caregivers can lead to significant improvements in communication quality and overall well-being for both caregivers and individuals with dementia (Graff et al., 2006).
Moreover, incorporating improvisation techniques, such as mirroring, storytelling, and music, can be particularly beneficial in enhancing communication with individuals with advanced dementia. A randomized controlled trial of music therapy showed that it led to significant improvements in communication and social interaction among individuals with advanced dementia (Raglio et al., 2015). Another study showed that using storytelling and role-playing techniques can lead to significant improvements in communication and emotional well-being among individuals with advanced dementia (Hsu et al., 2018).
Improving communication with individuals with advanced dementia can lead to several benefits for both the person with dementia and their caregiver. Incorporating improvisation techniques can enhance the effectiveness of communication interventions and improve overall well-being.
The components of improv can be applied to dementia care to help improve communication, build trust, and enhance the overall care experience for both the caregiver and the person with dementia.
Components of improv for dementia care include:
Acceptance: Accepting and building on the ideas of others is a key component of improv. In dementia care, acceptance can involve acknowledging and validating the thoughts and feelings of individuals with dementia, even if they are not based in reality. This can help build trust and improve communication.
Listening: Active listening is essential in improv. In dementia care, listening involves paying attention to verbal and nonverbal cues, as well as being open to new ideas and adapting to the needs of the person with dementia.
Agreement: In improv, performers agree to the reality of the scene and build on it. In dementia care, agreement can involve finding common ground with the person with dementia and building on their ideas and interests.
Creativity: Improv is all about creativity and thinking outside the box. In dementia care, creativity can involve finding new ways to communicate, engage, and connect with the person with dementia.
Flexibility: Improv requires performers to be flexible and adapt to changing situations. In dementia care, flexibility can involve being open to new ideas and adjusting communication strategies as needed to accommodate the needs and abilities of the person with dementia.
Playfulness: Improv often involves a playful and lighthearted approach to communication. In dementia care, playfulness can involve using humor and creativity to make communication more enjoyable and engaging for the person with dementia.
Using improv techniques can help caregivers communicate more effectively with individuals with dementia by fostering flexibility, active listening, engagement, and humor. These techniques can help improve the quality of communication and enhance the overall care experience for both the caregiver and the individual with dementia.Improv can help communicate with someone who has dementia by:
Emphasizing flexibility: Improv involves being open and flexible to new ideas and situations. This approach can help caregivers communicate more effectively with individuals with dementia, who may have difficulty following a specific train of thought or conversation. By being flexible and open to new ideas, caregivers can adapt to the needs and abilities of the person with dementia, allowing for more successful communication.
Encouraging active listening: Improv requires active listening and responding to what is being said in the moment. This approach can help caregivers communicate more effectively with individuals with dementia, who may have difficulty following a conversation or articulating their thoughts. By actively listening and responding to the person with dementia, caregivers can help them feel heard and understood.
Fostering a positive and engaging environment: Improv involves creating a positive and engaging environment that encourages participation and creativity. This approach can help caregivers communicate more effectively with individuals with dementia, who may become easily disengaged or frustrated during communication. By creating a positive and engaging environment, caregivers can help individuals with dementia feel more comfortable and open to communication.
Using humor and playfulness: Improv often involves using humor and playfulness to communicate and connect with others. This approach can help caregivers communicate more effectively with individuals with dementia, who may respond well to humor and playfulness. By using humor and playfulness, caregivers can help lighten the mood and make communication more enjoyable and less stressful for everyone involved.
Improv Techniques
There are many improv techniques that can be used on a client with dementia. By incorporating these techniques into their care approach, caregivers can help improve communication, reduce stress, and enhance the overall care experience for the person with dementia.Here are a few examples:
- "Yes, and..." technique: This technique involves building on the ideas of the person with dementia, rather than shutting them down or correcting them. For example, if the person with dementia says, "I want to go to the moon," instead of saying "That's not possible," the caregiver can say "Yes, and maybe we can pretend to go to the moon by looking at pictures of space."
- Mirroring technique: This technique involves mirroring the body language and facial expressions of the person with dementia to help build rapport and understanding. For example, if the person with dementia is smiling, the caregiver can mirror their smile to help create a positive and engaging environment.
- Storytelling technique: This technique involves creating a story with the person with dementia by building on their ideas and interests. For example, the caregiver can start a story with "Once upon a time, there was a cat who loved to play in the garden," and then ask the person with dementia what they think happens next.
- Role-playing technique: This technique involves engaging the person with dementia in role-playing activities to help stimulate their imagination and memory. For example, the caregiver can suggest playing "restaurant" and ask the person with dementia to be the customer, while they act as the waiter.
