Behavioral communication is not exclusive to dementia
*Resident names and any identifying details have been changed for privacy.
July 10, 2020
We all do it.
- When we're "hangry".
- When we're cranky because we feel unwell or stressed out.
- When we're irritable because we haven't been sleeping right.
- When we overreact and yell in a situation we normally wouldn't.
- When we’re catastrophically upset and slam a door or throw something.
- When we're feeling frustration, disappointment, shame – or any other emotion that might feel too painful or too scary to deal with in the moment.
We try to ignore the feelings. We resist them.
And then they go away…. Ha! Nope.
We may snap or pick fights. We may behave passive aggressively. We may spiral into feelings of anxiety, depression or overwhelm.
We may not think clearly. We may get tired, forgetful, accident prone or otherwise become "lower functioning".
We'll be better poised to:
- be observant
- say the right things
- NOT say the wrong things
- recognize others' needs
- help others feel better
- be productive
- be happy
- be well
- be wise
In many cases, people who are drawn to caregiving-type roles professionally are used to putting others' needs before their own. We may be better at seeing and meeting others' needs than our own.
But this isn't healthy or sustainable – it's a recipe for compassion fatigue.
Compassion fatigue is a collection of distressed symptoms that can result when we experience long term exposure to stressful and emotionally challenging situations. It is common among people who care professionally or extensively for others.
According to the Compassion Fatigue Awareness Project, the key to preventing or treating compassion fatigue lies in practicing authentic self-care.
For many people, this will entail learning how to practice self-care in the first place.
One reason that self-care can be difficult is that it takes a good deal of mental and physical energy to notice what is needed, make a decision and take action. The good news is that by developing or changing our habits we can save 40% of that energy.
Self-care has been all the buzz lately. The term has been used to describe a huge range of activities from taking a nap to learning a new language. Many of us don't see how we could possibly indulge in a massage or a mental health day when some days we can barely squeeze in a shower.
It's interesting to look at why self-care may be so hard for some of us, and why true self-care goes beyond a massage and a mani-pedi. It's a pattern of treating ourselves with compassion and accepting our human imperfections.
So, what would we do if we were taking care of someone with dementia who was acting cranky, irritable, emotional, snappy, argumentative, anxious, depressed or overwhelmed?
And no, I'm NOT talking about psychotropic medication! (haha)
We'd remove or minimize environmental stressors. We might take the person to a different setting or make changes to the situation or environment accordingly.
We'd look for any needs that may be unmet and try to fill them.
Essentially, we would figure out the root cause of the problem by asking ourselves why we're seeing the behavior.
(And anyone who's studied root cause analysis will ask themselves "why" 5 times of course! 😆)
When considering potential unmet needs, first we run through the basics: hunger, bathroom needs, pain, discomfort, thirst, medical conditions.
But it's important to remember that our human needs extend beyond basic physical wellness.
In fact, depending on exactly who you ask, there are four to eight (or even more!) dimensions of health that must be maintained for wellness. Here are the six that most generally agree upon.
The six dimensions of wellness include:
Do we have a healthy diet, regular exercise and practice healthy habits?
Do we get sick frequently?
Are we able to feel our emotions, label them and express them appropriately?
Can we laugh and have fun?
How do we communicate, resolve conflict and get along with others?
What is the quality of our relationships?
Are we able to maintain healthy boundaries with others?
Can we recognize emotions in others and respond to them appropriately?
What gives our lives meaning and purpose?
How "at peace" do we generally feel?
What guides our sense of morality?
Can we maintain a healthy work/life balance?
Is our work meaningful, fulfilling and satisfying?
Do we have opportunities to feel productive and useful?
Do we balance our finances without excessive spending, hoarding or gambling?
Are we continuing to learn, grow and enjoy mental stimulation?
Do we think critically?
Are we curious? Creative?
Each aspect of health should be observed, honored and maintained whether we're talking about ourselves or someone with dementia.
We can appreciate our own behavioral communication if we pay attention to it. We can use our feelings to give us information about our own unmet needs. From there we can seek to fulfill them the way we would do for someone with dementia.
- Be patient and calm
- "Listen" with your ears, eyes and heart to their verbal and non-verbal communication
- Maintain eye contact, speak clearly and allow time for them to respond
- Reduce distractions and pay them your full attention
- Don't argue
- Seek to see their reality... recognize that their really is as true to them as yours is to you
- Take seriously the things that are important to them
- Keep a sense of humor
- Be heartfelt and trustworthy
- Respect, appreciate and value their time and contributions
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