How to Return to In-Person Visits when Dementia is Involved

3 Strategies to Have the Most Joyful Experience Possible

Image of a caregiver and senior looking out of a window together after COVID-19 has passed

By Polly Logan,
Positive Approach to Care team member

For most of us who have loved ones or friends living in residential care facilities, it has been a very long time since we have been able to be in the same room to visit with them. Most interactions have been restricted to window visits, phone calls, or video chats on the computer.

With the rising availability of vaccines, being together in person is starting to be a possibility again for some. However, when dementia is involved, coming together again after a long pause may unfortunately not be as easy as you might imagine. What are some strategies for easing the transition back to in-person visits?

1. Recognize that things will likely be different

A series of arrows going one way, with one shooting off going in a different direction, indicating that something is different.
A series of arrows going one way, with one shooting off going in a different direction, indicating that something is different.

During the time that you have not been able to be together, the person living with dementia will have changed.

Even though you may well remember them as they were before COVID-19 hit, factors such as social isolation, lack of physical and mental activity, anxiety, depression, or other pandemic-related issues may have contributed to changes in the individual.

They may have experienced physical, cognitive, or emotional changes, or a combination of all three. Also, it is important to remember that you have changed, as well. The COVID-19 pandemic has affected us all in ways in which we may not even be aware.

With all of these factors, it may be necessary and helpful to adjust your expectations of the upcoming visits. Even though you may be overwhelmed with excitement to be able to visit them in person, try to remember that the individual may not react the way you want or expect them to.

Use your initial visits as an assessment of how your special person is doing at this point in time. If there are significant changes, try your best to grieve these changes later, rather than in front of the individual. Instead, do your best to focus on the positive by noticing the things they are still able to do and the ways they are able to connect, even if they seem small.

2. Go Slow

When you first see them, it may be best to avoid the temptation to rush right up to them and hug or touch them. Holding back in this way may be quite challenging, especially after all the time apart! However, there is a good chance that such a greeting may be a bit too overwhelming for someone living with dementia.

Instead, we encourage you to use the Positive Physical Approach™:

  • If you are visiting them in their room or apartment, knock and then pause for several seconds before entering.
  • Approach them, then stop when you are six feet away. With your open hand (palm out), held motionless next to your face, smile and say “Hi, ____­____(their name), it’s _________(your name). If you typically call them by another name (Mom, Auntie, Grandpa, etc.), you may certainly use that, but if they do not seem to respond or completely understand your relation to them, you may want to then switch to using their first name.
  • Then, extend your hand to them and move forward slowly. If they are ready to connect with you, you will likely see a recognition in their face, a light in their eyes, and they will reach out their hand to yours. If none of these things occur, then they may need a bit more time, and you may want to pause before moving closer.

It is also helpful to remember to move to their dominant side, which is known as the supportive position. If they are sitting, it is typically best if you can sit, squat, or kneel to their side, so you are not standing over them, which can be perceived as dominating or threatening.

3. Match their tone of voice, mood, and pace

Once you have connected with the Positive Physical Approach, it’s now time to match their tone of voice, mood, and pace. If their reaction times and responses seem slower than you remember, then slow yours down, too.

Remember that pauses are important because they allow time for the individual to process incoming information and formulate their response. Allow them time to find their words before jumping in to finish their sentences. If you are having a difficult time remembering to pause, count to five in your head, or take a few breaths.

Also, it is usually best to avoid skipping quickly from topic to topic, which may make it challenging for them to follow the conversation.

If their mood seems somber or sad, try to avoid the common mistake of using a very upbeat or happy tone to cheer them up. Instead, tone down your mood and tone of voice to meet theirs, which demonstrates empathy and understanding of how they are feeling. If, over the course of the conversation, their mood lifts a little, then you certainly may lift your tone a bit, as well.

Keep in mind that if you are feeling a bit anxious about the visit, this may translate to you speaking a bit more quickly and in a higher tone of voice than usual, so take deep breaths and try to slow your pace.

Also, even though it may be tempting to have an agenda or particular plan for visits, it may be best to put that aside and follow the person’s lead with their mood, abilities, and interests instead.

Below is an example of what can happen when the Positive Physical Approach is not used, and the mood of the person living with dementia is not matched.

Did you notice how Melanie’s excitement and mood was quite different than Teepa’s, and it caused Teepa to shut down?

On the other hand, now watch the example below of how it might be done differently for a more positive result.

Did you notice how Melanie was able to slow herself down and not overwhelm Teepa, which resulted in a much different outcome?

We understand how exciting it can be to visit someone you have not been able to see in person for over a year. However, when dementia is involved, it may be helpful to keep these suggestions in mind so the visits and interactions can be as smooth and positive as possible.

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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.

Positive Approach to Care (PAC), founded by dementia care educator Teepa Snow, offers caregiver education through effective hands-on care skills and techniques.