- Musical improvisation technique: This technique involves using music to engage the person with dementia and create a positive and engaging environment. For example, the caregiver can sing a familiar song and ask the person with dementia to join in or use music to help create a calming environment during a potentially stressful situation.
Using improv techniques 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.
To Receive Continuing Education Credit for Nursing, Texas Social Work, Texas Licensed Professional Councilor Click HERE.
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/
To Receive Continuing Education Credit for Nursing, Texas Social Work, Texas Licensed Professional Councilor email Kathleen@SeniorsBlueBook.com for the link.
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
Do Therapy Dogs Help Alzheimers Dementia Patients?
Visit any critical care unit, childrens hospital, or other specialty inpatient facility, and youll find a common feature: therapy dogs. For decades, healthcare practitioners have understood the surprisingly positive effects on patients of time spend with cute and cuddly dogs. Therapy dogs reduce stress, improve mood, and can help patients reframe their outlook on whatever condition ails them. The positive effects of patient interactions with therapy dogs are a well-documented fact of the medical world. Senior citizens with limited mobility and other health conditions also benefit from the companionship of dogs. Owning a pet reduces feelings of loneliness among seniors living at home or in a retirement facility, which in turn greatly reduces the risk of diseases associated with loneliness and isolation. Pets can also decrease the number of stress hormones in a persons blood, lower blood pressure, and contribute to a more positive outlook on life. Dogs and other pets, it seems, have tremendous healing powers!Since Alzheimers patients cannot adequately care for a pet, owning one is out of the question. Considering the nature of Alzheimers dementia, it is easy to assume that a loved one may not benefit from a pet since they will not remember the interaction. Researchers, convinced therapy dogs would have a positive effect on Alzheimers patients, put this question to the test: Do Therapy Dogs Help Alzheimers Dementia Patients?Short-Term Benefits of Therapy Dogs for Patients with Alzheimers Dementia.A study conducted in the early 2000s looked carefully at the subject of therapy dogs and Alzheimers dementia patients. They measured the incidence of behavioral disturbances among patients in a nursing home for a period of four weeks, then introduced therapy dogs. Their initial findings showed that the dogs helped to reduce behavioral disturbances in the short term, meaning they helped to immediately calm patients. The short-term effects proved that therapy dogs do have a positive effect on patients with Alzheimers disease, particularly in regards to anxiety, anger, and changes in behavior associated with the disease.Long-Term Benefits of Therapy Dogs for Patients with Alzheimers Dementia.The same study did not stop at the short-term effects of therapy dogs on Alzheimers patients. Previous assumptions suggested that since patients would not remember their encounters with the therapy dogs, the effects of spending time with them would vanish from one day to the next. Not true, the study authors found. Although most of the patients did not remember their interactions with the therapy dogs (some did), the behavioral disturbances noted in the four weeks prior to the study reduced. In fact, the longer and more frequently patients interacted with the therapy dogs, the less they exhibited behavioral disturbances.Therapy Dogs As A Long-Term Therapy.The study findings confirmed what clinicians suspected all along: dogs are an excellent long-term therapy for persons with Alzheimers dementia to reduce the incidence of behavioral disturbances. Therapy dogs also had the same effect on Alzheimers patients as they do on other kinds of patients, including reduced stress and anxiety, lower blood pressure, better appetite, and fewer feelings of loneliness. These effects continued to increase the longer and more frequently patients interacted with the dogs.What Makes Dogs Such Good Therapy?Dogs are wired to give unconditional love and devotion. They can provide physical and social contact where it is missing, and they are not picky. what sets dogs apart, particularly those trained as therapy dogs, is that they will approach anyone regardless of their physical or mental deterioration, and initiate contact. Patients can pet, hug, and cuddle dogs unlike any other kind of pet. These positive interactions provide a distraction to the other goings-on around them and provide relief for those suffering from sadness, anger, or angst.The Takeaway.Dogs have a tremendous healing power. While studies have focused specifically on Alzheimers dementia patients, their positive effects will benefit anyone suffering from general dementia. Families of patients will feel relief that their loved ones have fewer outbursts of anger, sadness, or angst. While dementia impairs memory, it does not interrupt the long-term benefits of regularly interacting with a therapy dog. In fact, the more they interact with a therapy dog, the fewer behavioral problems they exhibit.
