Understanding Reactions and
Communication as a Carer
When it comes to caring for a loved one with Dementia their reactions to certain situations will let you know their frame of mind long before their words can. The non-verbal or body language indicators like facial expressions, body posture, gestures and touch will help you navigate the ups and downs of being a Dementia sufferer’s carer. Learning how your patient or loved one attempts to let you know what they want will aid you in your endeavour to make them safe and loved. If they lose the ability to speak this will be the only way you have to communicate together and understanding that early on can speed up how you notice the non-verbalised communication better.
Facial Expressions
The simplest of looks can indicate if the person you care for is happy with how you are helping them or if something is wrong. If you are hurting them or they are in distress, they will most likely be indicate it in how they look at you even if they don't verbalise it. So always pay attention to the eyes and facial muscles for indicators to aid you.
Body Posture
How a person's body is postured can tell you a great deal especially if they are sitting a lot because how they sit can indicate pain, incontinence, irritability, boredom, tiredness, etc. Knowing the different postures the person you care for has can be helpful in determining the care they need from you at that time. Also if they are on the move a lot that can tell its own tale of boredom or simply they need the toilet or maybe they want to go out, if they are capable.
Gesture
A simple gesture can tell you so much about what the person you care for wants. Gestures include movement of the hands, face, or other parts of the body to indicate a person’s feelings. Gestures differ from physical non-verbal communication as they do not communicate specific messages and allow individuals to communicate a variety of feelings and thoughts, from contempt and hostility to approval and affection. To understand a simple gesture is to have your own language with one another and can simplify the need for numerous questions to get to an answer.
Touch
A person with Dementia can differ in the way they use touch which means they can either be very stand-offish or very touchy. So the way you can use this as an advantage is by noting which the person with Dementia is most of the time, then if they are the opposite at any point that could indicate a need or a want for help. For example if they are always stand-offish, but then suddenly want to be hugged or touched this could mean they are in distress and vice versa.
Reacting and Communicating as the Carer
As the carer how you conduct yourself around a Dementia sufferer is very important because that will determine whether the person been cared for feels safe or not in your care. So how you sound, move, touch and act around them will either generate a feeling of safety or make them feel they are in danger. The response you want to instil is one of safety especially if they are at a stage where they don't recognise you 90% of the time and respond to you as a stranger. The way you deliver your persona may be the most important lesson of your life and help you understand how you are seen through someone else's eyes.
Sound
When communicating with someone with Dementia the tone and level of your voice can either be soothing or scary, so it is very important to keep a calm balanced tempo to how you speak at all times. Never raise your voice, never shout and never portray anger, no matter how frustrated you are feeling. Also be aware of the level they can hear at when you are speaking because they may be partially deaf through age and adjust your calming tone to that level. Another point to be aware of is the speed and language you use because in their impaired state they may take longer to understand. Again due to their level of understanding ask a question, then give them time to answer before repeating the question again, all while verbalising in a calm soothing tone to help with understanding. When speaking always do it from straight in front of them and never from the side or behind, so as to prevent confusion. It will help them understand you are speaking to them and will help you know they are listening.
Movement
When it comes to movement slow, smooth and controlled is best around a Dementia sufferer, so as not to startle or scare. Fast aggressive movement can make them feel they are in danger. Also always approach within their eye line from the front and never from the side or behind just to prevent any unnecessary reactions from them. When helping them to move about revert your own pace to theirs rather than the other way around and when helping with personal hygiene or feeding keep your movement to smooth slow unaggressive hand movements. At all-time be aware of keeping your body movement friendly and non-threatening.
Touch
When it comes to touch it should be gentle enough not to hurt or bruise, but sturdy enough to support and be done with care for two reasons which are 1) As they age their skin can become like paper and tear easily so care needs to be taken when touching or gripping them and 2) if they show too much bruising or tearing you could be blamed for abusing them, when it is simply just accidental. Another pointer to be aware of is they may not like been touched, so if they are still capable always ask for permission before touching because it may cause distress or aggression which are both unwanted reactions to you simply caring. Finally dependant on the sexes of carer and cared for, be conscious of touching private areas of the body and try to use same sex carers when the need arises to touch private areas, but if same sex carers not available ask permission when mental agility still present.
Act
How you act incorporates all of the three previous headings of sound, movement and touch combined because your overall actions will either distress or calm the individual you are caring for making life for you both easy. A loud, aggressive and heavy handed mannerism used when performing your caring role will create a poor experience for your patient or loved one leading to a deterioration in their quality of life and possible legal action against you. Whereas, if you act in a calm, soothing and considerate manner you will improve not only theirs, but also your own quality of life. The latter will also bring you closer to the person you care for instilling a closer bond you may never have had before. Poor action equals distress and thoughtful actions equals wellness.
Conclusion
What can be learnt is that it takes two to create an understanding within communication, but where one party is slightly impaired or vocally disadvantaged, non-verbal or body language can serve as a necessary form of communication, but only if the person doing the caring is open to watching out for the non-verbal indicators the patient or loved one is projecting. Also how you appear outwardly can influence how easy or hard you find the role as your actions, language, tone and mannerisms will be mirrored by the person you are caring for in how they respond to you. So working together and understanding each other can aid in the overall carer role, but remember even if they don't recognise your face they will recognise you by how you speak, act or conduct yourself around them. If you combine how you conduct yourself with their non-verbal cues life will be well worth living for both of you. Caring for someone should never be just a job, it should be a privilege especially if it is a parent or a long term partner for it is done out of love not obligation and if it starts to feel like an obligation then it the time to pass that duty to someone who will see it as privilege.
A helpful website to visit for information on communicating with a person with dementia is https://www.nhs.uk/conditions/dementia/communication-and-dementia/
