All of us can become fixated on an issue or very upset about an event. But for an individual with dementia, the ability to move past the event or let go of the issue can be very difficult. That is why it is so important to be able to redirect conversations and actions.
As well as redirection in the moment, the use of art, music or other activities that provoke interest can focus attention on positive interactions and events.
Below are ten quick tips for redirecting behaviour and creating a positive and relaxed environment.
Ten Quick Tips for Redirection
Tip One — Stay Calm
When behaviour is difficult, stay calm and confident. Breathing deeply can help you maintain your cool rather than getting excited and shout about the behaviour. Individuals with dementia react to emotion, so if you are agitated or upset by behaviour that will increase their agitation.
Tip Two — Use Your Game Face
People are more likely to follow someone who is being warm and friendly and this is doubly true for an individual challenged by dementia. Because individuals with dementia are so attuned to emotions, it is important to be in a good frame of mind and have your ‘game face’ on. Greeting individuals by name, gently clasping their hand or showing other gestures of openness and affection go a long way to gaining their attention.
Tip Three — Use the Trust Plane
Always start with a smile. We may underestimate the value of the simple cues that we give, so having a friendly tone to your voice and open, welcoming body language can lower agitation and help you focus attention. Having your arms in the ‘trust plane’ — open around the midriff, and palms facing outwards can send subconscious cues that you are to be trusted.
Tip Four — Ask Questions
If someone is upset – ask questions. When you show understanding about what is going on, not only will you gain insight, but the fact of showing understanding can deescalate or redirect the behaviour.
Tip Five — You Don’t Have to Be Right
Trying to prove or persuade the other person that you are right will not be effective in redirecting behaviour. The problem with arguing or justifying with ‘reasonable’ arguments is that it often leads to an increase in defensiveness. The individual is already confused and frustrated. Trying to convince them that you are right will only add to their frustration. It is better to try and redirect them to another topic.
Tip Six — Listen with Empathy
Following on the previous tip, it is better to go along with the outspoken opinions being expressed and show that you are listening. Just the act of being heard can help an individual calm down. At that time, redirection can be very effective.
Tip Seven — Bridge the Sentence
An excellent way to redirect is to use bridging sentences. A bridging sentence might be something like: “… that reminds me, do you want to walk down to the mailbox?”
Tip Eight — Offer a Snack
Redirection can also be effective through the introduction of a new activities such as new chore, or moving to a new room or offering a snack. Keep the activity introduction low key. The focus is to reduce the emotional temperature, so acting as if the request were no big deal can really help.
Tip Nine — Purposeful Activities
Try to find things that are purposeful such as folding the towels. Sorting activities can be effective, particularly when the behaviour you are trying to reduce involves the hands. One brilliant redirection that I observed was having the individual wipe off all the menus in the dining room. It was a useful activity and the individual felt good about doing it.
Tip Ten — Use Music or Pets
For restless behaviour caregivers can introduce music, or interacting with a pet. Therapy dogs or cats are great for redirection. Watching an old comedy or another favorite show can also be effective.
It is more effective to redirect difficult behaviour than to confront it. Due to the nature of the disease, resolving conflict through rational argument is not effective.
Relying on redirection and building up a positive environment with sufficient mental and physical exercise will improve the care relationship.
Nicole has trained hundreds of professional and family caregivers who have touched the lives of thousands of individuals living with a cognitive impairment. Nicole also holds a law degree from Osgoode Hall Law School, a Master’s in Law from Queen’s University specializing in Negotiations and is a Certified Professional Consultant on Aging.