How To Choose A Nursing Home
When someone you love needs extra care, it's time to think about a nursing home. This can be a tough decision, but there are ways to make it easier. Let's look at how to pick a good nursing home that will take great care of your family member.Location and BuildingThe first thing to think about is where the nursing home is. It's best if it's close to you so you can visit often. When you go to see the nursing home, look around carefully. Is it clean? Does it look nice outside? Are there places where your loved one can go outside for fresh air?Look at the rooms too. Make sure you see all kinds of rooms, not just the fancy ones. Ask yourself if the rooms feel cozy or if they look too much like a hospital.Staff and CareThe people who work at the nursing home are very important. You want to make sure there are enough workers to take care of everyone. Ask how many nurses and helpers there are for each patient. Also, find out if the same people work there for a long time. If workers stay at their jobs, it usually means they like working there.It's also good to ask how the workers are trained. Do they know how to help older people with different health problems? Make sure they know how to take care of your loved one's special needs.Daily LifeA good nursing home should help your loved one have a nice day every day. Ask about what kind of activities they have. Is it just bingo and movies, or do they have other fun things to do? Can your loved one go on trips outside the nursing home?Food is important too. Ask about the meals and snacks. Can your loved one eat whenever they want, or are there set meal times? Try to taste the food if you can.Some nursing homes let people help out with small jobs if they want to. This can make your loved one feel useful and happy. Ask if they have chances to do things like help deliver mail or read to other people.Respect and ChoicesIt's important that your loved one is treated with respect. They should be able to make some choices about their day. Can they decide when to wake up or what to wear? Can they eat in their room if they want to? Make sure the nursing home respects your loved one's likes and dislikes.Visitors and FamilyCheck the rules about visitors. Can you come anytime, or are there special visiting hours? It's good if you can visit often. Also, ask if your loved one can make video calls to family and friends.Money MattersNursing homes can be expensive. Many people think Medicare will pay for everything, but that's not always true. Medicare only pays for some types of care, and only for a short time. You might need to pay for some of the care yourself.Ask the nursing home how much it costs and what kinds of payment they accept. Some places might help you make a plan to pay over time.Keep Asking QuestionsEven after you choose a nursing home, keep asking questions and staying involved. Visit often and pay attention to how your loved one is doing. If you see anything that worries you, talk to the people in charge.Remember, the most important thing is to find a place where your loved one will be safe, happy, and well cared for. By asking lots of questions and looking carefully at different nursing homes, you can find the best place for your family member.
Successful Communication When Your Loved One Has Dementia
When someone you love has dementia, youll notice that things are changing quickly. When they make mistakes and fumble with the little things, our instinct is to correct and remind. Thats to be expected. After all, youre hoping that a little push and a dose of reality would be enough to lead them back to the person you know and love.As you will see below, corrections and reminders wont always work. Effective communication with a dementia patient requires an adjustment of expectations. In the following, well get you started.Forced choicesEveryone likes to have a choice. But having too many options can actually be confusing to a patient with dementia. Thats because their working memory is operating in limited capacity. Working memory is where the brain retains just the right amount of information to finish a task think of dialing a new phone number. So you can see how loss of working memory can be problematic in conversation and hinder decision-making.Thats where the forced choice method can lift that burden for your loved one, and cut the confusion. Watch the video here.Help with sequencingWe take basic daily tasks for granted: eating, standing, brushing our teeth. Though these tasks feel natural and automatic, we rely on the frontal lobe to help us complete these tasks. When someone is experiencing dementia, the brain degeneration can make them lose their ability to access this command center. When you see your loved one freeze, as if in confusion, you can help them through the basic task with sequencing, by breaking down the tasks into simple steps. This video about sequencing provides some examples.The therapeutic fibYou can never go wrong with the truth, or so youre taught. But when it comes to dementia and Alzheimers, the truth actually has a cruel side. Because when someone is living with degenerative memory, they sometimes lose track of key details of their loved ones. The fact that a partner or a child is deceased or gone can literally be forgotten. In cases like these, telling the truth can be devastating it will be as if theyre hearing this horrible news for the first time. This is where a therapeutic fib can get you both through the difficult moment, and this video explains how.Admit wrongdoing when youre rightSpeaking of truth, sometimes your loved one with dementia will get basic things wrong. They may insist, for example, that they cant possibly be a grandparent because in their mind, theyre only 25 years old! This can be a painful moment, because this represent a loss in your relationship with them and you want to hold on. But fighting these beliefs is futile. This video will show you how to gently move past the conversation.Repeating themselvesHearing the same story, especially if they think youre hearing it for the first time, can get frustrating. The wrong response is trying to make them understand theyve already told it. In this segment, well show you how to get through the moment.The important thing to remember is when a person has dementia or Alzheimers, the brain is going through massive changes. That can be difficult to take. Take a look at this video, Whats Happening to Their Brain?, so you can put yourself in their shoes. Understanding whats at work can go a long way in good communication when your loved one has dementia.Learn more about how we provide specialized care in our series Insights from Arthurs featuring educational videos from Arthurs Director of Development and Senior Care Consultant Deb Nygaard.
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.