Respect Shouldn’t End with Dementia Diagnosis

Respect Shouldn’t End with Dementia Diagnosis post page

By Debi Tyler NewsomJune 17th, 2021

Respect Shouldn’t End with Dementia Diagnosis


by Debi Tyler Newsom, OTR/L,

PAC Client Relations Director

How would you describe staff language in your organization as they address those receiving care? Do you hear adults referred to as honey, sweetie, or mama? Are they addressed with respect? If you closed your eyes and listened, would it sound like they were speaking to an adult who had lived a life full of experiences and contributed to the well-being of others? Or would it sound more like you had been transported to the toddler room of a day care center?

In a recent PAC article entitled Stop the Baby Talk! People Living with Dementia are Not Children, Polly discussed the importance of speaking to adults in a way that affirms their life experience and dignity. Even if people living with dementia cause us concern about being rational and reasonable, it is still different than speaking to a child.

What if the person with dementia cannot use good judgement when cooking, driving, or doing self-care? What if they can no longer make informed choices for themselves—or if cohesive sentences are difficult and utterances sound more like infant babble? What if sensory exploration preempts their awareness of safety and they put buttons and beads and candy wrappers in their mouth? Does that make it ok to use baby talk?

Adults have lived for decades and have had many experiences that have shaped their lives and made them who they are. They have certain skills like driving, cooking, or choosing what to wear that they have used for years. They have functioned independently in school, with their families, in their jobs, in leisure activities, and in community settings. Most have been responsible to others for their decisions and the impact of those choices on those around them.

While it might be easy to see the similarities between adults who have dementia and children, it might be worth considering the differences and using that to inform our word choices and manner of speaking. Often, it is not about the message being conveyed so much as the way it is done. What could that look like in a facility that provides care, or in a home health environment?

Here are some suggestions:

Offer choices, reasonable choices, such as, This one or that one? Red or Blue? Be sure that both are viable choices, for instance don’t offer, Do you want to sit by the window and watch it rain, or sit outside on the bench and feel the rain? if you are not willing to honor the second choice.

How do you refer to those in your care? By a preferred name? By a title they have earned? By their professional title? By a nickname? How are family members used to provide input? When staff do not know or remember a resident’s name, is there a term they default to? How do they find out what the preferred name is?

When safety is a concern, is there a pause to decide if the behavior is just annoying, somewhat risky, or flat-out dangerous before intercepting? A candy wrapper might not have any nutritional value but chewing a bit of paper is not likely to be life-threatening.

Sometimes, reining in our own reaction for an appropriate response is the key. It takes practice not to automatically scold, or snatch something away rather than offering a more appealing alternative in a calm and friendly voice.

Our desire for dignity and value does not disappear with the diagnosis of dementia. Formal language skills can change, and not being able to correct someone else does not constitute permission to use language or terms that are demeaning or condescending. Let’s show the adults in our care the respect they deserve for the full lives they have lived by addressing them appropriately, offering them choices in their daily routines, and controlling our own knee-jerk reactions.

For more information on virtual training opportunities for organizations, please contact Debi Tyler Newsom at PAC Team.

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