Visual, Verbal, then Touch
by Stephanie “Teffie” Landmann, COTA/L,
PAC Support Mentor, Coach, and Trainer
PAC Marketing and Outreach
A loud scream came from the senior living dining room. Everyone stopped to look and see what happened. Did someone fall? Is someone hurt? Or did someone just not like the meatloaf?
A hug. A hug was the reason for the scream. A staff member hugged a resident. The two have known each other for years. The resident normally enjoys hugs. How can a hug cause such a commotion?
Close your eyes and imagine yourself in a large cafeteria full of people.
What do you hear? Tables full of people talking and eating? The sounds of the kitchen staff moving about as they are preparing and serving food? A loud TV broadcasting the news? Maybe some background music over top all of that? Sounds a little overwhelming.
What do you see? Staff and residents filing in and out of the room? Servers and kitchen staff walking about helping residents? A large TV showing countless images as it broadcasts the news?
What do you smell? The meal for the day? The flower arrangements? Other residents?
While you are processing all of that information, maybe you get lost in old memories or thoughts from a song you hear, the smell of the flowers, or the sight of something on the TV.
Next thing you know someone comes up from behind you and grabs your shoulders. What is your natural response? Scream? Jump up? Or push your elbow behind you in self-defense? All valid responses. But this person just wanted to give you a hug.
Imagine the same scenario, but you are living with dementia. For someone living with dementia the brain can’t properly process all of the data and stimulation around them. Depending on their GEMS State or where they are in their dementia, it may take all of their energy just to focus on their plate and feed themselves. Some of the data is not processed by the brain in order to focus on the task at hand, eating. Oftentimes in late-stage dementia, individuals will have other senses shut down to provide more ability to the skill they are immediately using. For example, you might notice someone closing their eyes while chewing their food.
How can we change this scenario to make it more dementia friendly? What are some things we can do to change this scenario? Turn off the TV? Create a flow pattern for staff and residents? Not sneak up on residents from behind? Try using a Positive Physical Approach™ (PPA) when greeting your residents.
· Get into their visual range, approximately six feet away and pause
· Place your open hand next to your face, smile, and greet by name
· Offer you hand in a handshake position
· If they extend their hand, approach slowly from the front with your hand extended
· Move from a handshake to Hand-under-Hand® position
· Get at or below their eye level, but don’t lean in
From here you can use Positive Personal Connections (PPC) such as the following to make a connection:
Looks like meatloaf today. One of my favorites. Point down at the plate.
Followed by Positive Action Starters (PAS) like those listed below to get started on tasks:
It’s time to eat dinner. Would you like water or milk to drink? Try a bite of meatloaf.
Visit Teepa Snow’s Positive Approach to Care website to download free resource cards on PPA, PPC, and PAS as well as other dementia information.