Teepa Snow and the Positive Approach to Care (“PAC”) team, emphasize several key strategies for deescalating tension between caregivers (“carepartners”) and individuals living with dementia. Her approach is rooted in the Positive Approach to Care, which focuses on understanding the person with dementia, adjusting care strategies, and promoting positive communication. Here are some of their recommendations:
Contents at Nurse Partners PA
show
1. Stay Calm and Use a Positive, Supportive Tone
- Approach with empathy: The PAC stress the importance of remaining calm and non-confrontational. The care partner should use a gentle, positive tone of voice, avoiding frustration or anger, as people with dementia often react strongly to emotional cues.
- Body language: Non-verbal cues such as facial expressions, body posture, and gestures are critical. Teepa advises maintaining a relaxed posture, a soft gaze, and open palms to convey safety and support.
2. Step Back and Observe
- Recognize triggers: The PAC suggest that care partners should try to identify what might be causing the tension. Is the person with dementia feeling anxious, frustrated, or confused? Understanding the root cause can help the carepartner intervene more effectively.
- Pause before reacting: Instead of reacting immediately, encourage caregivers to take a step back and assess the situation. This moment of reflection can allow both the carepartner and the person with dementia to cool down.
3. Use Positive Physical Approach (“PPA”)
- Approach from the front: The PAC emphasize approaching the person living with dementia from the front, so they can see the care partner coming. Sudden movements or approaching from behind can be startling and escalate tension.
- Create a connection: Establish eye contact, offer a smile, and touch gently if appropriate (for example, on the forearm or hand) to create a sense of trust and safety.
4. Modify Communication
- Simplify language: The PAC advise carepartners to use short, simple sentences with clear instructions. This helps the person with dementia process the information more easily.
- Validate emotions: Acknowledging the feelings of the person with dementia, even if their logic seems off, is crucial. For example, saying something like, “I see you’re upset. Let’s see how we can make this better” can help defuse a situation.
- Avoid arguing or correcting: Instead of trying to convince the person of reality or correct them, go along with their perspective in a non-confrontational way. This prevents unnecessary conflict.
5. Redirection and Distraction
- Shift the focus: Gently redirect the person’s attention to something else if they are fixated on something that is causing distress. This could be an activity, a change of environment, or engaging them in a simple task.
- Offer a choice: Giving the person two simple options (e.g., “Would you like to sit here or over there?”) can help them feel a sense of control and diffuse tension.
6. Adapt Environment and Expectations
- Minimize overstimulation: The environment can play a significant role in how a person with dementia responds. Reducing noise, simplifying the space, or turning off a TV can reduce confusion and agitation.
- Adjust expectations: Encourage carepartners to meet the person where they are, adjusting tasks to the person’s current abilities and avoiding frustration with unrealistic expectations.
7. Use a “Hand-under-Hand” Technique
- The PAC developed a method called the Hand-under-Hand technique, which allows the carepartner to guide the person with dementia through tasks, offering support and connection without being overpowering. This technique helps with both communication and physical interaction, providing a sense of safety and reassurance.
The PAC methods focus on fostering a compassionate, respectful relationship, where the carepartner seeks to understand the perspective and needs of the person living with dementia, thus preventing and deescalating tension effectively.