Dementia is the progressive debilitation of the cognitive function of an individual which affects their ability to properly process thought. Dementia can be brought about by the normal process of aging, or can have its onset which results in damage from a stroke, or it may be brought on because of a disease process, such as Alzheimer’s disease. Although dementia is common in the elderly, individuals of any age can be affected by this condition.
Dementia is a non-specific syndrome that affects the cognitive function of the brain. This condition can affect ones language, memory, problem solving skills, and their attention span. Dementia is a progressive condition which essentially, affects an individual’s ability to process thought in the proper manner. Although it is normally brought on due the aging process, it can also be a result of a severe stroke, or from a disease process such as Alzheimer’s Disease, HIV, AIDS, and Huntington’s Disease as well as other disease processes.
There is no cure for Dementia, however researchers believe that certain drug therapies may help to slow the progression of the syndrome during the early stages. Additionally, it has been indicated that cognitive and behavioral therapies are useful in dealing with patients with Dementia. Music therapy has also shown as an effective intervention therapy for Dementia patients. (MNT, 2009). A patient affected by Dementia may present with memory loss, often times forgetting names and places, and may find it hard to keep track of the day of the week or month. In addition, the affected patient may become extremely moody and be unable to control their emotions as the part of the brain that controls emotion progressively becomes damaged. Their moodiness may be brought on by anxiety or fear of their condition, as well as other life events. One of the major issues with Dementia is difficulty in communication. Over time, the Dementia patient may have difficulty talking, reading and writing, resulting in major communication barriers that not only affect the individual, but also has a profound impact on the patient’s caregivers and family. As Dementia progresses, the patient’s ability to care for himself/herself may become diminished, as they are unable to carry out everyday tasks, requiring a higher level of care and understanding from those providing care.
In the healthcare field, specifically nursing, caring for patients with Dementia will require patience, compassionate caring, and respectful effective communication along with empathy, in an effort to minimize distress and confusion on the behalf of the patient. Compassionate care can significantly improve the quality of life in a patient with Dementia. Ethically, communication is a human right and individuals have a basic need to communicate with one another. Nurses caring for Dementia patients should strive to facilitate communication in order to bridge the barriers caused by the debilitation.
Dementia patients can become confused and disoriented, resulting in fear for the patient, causing them to become agitated or aggressive. It is important for the nurse to calmly reorient the patient to their familiar surroundings in an effort to comfort them and alleviate their fears.
It is necessary to develop and possess the ability to communicate with patients throughout all stages involved in the Dementia process. The caregiver should always remain positive and flexible during communication. It is imperative that you take the time to really understand what the patient is attempting to convey through their expression and what is being said.
During any interaction with the patient, the caregivers should always implement the ABC’s of communication. 1) Avoid confrontation, 2) Be
practical, and 3) Clarify the person’s feelings and offer comfort.
In caring for Dementia patients, you should use everyday language for communication, speaking to them in a low calm tone, and ask the least amount of questions possible, do not ask why type questions that could be difficult for them to respond to and use positive statements. Gain the person’s attention by introducing yourself and acknowledge them by name. It is very important to establish a trusting relationship so that the patient becomes comfortable in communicating with you. Exaggerate eye contact and make sure that your facial feelings match your words. All effort should be made to validate the patient’s feelings; it is acceptable to repeat back what the person expressed to you to communicate that you understand them.
When speaking to your patient with Dementia, speak slowly and clearly, using six word sentences. If appropriate, you should show them things or demonstrate what you are talking about. Be patient and give the patient time to reply to you during communication and be aware and familiar with the various types of communication such as verbal, non-verbal, facial, and body language. 93% of meaning comes from tone, gestures and body language make sure that these attributes you exhibit are consistent, positive, and attentive. It is pivotal that positivity, compassion and encouragement be conveyed to the patient.
Do not contradict the patient’s view on topics or memories, join in the person’s world and reality but be able to reorient them to themselves, time, and place. In caring for the Dementia patient, if the patient is comfortable with the caregiver it is okay to engage in appropriate touch. Make sure to employ intense listening skills and have the awareness when to provide periods of silence, offering a quite and supportive presence.
Patients with Dementia often feel they are back in time and may like to spend time reminiscing, always be a good listener, yet still being able to make appropriate observations of your patient’s physical and mental capacities.
Value talk with these patients for its own sake and remember that these patients are someone’s loved ones and that they have value as an individual. (Gordon, 2011). In conclusion, patient centered communication should be heartfelt and always remember that actions speak louder than words. It is necessary for a nurse to be patient and understanding with Dementia patients, while skillfully practicing their critical thinking and clinical skill to provide exemplary patient care.
Dementia: What is it? What Causes Dementia? Symptoms of Treatment. (2009). Retrieved from http://wwwmedicalnewstoday.com/articles/142214.php
Gordon, C. (2011). Bringing Out the Best. Successful Patient Communication. Retrieved from http://www.dementiaknowledgebroker.ca/sites/default/files/CDRAKE_CommunicationSlides_ChristeneGordon_Feb322011.pdf Haddad, A., Purtilo, R. (2007). Health Professional and Patient Interaction. (7th ed.). St. Louis, MO: Saunders Elsevier.