It’s all in the approach.

How you approach people makes a HUGE difference in how they respond to you.

Think about it:  In a normal interaction…

If someone smiles at you, you smile back.  If someone approaches you with a frown, you may think that s/he is upset with you.  If someone approaches you from behind, you will likely be frightened and may even become defensive (and someone will likely end up with an elbow in their solar plexus).  If someone approaches you from the front, they will get your attention.  If they approach too quickly, you may become scared and be put on the defensive.  If someone approaches you slowly, but gets too close for comfort, you may push them back – and if they keep getting too close without permission, they may even get slapped.  If someone approaches from the side and you don’t sense them there, you will get startled.  If they approach from the side, and you know that they are there, you may put a friendly arm around them.  If you are sitting down and someone approaches you and remains standing over you, you will feel intimidated and get uncomfortable.  If someone approaches you and doesn’t say anything, you may become suspicious and not trust them.

So…why do we think that individuals with dementia are any different?!  When we do any of these negative things to a demented person and they have a negative reaction (those dreaded “behaviors”), how can we say that they are acting abnormally?!

I don’t know how many times, I have seen someone come up behind a demented individual and start pushing his/her wheelchair without first making their presence known, and without saying anything to him/her.  And then when the demented individual protests, they are shocked/surprised that there is a negative reaction/behavior!

When working with someone with dementia, we need to keep a few things in mind:

1.  Approach from the front and do so slowly.

2.  Make sure that the individual sees you/knows that you are there. (Remember that many of them have visual and auditory impairments that complicates the situation)

3.  Get on their level – if they are sitting, sit or kneel (don’t stand over them).

4.  Give them adequate personal space – don’t invade.  (More space for an angry individual and less space for a sad individual)

5.  Use both verbal and non-verbal communication – EYE CONTACT is very important.

6.  Greet them/acknowledge them as a person before trying to get them to do anything.

7.  Offer an open hand (and wait for them to accept it).

8.  Stand at an angle – not head on or squared up (at an angle is friendly and squared up is intimidating)

9.  Wait for them to accept you before proceeding.

And,  MOST importantly, be alert in reading the demented individual’s reactions to your approach/interaction and readjust accordingly.  Know when to engage and when to back off.  You may just save yourself from a confrontation, elbow to the solar plexus, or a slap in the face!

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