Dementia: Improving Communication with Improv | "Yes and..." Technique

Dementia: Improving Communication with Improv | "Yes and..." 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 As the disease progresses, individuals with dementia may have trouble communicating and may become withdrawn and isolated.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 "Yes and..." technique. Learning the "Yes and..." technique can ultimately improve the quality of life for individuals with dementia and their caregivers.

"Yes and..." technique

The improv - yes and is a communication technique that can be particularly effective when communicating with someone with dementia. This technique involves accepting what the person is saying and building on it, rather than correcting or contradicting them. Here are a few ways in which improv - yes and can be useful when communicating with someone with dementia:

Validation: By using improv - yes and, you are validating the person's experience and showing that you are listening and accepting what they are saying. This can help to reduce frustration and increase a sense of connection and understanding.

Building on the conversation: Rather than trying to correct or redirect the conversation, using improv - yes and can help to build on what the person is saying and keep the conversation flowing. This can be particularly helpful when the person is struggling to find the right words or is experiencing memory loss.

Encouraging creativity and imagination: Improv - yes and can also encourage creativity and imagination. By accepting and building on what the person is saying, you are creating a safe and supportive environment where they can express themselves freely and without fear of judgement.

Reducing anxiety: Communication can be stressful and anxiety-provoking for individuals with dementia. Using improv - yes and can help to reduce anxiety by creating a positive and supportive atmosphere, where the person feels heard and understood.

Using improv - yes and can be a powerful tool when communicating with someone with dementia. By validating their experiences, building on the conversation, encouraging creativity and imagination, and reducing anxiety, you can help to create a positive and supportive communication environment that can benefit both the person with dementia and their care provider.

Teaching someone the improv - yes and communication technique: 

• Explain the concept: Start by explaining what the improv - yes and technique is and how it can be used in communication. Explain that the goal is to accept what the other person is saying and build on it, rather than correcting or contradicting them.

• Model the technique: Demonstrate the technique by having a conversation with the person, using improv - yes and. Start by saying something and then build on what the other person says. For example, you could say, "I love to dance" and the other person could respond, "Yes, and I love to sing while you dance." Make sure to emphasize the importance of accepting and building on what the other person says.

• Practice the technique: Give the person the opportunity to practice the technique. Start by having them say something and then respond with improv - yes and. Encourage them to be creative and build on what the other person says.

• Provide feedback: As the person practices the technique, provide feedback and encouragement. Emphasize the importance of accepting and building on what the other person says and help the person to identify areas where they can improve.

• Reinforce the technique: Encourage the person to use the improv - yes and technique in their daily communication. Reinforce the technique by reminding them to accept and build on what the other person says, rather than correcting or contradicting them.

Teaching someone the improv - yes and communication technique can be a fun and engaging process. By explaining the concept, modeling the technique, practicing, providing feedback, and reinforcing the technique, you can help the person to improve their communication skills and create a more positive and supportive communication environment.

Example of using the "yes and" technique with someone with advanced dementia:

• Caregiver: "Hi there, it's such a beautiful day outside, isn't it?"
• Person with advanced dementia: "I don't know. I can't see it from in here."
• Caregiver: "Yes, it's true that we can't see outside from in here, but maybe we can imagine what it looks like. Do you remember a time when you enjoyed being outside?"
• Person with advanced dementia: "I used to love going for walks with my dog in the park."
• Caregiver: "That sounds like a wonderful way to enjoy being outside. What kind of dog did you have?"
• Person with advanced dementia: "She was a black lab. Her name was Sadie."
• Caregiver: "Oh, I love labs! They are such loyal companions. What did you and Sadie enjoy doing on your walks?"
• Person with advanced dementia: "We used to play fetch and run around in the park. It was so much fun."
• Caregiver: "Yes, that sounds like it was a lot of fun. It's great that you have those happy memories to think about. Thank you for sharing them with me."

In this example, the caregiver uses the "yes and" technique to validate the person's feelings and experiences, even though they may be experiencing some confusion or disorientation due to their advanced dementia. By acknowledging the person's memories and encouraging them to share more, the caregiver can create a positive and engaging communication environment that helps the person with advanced dementia feel heard and understood. The caregiver also reinforces the person's memories by acknowledging the positive experiences they had with their dog Sadie, which can help to promote a sense of well-being and connection.

Using the "Yes and..." 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.