Have you ever tried to understand what your loved one with dementia was saying or why they were doing a certain behavior? And did your attempt to respond end up backfiring like you or your loved one got MORE upset by your attempt to help them? Today I’m going to share with you a simple 4 step process to help you stop the arguing from happening.
You may have had the experience of your loved one saying or doing something that doesn’t make sense. The 4 step process I’ll share with you today will help you improve your communication with your loved one with dementia so that instead of arguing when your loved one says or does something that you find challenging, you can actually have a meaningful connection with them.
If you would rather watch a video on this topic, click here.
I’m going to break down the 4 steps of communication and then give you an example of how this would look in a real life caregiving situation.
The 4 step process is called The VERA framework stands for:
This process was originally created to help nurses and other healthcare providers working with people who have dementia because a lot of nursing students had concerns that they didn't know how to respond and communicate with someone who had dementia, especially when the person’s behavior was challenging.
I think this framework also applies to family members and can help you with all communication, but especially when faced with something challenging.
So the first step is Validate.
Here you are not trying to correct your loved ones reality, intead you are tryinng to understand their feelings and meaning of their underlying actions. At a very basic level, in validation you are accepting that whatever your loved one is saying and doing has some value to your loved one. You are genuinely accepting what they are saying and doing at face value without trying to change it or correct it immediately. This step means we aren’t just dismissing whatever they are saying or doing as meaningless and a symptom of the dementia. We accept it and assume they are communicating something of value.
The second step is Emotion
Like I’ve mentioned in many different videos, rather than only paying attention to the words your loved one is saying, which many times don’t make sense, you instead pay attention to the emotion underneath those words. You are acknowledging the feeling that is being expressed rather than the words that are being expressed. Many times the emotion will be pretty clear but you can pay attention to their body language, tone of voice, and facial expressions to get an even better idea of what it is they are feeling. Here, you are really trying to understand what they are feeling and you truly are trying to make a connection. Again, I’ll use a real life example here in just a minute to demonstrate.
The third step is to Reassure.
This is where you try to let the person know they are safe, that things will be okay. This can be done in a variety of ways from smiling, being gentle, nodding, and telling them things will be okay, or that you will figure it out or that you are there to help. Sometimes a simple touch of the hand or hug can also work depending on the person and the state of emotion they are in.
Reassurance is basically the non-verbal and verbal communication that tries to relieve the person’s distress. You are trying to make them feel better by being kind and optimistic for them.
The fourth and final step is Activity.
This is where you do an activity either that relates to whatever it is they are trying to communicate, or something else entirely that simply gives them some sense of occupation or pleasure. Again, we’ve talked many times on the importance of activity here on this channel and the general take away is that when your loved one is engaged in a pleasant or purposeful activity, they can’t also be engaged in a distressing behavior at the same time.
So let’s take these 4 steps and apply them to a caregiving situation.
Your loved one is in the kitchen going through all the drawers and cupboards looking for something. You ask what she is doing and she says she needs to get dinner ready for the kids.
Step 1: VALIDATE
"You’re trying to to get dinner ready for the kids."
Notice you are accepting what they are doing and not questioning or correcting. This allows them to say more about it if they want and shows them you aren’t trying to just stop them from something they think they need to do.
Step 2: EMOTION
"You sound upset and worried that dinner isn’t ready."
Notice how this is addressing the emotion the person with dementia is experiencing and beginning to form a connection.
Step 3: REASSURE
"Everything is going to be okay, Sandra. I can help you through this."
Here you give a simple statement that you are there to help and are on her team.
Step 4: ACTIVITY
"I saw some pasta in the cupboard, let’s boil some noodles."
Here you redirect the behavior into something more enjoyable, less stressful, and less disruptive. Rather than Sandra continuing to go through all the cupboards, you can connect over making some spaghetti. You don’t invalidate her worry and tell her no one is coming or there’s no one to cook for, perhaps you both enjoy making some food and now you have lunch ready for tomorrow.
Now you may be thinking, "but what if I don’t want her cooking or making a mess in the kitchen". You can also redirect to another activity all together. You can say, "I think we’d all like some takeout, let’s take a look at a menu and decide what to get."
Or, if you are thinking I don’t want to deal with making or ordering food altogether, then perhaps you can try something like, "the kids called and won’t be able to make it over today, let’s plan what we’d like to make for their next visit" and then you go through a cook book, look at recipes online, talk about favorite meals, etc.
No where in this process did you tell your loved one to stop, tell them that whatever they are thinking isn’t real or isn’t happening. This approach goes so far in building better communication, connection, and relationship with your loved one, which has huge pay off.
What do you think Careblazer, Can you give the VERA approach a try and see how it changes your interactions and also your stress level?
And Careblazer, in just a few days, I’m opening up my Care Course. My signature program for successfully getting through this caregiving journey. This will be the last time you can grab my program at this price, the price goes up after this. Now’s the perfect time, not only because this is the last time you’ll get it for this price, but because the holidays are right around the corner and if there is ever a best time to get a handle on caregiver stress, it’s right now. Be sure you put your name on the wait list. Click here to sign up!
I’ll be back next week