When Communicating with Someone Who Lives with Dementia: Wait.
I love growing PersonFirst® teams. For many reasons, it is highly satisfying to collaborate with caring, willing people to really think through and then take action to empower those who live with dementia. And what I love most is how much I learn every time I engage with a new team. This year, one of the things I learned was from a CNA who is a Neighborhood Coordinator in a dementia specific neighborhood.
It is the very simple and very powerful thing she says she teaches all of her staff: wait. Wait at least 90 seconds for someone who lives with dementia to answer or respond. Do not ask again, do not suggest, just patiently, wait. This was such an easy thing to remember that is stuck with me. And I try to use it. One morning recently, I was visiting a newly opened household. My mission was to find out how life and work was unfolding and to be able to offer any support or suggestions. To do this I talked with as many people living and working there as I could. The household I was in was nicely appointed, wide open spaces, the kitchen and dining area opening into the living area where here were comfy chairs, a table with chairs and a couch. At the table, Marge was sitting in her wheelchair. I introduced myself and asked her name. Then I explained my mission and asked, “What do you like about living here?” I then waited...30, 60, 90 seconds passed. I am not a patient person, usually. I am much better about it when serving those who live with dementia, but it is not my nature to be patient – but I waited. After about two and a half minutes, Marge said, “It’s quiet here. ”“Oh,” I said, “What else do you like about living here?” And... I waited. This time she answered in about 60 seconds, “The space.” Then she nodded her head and shut her eyes. I took that as a signal that she was, in fact, finished speaking with me.
I went on to talk with others who live and work in that house, moving around the space, until lunch time when I found myself back at the table in the living room with Marge who was still sitting there though now awake. I greeted her by name and sat down. Presently, the household leader came to remind Marge that is was lunchtime. She said, “May I take you over to the dining room?” Marge replied, “No.” She then looked at me and asked, “Will you take me to the dining room?” I was surprised, but mostly honored. What I think happened is that I waited.... and listened, and heard. Even people who feel in their hearts that they care deeply, at times do not recognize that interactions that may be slow, soft and quiet often grow a relationship. I did take Marge over to the dining room. We ate at the same table. She said little. I said little. Yet, we were together for that time.
Megan Hannan, MS, is an Executive Leader at Action Pact and has provided leadership in long-term care for over 25 years. Megan developed Action Pact’s signature train the trainer program, PersonFirst®. She serves on the Board of Directors of The Pioneer Network.