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

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.

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.

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.