5 Tips to Get a Person Living with Dementia to Consider Making Major Life Changes
Strategies for making transitions as respectful and collaborative as possible
By Valerie Feurich
Have you ever tried to convince someone that you care about to make a major life change, and were met with rejection? Do you have a loved one living with dementia who is no longer safe alone in their own home, but refuses to move to a senior care community? These types of conversations can be tough, and can strain the relationship between you two. However, when a person is living with dementia, they may reach a point where a move to a community with more support is needed. What can you do?Here are 5 tips to keep in mind as you prepare to have this type of conversation with the person that you care about:
1. The relationship always comes first
You may have heard Teepa say before Know your agenda, don’t show your agenda. Why? Because your relationship should always come first. If you rush ahead and try to force your will onto someone else, chances are you’ll reap resistance and mistrust. Don’t risk harming your relationship and complicating things further down the road.While caregivers (or care partners, as we call them) mean well with phrases like Mom, we have decided that it isn’t safe for you to live here anymore, try to put yourself in the other person’s shoes. How would you feel if someone tried to abruptly tell you how to live your life? What would you think if someone told you you’d have to leave your long-time home? Chances are, you wouldn’t like it.As you talk to the person you’re concerned about, try to be an equal partner. Remember that you are talking to an adult, and treat them as such. We understand you are concerned about the person, and your stress level may be running high as you’re truly worried that they’ll get hurt. However, this anxiousness may cause you to rush into the conversation, exposing your agenda far too early.To have a chance at a productive conversation, you’ll need to be truly connected to the person first. As you’re chatting with them about other things, find one positive moment at a time, over and over again, to build that type of comfort and trust between you two. Once you feel you two are genuinely connected, you may try to guide the conversation toward the topic that is on your mind.How? Read on in #2 below
2. Use Teepa Snow’s Positive Action Starters
What are Teepa’s Positive Action Starters (PAS), you may wonder? Simply said, they are five strategies to build a positive connection with a person before you to get them to do or agree to something.In this instance, the PAS of I share, you share can help you gently guide the conversation. Start by sharing something about yourself, and then ask how they see that same topic for themselves.As an example, you might say something like In my family, a lot of my grandmothers or great-aunts got to a certain age where they thought they would be safer in a senior care community. For me, I look at maybe 72 as a cut off age for finding more supportive living. And then you ask them to share: For you, do you have a specific age like that, or something else?This way you’re not saying anything directly about them moving, or giving them instructions on what you think they should do. Instead, you’re opening the door to a conversation on the matter, and giving them the space to express their thoughts around it.
3. Reflect what they are telling you
As you listen to the person, occasionally repeat back a few of the last words that they’ve just said.So, if your person were to say this place is my home, I have all of my things here, you may want to respond with yeah, all of your things are here, and then pause. Or if the person were to say I’m not ready to move to a senior care home, you could respond with yeah, you’re not ready to move.How does that help? When you reflect back their words and pause, you’re effectively inviting them to tell you more. And by them telling you more, you get the chance to learn about their objections to the move, which may allow you to brainstorm solutions to overcome them. Additionally, by reflecting the other person’s words, you signal to them that you hear what they are saying. Not only does that support a person living with dementia cognitively in a conversation, but it is also comforting to know that the other party is truly listening.Now, we know what you may be thinking: Doesn’t that make the conversation a little awkward? Most likely, the other person will not notice that you’re repeating or rephrasing their last few words, thereby encouraging them to tell you more. But as with all things in life, we get more comfortable with a new technique the more we use it, which brings us to the next point:
4. Practice the conversation in advance
How well do you want this conversation to go for you and the person you’re concerned about? Would you go into a potentially life-changing test without having practiced prior? Most likely, you’d spend some time preparing to increase your chances for success. Well, the same concept applies here.See if you can find a family member or friend to practice this conversation with. You may even want to record yourself. Watch the video to see whether you can detect signs of impatience or stress in your voice or body language, so you can be aware of how you really come across and what you may want to do differently.Why? Because the other person is likely to pick up on verbal and non-verbal cues that you’re giving off with nervousness, giving them a sense that you have an agenda up your sleeve.Instead, practice this conversation and the various ways it could go with a friend. Practice reflecting their last words, as well as the I share, you share PAS we discussed in tip #2. See where you get stuck or what goes well, and get comfortable with a variety of possible scenarios. That way you’re less likely to be caught off guard, and increase your chances of resolving this matter in the most respectful, collaborative way possible.
5. If things go sideways, back away
Remember tip #1? Your relationship comes first. In this situation, that means that if you sense the conversation has taken a wrong turn or you can tell the person is starting to get suspicious of your intentions, back off and let it go for the time being.The same concept applies if you cannot build a deeper connection with your person on that day. Ask yourself: What is going to take longer? Getting connected before you approach the topic that’s on your mind, or being impatient, rushing into your agenda, and fighting instead? If you sense a bit of distance between you two, leave the agenda at the door.Try again another time, when you’re sensing a genuine connection between you two.
Seeing the independent person you once knew become less and less safe in their surroundings can be tough. And trying to convince someone to move when they’re not ready can create stress for all parties involved. While there is no silver bullet for this type of situation, by making sure you treat the person as an equal partner, you decrease the risk of harming your relationship. By demonstrating that you’re listening by reflecting their last words and preparing for this conversation in advance, you increase your chances of getting to a place where it truly is two adults helping each other through a tough transition.
Interested in learning even more?
Watch the full 29-minute episode on this topic of Live@5 with members of the Positive Approach to Care team: