I had the pleasure of being invited to observe a workshop by Teepa Snow (http://www.TeepaSnow.com). The event was hosted by the Alzheimer’s Support Network and, to my great pleasure, was attended by staff from diverse facilities and organizations that provide dementia care.
Teepa is a very skillful and talented presenter/trainer. Her focus was on doing. She presented conceptual training in the form of role-plays of many challenges we face when trying to get into the world of someone who is demented. Her teaching style focused on doing rather than saying. She challenged but always coached participants into a success by offering specific prompts and modeling. Caregiving is not an intellectual exercise but is a hands on, participatory activity.
Teepa’s message is clear. You must provide person-centered care to be effective in caring for those with severe cognitive decline. We often give lip service to the concept of person-centered care but the actual practice takes intention, time, and effort.
There are several points that she drove home to me. I am only sorry that I must say rather than show you how her strategies work.
First, caregivers must often approach someone who is confused, fearful, or in distress. Teepa shows how to approach a person with dementia to about 6 feet, smile greet, move slowly, and get to eye-to-eye level. Despite the fact that many of us know this, we try to “save time” by direct, quick contact.
Second, words often get in the way. We are so accustomed to telling and asking that we forget that in working with infants, toddlers and pets they do not process our words. Rather we must use prompts, gestures, and demonstrations to show what we want done. We talk as patter to relax and comfort. It’s not the words but rather the tones, cadence, and calmness that we use words to convey safety and contact. Finally, touch is an important component of caregiving. It is so much more natural to do these acts with children or pets than adults.
Third, caregiving requires that you override your natural tendencies to react to the behavior emitted rather than work to understand and manage the communication with someone who is likely unable to express their needs in words. We must resist talking louder or using a condescending tone to our voice. We must avoid scolding. We must not blame the victim for what they can no longer do or understand. We need to realize that we are often the problem, not the person who is demented.
Finally, dementia care takes enormous energy, presence, and focus. The skills of care are natural to some but many of us need to work hard to master them and practice often. Caregiving takes time and cannot be approached as a task to get done. Caregiving is a human interaction where we assist someone who is confused to feel safe, supported, and understood. We must facilitate engagement in those who cannot initiate on their own. We must be with them in the moment.
I am sure that I have not done justice to Teepa’s message. However, I hope that she gains a much larger audience of those who care for demented adults when she is invited to Naples again.