Approaching Your Loved One

Today’s insight discusses approaching your loved ones with dementia. How do you approach your loved one who has dementia?

Transcription of video:

Hi, I’m Deb Nygaard with today’s Insights from Arthur’s.

Today I have Kate Jabe with me. Kate is the residential supervisor here at Arthur’s Residential Care and she’s volunteered to help me just to demonstrate today’s Insight from Arthur’s which is all about the approach. How do you approach your loved one who has dementia?

I want to talk about your comfort level when you’re talking with someone, especially if she’s seated. If I come directly in front of Kate, this a very uncomfortable position. It’s hard on her neck and it puts me in a position of authority, and that’s not the message I want to communicate to her. Plus it’s very uncomfortable for her neck. If she is hunched over like many people who are older, looking up at you is even more difficult.

In one of the previous Insights I mentioned that for people with dementia, peripheral vision typically decreases to the point where they can only see a very small target. So when I approach Kate, about all that she is going to be able target in on is my face — a small area. So what I want to do is let her know that I’m coming. The way that I do that is by approaching from the front. If I were to approach Kate from the back, especially if I’m not making any noise, she doesn’t know that I’m coming. If I were to touch her, it could be quite startling for her because she hasn’t had any warning.

You always want to get permission to get close, and the way that you do that is by making a verbal connection. And so I can say, “Hi Kate, how are you doing?” And now I’ve put my hand up here; it might feel a little awkward to you at first, but the idea is that she can see this hand because she can see my face.  And so if I come to her she’s going to be able to respond with a social cue, a social norm is to shake hands. “Hi Kate it’s Deb, good to see you.” So now I create a connection; now it’s ok for me to get closer because she knows I’m coming and she’s shaking my hand: this is permission.

Now the next thing is something I want you to practice. We’re going to rotate our hands just a little bit so that we’re holding each other’s thumbs. So I’ve got the fleshy part of her thumb and vice versa, but her hand is on top, and this is really important.  Kate is a dignified woman, she’s lived a full life, she has been in control of a lot of things and I want her to feel in control right here because of the way our hands are situated.

The next thing I’m going to do is I’m going to get beneath her –if you’re not able to kneel down, you can pull a chair up — so that you are in a very comfortable position for her neck. She’s taller than me, and she’s in charge here.

“Is this a more comfortable position for you?”

And the other thing that this does is that it keeps you out of harm’s way. You’ve got her hand so if she’s in a punchy mood, which she does sometimes, or if she’s in a kicking mood, I’m a lot safer if I’m over to the side.  By the way, I’ve made these mistakes, this is how I know. Now we can have a conversation.  

By the way, if Kate is agitated today, what I can do is give her a little squeeze on this fleshy part of her thumb because pressure in the palm is a calming thing. I’m not going to put pressure on the back because we lose fat as we age in our hands and you can cause a bruise pretty easily. So I can touch her there but I’m not putting pressure there, but I can put quite a bit of pressure here. And if she needs the comfort sometimes she will just take it, she will squeeze back and take as much pressure as she wants.

That’s today’s Insights from Arthur’s. I’m Deb Nygaard.

Contact Deb Nygaard
Director of Development
Arthur’s Residential Care: 651-429-4798