Have you ever wondered how to create more meaningful moments for you to share with your person living with dementia?

How to Increase Harmony and Meaning In Your Care Relationship

Original article by Teepa Snow, MS, ORT/L, FAOTA, with minor updates by Valerie Feurich, PAC Team Member

By Valerie Feurich, PAC Team Member

Have you ever wondered how to create more meaningful moments for you to share with your person living with dementia?

In dementia care, we frequently hear the term activities. An activity, simply said, is the task you engage in. However, an activity on its own does not necessarily add meaning to one’s life. To do that, the interaction you two share during the activity is what will add meaning to the task.

So, how do you best approach your interaction to create more meaningful moments for you both?

1. Add Meaning to Your Activities (Engagement)

To create more meaningful moments, try adding engagement to your activities. What do we mean by that? Let us explain.

For example, an activity, on its own, could be bird watching.

An engagement, on the other hand, would be the both of you looking at a book of birds that you would like to watch. Another example would be looking out the window together to see which type of feathered friend you might discover. Or you could go for a walk together to look for birds. Or you could learn about the best ways to find and see some of the rarer types. There are many possibilities of how you could engage with this activity.

So, in a way, an activity is like the menu, and engagement is what you choose to do with the other person in the process. Engagement, in fact, goes beyond activities and can help add meaning to everyday care tasks. How? It starts with your approach.

2. Do Things With and Not To

If you have read any of our previous blogs, you may have noticed that we commonly refer to caregivers as care partners. Why?

Because, when you partner, you do things with a person, while when you give care, you’re doing things to the person. While this seems like a small, minor difference, it can have a major impact on how you approach a task and how both of you experience your care relationship.

Try to think of it this way:

1. Imagine someone taking a toothbrush and trying to stick it in your mouth without much warning.

How would that feel?

Would you just let it happen, or do you think you might resist?

2. On the other hand, now imagine the person comfortably holding your dominant hand while also holding your toothbrush with their first three fingers  (using Teepa Snow’s Hand-under-Hand® technique).

The person then uses their free hand to first give you a visual signal for brushing teeth. Then calmly rests that hand on your shoulder to create a physical connection with you. Next, the person lifts the toothbrush and your hand together to your mouth.

Which one would feel more comfortable to you?

The first or the second option?

Chances are, you’d prefer the second scenario.

Unlike the first one, where the person is giving care to you, the second scenario uses Hand-under-Hand® to partner with you and allows you to feel more in control.

In fact, a 2018 comparative study of different means of helping people with eating found that “Hand-under-Hand® elicited the least amount of resistive behaviors.” For example, moving the person’s arm in accordance with the task provided a motor cue and a sense of feeling in control to the person living with dementia.

So, to increase your chance of meaningful interactions between you and the person in your care, try to approach the person as your partner. No one likes to feel like someone’s task, and changing your approach will likely make them feel like you’re in this together as a team.

3. Get Permission First

How would you feel if someone knocked on your front door and then simply proceeded to walk in before you could respond?

How would you feel if someone just walked up to you and, without saying anything or giving you a cue, reached toward your crotch and zipped up your fly that was accidentally left open?

Chances are, you wouldn’t like it much.

Without permission, we shouldn’t assume we have permission to fix or change something that we see as a problem for a person living with dementia. Instead, trying to partner with them in a friendly way to acknowledge something isn’t quite right and fixing it – either on their own or together.

Whenever you can, try to put yourself in the other person’s shoes and ask how you would like to be treated. Try to gauge the other person’s ability, and then try to match them. If you remember to get permission first, you’re much more likely to experience a meaningful engagement that is based on working as a team.


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