Saturday, October 17, 2015

She Talks Too Much

It was Saturday, and sensory stimulation was everywhere. Buzzing sheers, electric shavers, snipping scissors, and plastic aprons. The sounds, smells, head rocking, scalp scrubbing gyrations, were a rude awakening for Lori's mother who preferred her, " happy place," on a padded chair on a quiet deck  surrounded by singing birds, beautiful trees and passing clouds. There, without a care,  living in her "now-filled,"  presence of one-sided canine conversations, she was in control, she was loved unconditionally without any expectations, and could just sit in the silence. It was in this peace-filled presence, a partition for her soul, where she felt most alive.   Nonetheless, she approached this aerosol spraying, foil wrapping, chin waxing jungle, with hopes of future elegance, obtained only after putting in her obligatory appointed time in a spinning chair with hydraulic elevations. And hairdressers who had habits of filling in silent spaces with empty conversations, along with giving Lori's mother specific instructions that were difficult for anyone to follow, much less a person challenged by dementia.  "Tilt your head. Lift your chin. Tilt your head again. Could you lift your chin? Alright, almost done, just close your eyes, hold your breath, and turn to the right.  Now, if you wouldn't mind, could you tilt your head again?"  All of this effort, under the hood of a dryer with tightly wound curlers so that she could look, " put together," in her favorite pew, singing her favorite hymns on Sunday mornings at church. But even Lori's mother, as patient as she could be, knew her limitations.

 Lori's mother had other medical challenges, along with dementia and many times needed to rest which caused them to visit many different salons as a "walk in" rather than at an appointed time. The first hair salon Lori took her mother to was right around the corner from Lori's house. Lori's mother enjoyed the hair stylist, but after only a few months, the salon moved, and they needed to find a new place to go.

Every salon was different, but all of them had characters with unique faces.  Faces greeting faces with bleached hair, mousse ridden, hip swinging, gum smacking spontaneity. Very happy people in a happy place!  There was bright lipstick, painted nails, too much rouge, glued- on lashes, and eyebrows drawn above the eyes of one stylist with a  black grease pencil,  looking more like Mickie Mouse, than human!  And the new people cowering,  in the corner were easy to spot,  because they hid their hair behind magazine covers waiting for their names to be called, preparing themselves to be the new kids on the block.

Faces on the phone, faces with their heads all lathered up with soap, towel covered faces, faces with ratted up hair almost as tall as, "The Cat In The Hat!" Faces wearing curlers stacked and rolled in plastic cylinders clipped tightly to their heads.  But amid st the culture of creativity, there was a deep respect and heartfelt compassion, even from the oddest looking appearances. But Lori's mother didn't judge her hair stylists by the way they did her hair, but by the questions they asked.

Lori would point out different hair stylists saying, "Maybe she will take you next?"  And Lori 's mother would always say the same thing, "She looks like she talks too much."  Lori would say, "What makes you think she talks too much?"  Lori's mother would just roll her eyes, and would whisper under her breath for only Lori to hear, "I don't like her shoes."  And if Lori would ask her more questions there would be more insults. Finally after much searching and much hair spray, Lori and her mother found the perfect stylist. And true to form, the stylist is still her stylist today. Not only is she a skilled hair dresser, but she doesn't talk when she works on Lori's mother's hair. She is very comfortable with the silence.  After she works on Lori's mother's hair, her mother says the same thing, "I like her, we need to see her from now on." And Lori would ask, "What do you like about her, Mom?" And her mother would respond, "She doesn't talk so much."

So, the moral of the story is that if you are in a position to work with people, and the person in front of you has dementia. 1) Ask them one thing at a time and then pause for a response. If there is no response, then repeat, but repeat the same ONE question.  And if you have to give them specific directions in a medical or spa setting, be patient and  give one direction at a time. If you feel impatient, have someone who is more patient than you are work with the person. And watch how the person who is mindfully patient, handles the situation.  You will find yourself gaining skills that you never thought you had, but you must be willing to be led.

People with dementia can only take in a few things at a time,  and become not only confused but agitated when they are overstimulated by too many questions. If the person with dementia you, or your staff are working with always appears agitated,  (and doesn't have a medical history of  a pathology causing the agitation), organize a few dementia communication training sessions. It is quite possible that caregivers themselves, may unknowingly be causing the agitation. (I know this is hard to hear, especially when caregiving/care-partner's intentions are pure), but getting some training in positive dementia communication skills may be all that a caregiver needs to improve the agitation levels. And the good news, is that in time you may find that you, or your staff can become wonderful, patient and skilled, positive communicators!  So, again ask only one question at a time.

 2) Small talk with scattered subjects may be too much talk for people with dementia. Use small talk to connect, but make it about the present moment, not long stories about you, because they can't follow your long stories.  For instance: If you are standing outside and a leaf falls, talk about the falling leaf.  I promise you, the entire world of connections will open up for both of you, if you keep everything in the present moment.

 3) Let them lead you by their own conversations.  If they have a favorite memory from 60 years ago, go with them into their world. Ask questions about What? When? How? Where? Many things will open up and you will be FLOORED to see that they will not repeat these stories very much, anymore. All they wanted to do in the first place was to FEEL the emotion of the the memory of long ago, and your ability to connect with them while they are re-living that memory brings them to the innermost center of that emotion and they will then have closure and completion with that memory. (And this is true for unpleasant memories, too that may wake them up at night.) Please note: This isn't psycho- therapy. This is active, mindful and skillful listening, using validation.  Remember,  as Maya Angelou once said: " I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel."  (See Validation Breakthrough by Naomi Feil, MSW to learn more about this.)

Lori picked her mother up today from the salon. She was sitting in the front with the people hiding behind the magazines, but she wasn't hiding.  She was proudly and confidently holding up her ratted, teased, curled and sprayed hair. "How did it go mother? You look beautiful!! Lori's mother was smiling, "I like her a lot, she's my favorite, not like that other one. This one's a keeper," said Lori's mother. "This one, mother?  And not the other stylist? The one with he ugly shoes? " Lori was trying to get an answer out of her. "I don't like her at all. She talks too much, Lori!  She talks too much!"

Positive Communication methods for people living with dementia:  We recommend seminars by Teepa Snow,M.S., OTR/L.FAOTA, Naomi Feil, MSW,, and her books, all of them. And the life changing, ground breaking books, "Contented Dementia," by Dr. Oliver James, "The Mindful Caregiver," by Nancy L. Kriseman, and "Deeper Into The Soul," by Nader Robert Shabahangi, Ph.D, and Bogna Szymkiewicz, Ph.D

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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