How to Save Time in Dementia Care

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By Valerie FeurichOctober 13th, 2021

How to Save Time in Dementia Care


3 Tips for Reducing the Risk of Resistance and Refusals
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By Valerie Feurich
Are you caring for a person living with dementia? If yes, have you been met with resistance at some point? Whether you’re a family care partner or professional, chances are you have experienced refusals before. If you think through that situation now, is there something you could have done differently? Could one of the Snow Approach techniques have improved your interaction?

The Snow Approach, developed by dementia expert Teepa Snow, is a collection of proven care techniques that focus on providing human-centered care. At their core, they prioritize protecting the relationship between you and the person in your care. Why? Because if the person in your care does not like you or fears what you’ll do next, your care relationship will get significantly harder. (Think about it – would you want someone that you don’t like to be the one to help you undress and bathe? Chances are you answered no.)

An image of a note saying "the elephant in the room"On occasion, the Snow Approach techniques are met by caregivers with resistant comments like That’s nice, but we don’t have time for all of this. So, we thought it’s time to address the elephant in the room – how much time are you actually wasting with resistance, refusals, and if you’re in a community, writing up incident reports?

A little preparation and thoughtfulness can go a long way to improving your interaction, thereby saving you time as you don’t have to attempt the same thing over and over again. Instead, by approaching the person with a little planning, respect, and consideration of their abilities, your chances of successfully completing the task the first time around increase exponentially.

To help you try to reduce refusals and protect your care relationship, here are a few things to think about next time you get ready to approach a person living with dementia:
1. Observe and prepare for your interactions
An image with the word "prepared"When a person is living with a type or form of dementia, such as Alzheimers Disease, their ability to process and comprehend your spoken words decreases. Caregivers commonly think this is a hearing issue, when really, their hearing may be just fine.

Instead, the person’s language processing center in their brain has been damaged, which slows comprehension of the words you’re saying. This differs depending on the type or state of dementia the person is in, but as an example, a person living in the Emerald State may only be comprehending three out of four words you say. What does that mean for you as a care partner?

It means that you can improve your interactions and mutual understanding by slowing down, and giving the person a bit longer to process what you just said. Additionally, consider preparing in advance so you can incorporate visual cues into your interactions.

As an example, watch this roleplay interaction between Teepa and Amanda:
(Video not working? Watch it at https://teepasnow.info/prepare)
What did you see Teepa do to prepare for this interaction? Did you notice how Teepa gave Amanda a visual cue by pointing at her own jacket first?
Action: Pause here for a moment and actively think about how you can use visual cues to help improve your interactions. What are some examples or situations that come to mind? Maybe jot them down on a piece of paper or lay the objects close to you, to make it more likely that you’ll actually give it a try.
So, next time you’re about to jump into an interaction, take a brief pause, remember the recommendations above (slow down, allow them a little extra time for word processing), and incorporate a visual cue to help the other person understand.
2. Approach and do with permission only
An image of two hands reaching for one anotherImagine another person coming up to you and, either without saying a word or saying something you didn't understand, starting to unbutton your shirt. How would you feel? Chances are, you’d be surprised, and likely not very fond of that idea. You may even resist and try to fight them off. Not only did that person invade your personal space without permission, but they also started to do something to you without your consent.

Unfortunately, caregivers, in their effort to help, often forget that the person may need more time for processing, and to understand what they're giving consent to. In addition, caregivers may forget how their actions may feel to the other person. Just because a person is living with dementia doesn’t mean they have lost their sense of personal and intimate space around them.

So, next time before you approach a person living with dementia, try to get their permission first. How? Try Teepa’s Positive Physical Approach (PPA):
  1. pause at the edge of public space
  2. gesture and greet by name
  3. offer your hand and make eye contact
  4. approach slowly within visual range
  5. shake hands and maintain Hand-under-Hand®
  6. move to the side
  7. get to eye level and respect their intimate space
  8. wait for acknowledgement
Watch Teepa use PPA in Option 2 of this short clip:
(Video not working? Watch it at https://teepasnow.info/tiktokppa)
Action: Pause here for a moment and try to think how you can use PPA next time you get ready to approach a person living with dementia. Practice the PPA steps shown above, preferably multiple times, until you start to get a feel for it. (If you’d like more guidance, consider participating in a PAC Champion Course. There, you’ll have PAC Mentors teach you these skills in a live, virtual class.)
3. Take a step back if needed to collect yourself
An image of the words "take a deep breath"When you’re caring for a person living with dementia, chances are you’ve already encountered a surprise or two. As Teepa previously said, when dementia is involved, you have to expect the unexpected.

When you encounter a surprising situation, it can be really difficult to get out of the habit of immediately saying the first thing that comes to mind. Yet, realize that the first thing that often innately gushes out can sound judgmental, annoyed, and even hurtful. Neither will help the situation.

Instead, see if you can take a step back, take a deep breath, and take a moment to collect yourself. You may also want to use a non-judgmental interjection like Oh, wow! or Woooooow…! to give yourself a moment to collect your thoughts. Try to respond, and not react, to the situation at hand.

Take a look at this video with Teepa (don't be alarmed – it is just chocolate pudding!). In Option 2, can you catch where Teepa takes a step back to collect herself before responding to the situation?
(Video not working? Watch it at https://teepasnow.info/stepback)
Action: After watching this video, take a moment to pause and think through a situation where instead of reacting, taking a step back to collect your thoughts might have helped. What could you have done differently? Going forward, what can you try to help yourself be less reactive?
Conclusion
Yes, caring for a person living with dementia can be difficult, no doubt about it. And if you’re part of a team in a care facility, chances are you have limited time to get things done. Yet, always remember that people living with dementia are people first. By treating them as such, you’re much more likely to create a positive interaction and to achieve your desired outcome in less time. And if you’re truly honest with yourself, how would you want to be treated if you were the one living with dementia?

The Snow Approach methods listed here are just a few of the many proven techniques you can use to offer better care in less time. Learning a new skill takes perseverance and a willingness to do things differently. But, since you’ve made it all the way through this blog, chances are you likely already have what’s needed. Change starts with awareness and taking the first step towards a better path.

Taking a few moments ahead of time to prepare and slowing your pace may seem like it’s going to take longer. However, with practice, you will find yourself with fewer refusals and less resistance. Are you willing to invest time in yourself to try something new that will help you save time in the long run?
“In a gentle way, you can shake the world.” – Mahatma Gandhi
Download Print-Version (193kb)

Watch Teepa demonstrate how, with the right approach,
you and your team can save hours of wasted time:
(Video not working? Watch it at https://youtu.be/Qkwaq9ual3k)
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Professional Care Partners:
Do you want your team to be able to provide better care in less time? Give us a call at 877-877-1671, Ext. 3, today to get started!
Family Care Partners: Would you like to enhance your skills? Join a Champion Course to learn with PAC Mentors live, online, from the comfort of your home. Click here to learn more.

5 Comments on “How to Save Time in Dementia Care”

  1. Thank you ,you are so sweetheart I’ve started a new job in a dementia and Alzheimer’s facility. Looking forward to using all of what I have been taught through you. Many times when I have learned how to come to pass with positive outcome thank you Teepa , after each time what the outcome was good I do a little teepa .dance

  2. Thank you & your team once again for educating while demonstrating with us! Our family truly appreciates you!!

  3. Thank you so much! My husband never wants any help and calls me in after the fact. I will
    practice and work on your suggestions..we are still young and his ego gets in the way.

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