5 Tips for Reducing Conflict in Dementia Care
And Why Only Watching Dementia Care Videos Is Not Enough for Life-Changing Results
By Valerie Feurich, Positive Approach to Care (PAC) Team Member
Are you caring for a person living with dementia and have experienced situations where the person responded aggressively to you trying to help?
Understandably, this can leave you feeling surprised, frustrated, or upset. You were trying to help, and yet your efforts were met with resistance. But why does this happen in the first place? And more importantly — what can you do?
These questions are the foundation of the Snow Approach care techniques, coined after their creator — dementia expert Teepa Snow. These techniques, when learned and used correctly, effectively reduce resistance in dementia care. How?
At their core, the Snow Approach techniques are based on this three-step approach:
- Understand what is happening to the brain of a person living with dementia
- Understand how these brain changes affect the person
- Understand and know what you as the caregiver need to do differently
The truth of the matter is that without these three core steps, caregivers are often actively triggering negative reactions from the person in their care. Do we believe you’re not doing the best you can? No, that is most certainly not the case. What we are saying though is that you’re doing the best you can with the skills you have right now.
Truth is — to offer the best care for a person living with dementia, you’re going to have to learn some new things. No one is born knowing how to offer the best dementia care possible (not even Teepa!), so adopting a growth mindset, being open to learning something new, and actively practicing new skills will have a significant impact on your life and the person in your care.
That said, as with anything worth doing, you’ll likely need some time to learn and practice. So, what can you do differently, starting today?
Here are five tips to get you started:
1. Accept that the behaviors you’re seeing are caused by the disease, not the person
When your person living with dementia is changing and suddenly doing or saying things they never did before, it can be difficult to comprehend and not take things personally. Yet, it is important to remember that the behaviors you’re seeing are caused by the dementia and not the person.
As much as you can, try not to take things personally. Develop an invisible shield — a constant reminder that none of what you’re experiencing is proactively targeted at you. We know this can be very hard to do, but it’ll help protect the relationship that you two share.
2. Start using Exclusionary Categories
When a person is living with dementia, their ability to comprehend and produce language will diminish over time. As dementia progresses, the person will likely struggle more and more with words, and experience frustration when not being able to express themselves.
However, through the use of exclusionary categories, you can actively support the person’s communication efforts. How does it work? When you’re talking to the person, offer this or that, or this or something else type choices.
As an example, you may say Mom, would you like pasta or chicken for dinner? (this or that). Or you might say Hey Mom, are you looking for your purse or something else? (this or something else).
By using these exclusionary categories and offering specific choices, you’re helping the person better communicate their needs in spite of the dementia.
3. Regularly use Teepa’s Five “I’m sorrys,” even if you don’t feel like you’re wrong
One of the most important skills for you to learn on this journey is to say I’m sorry, and actually mean it.
Why? Because the main goal of an apology is not to let the other person know that they did something wrong or half-heartedly patch things up, but to protect the relationship that you two share.
Take a read through Teepa’s five I’m sorrys below, and see if you notice anything:
- I’m sorry, I was trying to help
- I’m sorry I made you angry
- I’m sorry. I had no right to treat you like a child.
- I’m sorry. That should not have happened.
- I’m sorry, this is hard. I hate it for you.
Were you able to detect something? If you noticed that none of these phrases blame the other person — nice work! The key is to not assign blame but to calm everyone involved and bring you two back on the same page.
Because here’s the thing: The most powerful way to engage is to recognize when you’ve made a mistake, and acknowledge it. Pause, timeout, and reset the agenda. At this point, the agenda is your apology.
Even if you were trying to help, the perception of the person living with dementia was different. As the condition progresses, their ability to see someone else’s point of view declines. Try to let go of being right, and choose relationship over ego.
4. Use reflection
Reflecting, or mirroring, is a communication technique that can help calm an anxious or upset person living with dementia. To try this method, reflect back or rephrase the last few words that the other person has just told you.
In addition, try to match their tone of voice. It might feel more natural to try to use a calm soothing voice, but do you like being told to calm down when you are upset?
Reflecting their words and their tone of voice (though just below their level), allows your person to feel heard and that you understand their feelings.
As an example, your conversation could go something like this:
- Valerie: “This isn’t fair, none of this is fair.”
- Teepa: (in a similar but slightly calmer tone) “You’re thinking this isn’t fair?”
- Valerie: “Yeah! None of this is fair. I didn’t do anything.”
- Teepa: (in a similar but even calmer tone) “It doesn’t feel fair, and you don’t like that.”
By reflecting the last few words the person told you, you’re signaling that you’re hearing what they said. And by reassuring that you heard them, they’ll be more likely to feel like you are there for them.
5. Move from passive learning to active learning
You’ve watched one or more Teepa Snow videos? Awesome! You’ve taken an important first step toward learning more about compassionate dementia care. But, here’s the thing… To truly learn new skills, watching a video is just the beginning. Why? Because you have not rehearsed enough!
Imagine you’re 16 again and are excited to get your driver’s license. Would simply watching a video on driving prepare you for safely operating your car on the interstate at 70 mph? Chances are, you’d need actual hands-on training to be truly ready for the road. Well, dementia care is not much different.
Watching a video is passive learning. However, human brains are much more inclined to remember information that they were actively involved with. (Ever noticed that Teepa asks her audience to copy her hand movements? She does this to increase your likelihood of actually remembering the information after you leave the room.) So, how can you turn your learning from passive to active?
Here are a few quick tips:
- Pause regularly, and actively think about what you just heard or read. Try to think of situations where and how you’ll use this information. Write your thoughts down, if possible
- As you’re learning, imagine that you’ll have to teach this content to someone else. This will force you to pay close attention, and increase your likelihood of remembering more information. Take this a step further by actually telling someone else what you’ve just learned. As brain coach Jim Kwik states in his book Limitless, “When you teach something, you get to learn it twice.”
- Join a Champion Course, a live online training course developed by Teepa herself. Led by trained PAC Mentors, these 2-hour courses focus on actively rehearsing her hands-on dementia care skills with you. The cost is $49 USD, and well worth the investment for family members and professionals who are serious about putting words into action and improving their skills.
Conclusion
You likely already knew — there’s no magic pill for better care. When a person is living with a changing brain, every single person in their environment is going to experience dementia with them.
By regularly reminding yourself that challenging behaviors are caused by the disease and not the individual (#1), by supporting your person through the use of exclusionary categories (#2), by using Teepa’s five apologies even if you’re not at fault (#3), by using reflections (#4), and by learning actively vs passively (#5), you’re already steps ahead of those unfamiliar with the Snow Approach.
Always remember — if you’re the one with the healthy brain, you have the opportunity to positively influence this journey of dementia. But remember that if what you’re currently doing doesn’t work, doing more of the same will not improve a thing. You have to choose to become a person that does things differently and actively take the next step toward your new, more skilled self.
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Positive Approach to Care
Positive Approach to Care (PAC), founded by dementia care educator Teepa Snow, offers caregiver education through effective hands-on care skills and techniques.
Interested in learning more? Visit www.teepasnow.com/blog.
