Friday, January 23, 2015

Dementia Communication TMI Bleep, Bleep!!

 Lori was seventeen, and her mother was working four jobs just to put food on the table. So, when Lori had a chance to take a summer job at a rural bean canning plant for $3.00 over  the minimum wage, she was elated. However, little did she know was that she was going to have to spend 12 hours a day shadowing a trainer with personal hygiene issues, and a history of TMI.

 A loud whistle blew promptly at 6 A.M., and Lori, wearing a hairnet, plastic goggles, and close toed shoes awkwardly made her entrance. "You're all mine today, and I hope I don't scare the SH. . .( bleep) out of you honey, but if you don't listen to me,  you could lose a (bleep, bleep)  F. . . g (bleep) finger!" A voice with an "edge," came out of nowhere. It was Ida (not her real name.) Ida looked like a beauty queen. Very feminine, petite, and under the hairnet, "made up." She was wearing clothes that looked greasy and dirty. Her over utilized, dollar discount spray bottle perfume was unable to hide the factory smell of metal, grease and body odor. "I like to wear my SH. .. (bleep). . - ridden clothes when I run the machines here, because when I walk in the side door  through the kitchen of my house, I am butt naked! Yep, butt naked like Lady Godiva from the cannery!! I park the car in the garage, leave my clothes in the trunk, take a shower, and then. . . . . . . . Well,  (bragging now with a BLEEP eating grin), let's just say, "Vah, Vah Vah Voooom!" "My new husband doesn't kick me out of bed for eating crackers if you know what I mean!!"  Then huge, (almost evil sounding) explosive laughter came spewing out of Ida, with her shoulders shaking while she entertained herself sharing (rather loudly I might add), her own story for everyone in the break room (especially the men) to hear. Lori, still an innocent, unworldly teen, was nervously looking around the room for an exit sign!! "I'm your trainer, honey, so you better listen up to everything I say!" Ida continued with more and more TMI.  And in the first five minutes of meeting Lori, Ida gave her more (unrequested) sex education, swear words, and gruesome, bloody visuals of how people had lost their fingers, arms, feet, hands and toes in the canning plant,  than she ever wanted to hear. Lori was exhausted. Her brain, and her physical comfort zone had been violated by TMI and TMS!!  (Too Much Information and Too Much Stimulation!) Lori lasted only one day on the job working with Ida, and her bean canning factory future summer ambitions, abruptly came to an end!!  Which is exactly the point of today's post.

How do we as caregivers communicate with our care partners in easy, respectful and understandable ways??? The above example was one of extreme and inappropriate behavior, (maybe too extreme of an example). But the question of how we are connecting and communicating with elderly people suffering from dementia is an important subject worth pondering. Are we overloading those that we love with TMI, and TMS??  Are they looking for an exit sign, ready to bolt out the door like Lori was in the story above? Or do they just hang up whenever you call them? Asking too many of the WRONG questions is a common mistake people make when communicating with people who have been diagnosed with dementia. I think that we all have made these mistakes (I know I have.)  So let's explore some common TMI mistakes that people make every day, unknowingly with people challenged by dementia.

Telephone communication with people experiencing dementia is extremely important. Hearing news from friends and family gives the language centers an opportunity to be exercised. However, people with dementia can only speak of , "now." So, when asking questions, it is not appropriate to ask, "What did you do earlier today?" "Did you have a nice visit last week with your doctor?" These questions are TMI, and impossible to answer. Why? Because they require memory retrieval, mainly short-term memory retrieval. If you call a loved one with dementia, do not ask difficult questions. Ask questions about, "now," or questions about the very distant past. "What are you doing NOW?"  "How are you feeling, NOW?" "Where are you sitting, NOW?"

Or, when your elder care-partner with dementia goes into a  conversational tangent about the past, ask very specific questions about the repeated story. Find out why it is so significant to them. Let them lead the conversation. If they go to the same story such as Lori's mother who always talks about going to church on Sunday's in the 1930's and 40's, her mother's cherry pies, and visits to her grandparent's house. Lori would ask, "What is your favorite memory about visiting grandma and grandpa?" "What did your grandparent's house smell like on Sunday's after church when you would first walk in through the front door?" "What activities did you and your cousins participate in after dinner at your grandmother's house?"  "How long did it take to drive to your grandparent's house in the 1940's?

If you are finding that it feels futile to contact your loved one on the phone, because there are the same stories, and a lull in the conversation, it could be that you are "TMI ing" them without knowing it which in and of itself can lead to over stimulation. If you are a parent, go back to what it was like with your 2 year old, when they would short circuit and have a melt down from being overstimulated. With elderly people challenged by dementia, it isn't much different. They too can become over stimulated with TMI.  A part of them wants to retrieve the information from their short-term memory reserves in their brains, but they can't do it anymore. So, when they become silent on the phone or in person, it may just be that you are asking the wrong questions causing a, "deer in the headlight" moment of an empty mental canvas. Unintentionally, when we find ourselves in these situations, it is almost as if we have hit the invisible "delete" button and now have an empty page!! If it is frustrating for us, it must be a thousand times more frustrating for our loved ones stricken with dementia, because one of the greatest needs that we have as human beings, is to connect to other human beings!!

 So, please remember, that although your loved one on the other end of the phone, may not remember that you called them, please call them ANYWAY!!!!  You are doing yourself and your loved one a HUGE disservice by not staying connected. They need to talk, and talking stimulates brain function.  And you need to know that on a heart level, you are still VERY MUCH CONNECTED!!!!! Don't become a "TMI /TMSer," become a listener, a follower, and a heart to heart connector! Pick up the phone and CALL! You will be glad that you did!!

 Copyright 2015 Caregivers Get Fit! Mama  Nicey

The information in this blog is information. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.

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