Don’t talk to a dementia or Alzheimer’s patient like a child. That’s the word from the International Conference on Alzheimer’s Disease in Chicago, meeting this week.
According to new research, adults with the disease are more resistant to care when spoken to with a style that resembled “baby talk”.
The study is small, but it has implications for everyone caring for an elderly adult, even when the patient seems disoriented or impaired.
At the University of Kansas School of Nursing, 20 nursing home residents (average age 82.9) with dementia were filmed bathing, dressing, and brushing their teeth, among other activities. The researchers reviewed the tapes.
When the nursing staff used normal speech, the residents were more likely to cooperate with the directives.
But when the nurses or caregivers raised their voice and used child-like or baby talk using language such as, “sweetie,” “honey,” “good girl,” and other diminutives such as, “are we ready for our bath? ” the researchers saw a resistance to the directions that could be observed in body language - grabbing the caregiver, hitting/kicking, pushing away, saying "no", crying and screaming, among other reactions.
“Behaviors that can be read as indications of distress at being patronized or infantilized,” said lead researcher Kristine Williams, a professor at the School of Nursing.
Resistance to care is not only dangerous, it increases the stress among nurses, the time needed to provide care and ultimately the cost of care. Ultimately, the needs of the person with Alzheimer’s may remain unmet since they are unable to communicate in the conventional adult way.
The study suggests that even though behaviors in Alzheimer’s patients may be child-like, that they retain their sense of being an adult and resent being patronized.
The results also apply to those being cared for at home.
"This may significantly impact nursing care and how nursing home staff should best be trained to communicate with residents with Alzheimer's. Future research is needed to test whether interventions that reduce nursing staff elderspeak communication will contribute to greater cooperation with care for persons with dementia," said Williams.
“The style of communication that we use with people with Alzheimer’s influences how they feel about themselves and how well they respond to those providing care,” said Sam Fazio, PhD, Director, Medical and Scientific Relations at the Alzheimer’s Association.
Dan Kuhn, director of the professional training institute at the Alzheimer Association’s Greater Illinois chapter, tells the Chicago Tribune that this study validates anecdotal observation about how to communicate with the mentally diminished suffering from Alzheimer’s.
Today, the approach is to "enter into a patient's reality instead of forcing that person into our reality," Kuhn explained. "Don't remind them of their disability. Don't tell them they're wrong. And by all means, don't be condescending or critical."
Kathleen Ustick who oversees Alzheimer’s services at Lutheran Life Communities, tells the Chicago Tribune about a patient with dementia who kept asking for his mother. She suggests a caregiver observe his body language and the tone of his voice.
“I think the meaning behind his words is, ‘I don’t feel safe right now.” Mom represents safety, security, love. And the message for staff is, we have to help calm this person down,” she says to the Chicago Tribune.
A good response – “No, I haven’t seen your mother. But why don’t you stay with me for a while?” she suggests.
A wife, who takes care of her husband with dementia tells the paper the story of her husband. Barbara Dennis says her husband understands 80 to 90 percent of things, but gets confused with people around him or when he feels pressured.
Recently while watching television news he asked her, “Where are the girls?” He was watching the nightly news about presidential candidates Barack Obama and John McCain.
“Oh, you mean the girls on CNN?” she told the Chicago Tribune. No, he said, “The girls who were on.”
Barbara said it just clicked for her. Her husband was talking about Senator Hillary Clinton. When she asked her husband if he meant Hillary, “he just brightened,” she says.
At least five million Americans are living with Alzheimer’s disease. By the year 2050, there are predicted to be 16 million Americans living with the disease. There are no survivors and there is no cure.
PBS will air a documentary, "The Forgetting," August 3. Viewing parties are being arranged for and by caregivers. Check your local PBS station for times. #