This is really a post to cheer Mr Bojangles, but it is also a post about dementia. Two weeks ago, I was invited to join my manager to help present a training session on dementia to a dozen or so new volunteers. My task was to talk about my experiences on the ward with dementia patients, and to give tips on good communication. Well, I put my words into action and went out into the seated audience and spoke to people face to face. I was really saying “well done for volunteering, it’s good to meet with you.”
The first thing I taught them was a passcode. A six-digit number that they must remember! I told them it was not a key to opening a door, nor a key to a medicine cabinet but a key to a secret entrance! This immediately got their attention. I told them the code: 553807 and that I’d ask them later if they could remember it, forbidding them to write it down.
Well last week I approached a bed where a lady patient was shouting and was certainly disturbed. She shouted out “Call the police.” Well, I made my first mistake here, being put on the defensive, especially as she repeated “call the police.” I said I’m sorry, but I don’t have a phone. Immediately I said that I realised what a dumb answer that was, for she was likely to say “Well bloody go and get one”. Anyway, I tried to climb out the hole I had made by asking her “Why do you want to call the police” and she shouted out, “because I’m dying.”
I found this both sad and funny! Funny, that she was already in a hospital bed; the right place; but sad for she was clearly disorientated and quite possibly delusional. I could easily have said that she was already in hospital in the right place but instinctively I felt that anything I might say would produce more illogical argument. It was then that a watchful nurse told me that the patient had told her earlier that morning that she (the patient) had died yesterday! How would anyone react if a person came to you and said “I died yesterday.” The only person who could get away with saying that is Mr B for he seems to be forever coming back from misfortune! I think he told me he had already put two old pennies on his eyes as a joke!
I continued to tell the audience of specific and challenging conversations with patients one being the elderly gentleman in his wheelchair that told me “You’re wearing my shoes!” Mr reply was “What size shoes do you take?” (thinking the logical conclusion that his large feet and my small feet would make this impossible.) But he came back at me “But you’re wearing my shoes.”
So, I put a series of possible answers to my audience of new recruits, namely:
a) They are very comfortable,
b) Yes, I’d like to borrow them for half an hour.
c) Yes, they are hurting me feet.
A lady in the front row suggested I could have answered with a compliment like “you have very good taste sir”. I like that. Distraction can work. We can go with the flow of a conversation or try distraction techniques. I remember one elderly man, every time I tried to turn the subject matter to music, he would say, “I know you’re trying to con me”.
One patient told me that she was the Queen’s sister. She even told me that she had not at first believed this, but the Queen has insisted on this being true. So, on that occasion I went with the flow, going along with the fact that she was indeed the Queen’s sister but that she felt uneasy with this role!
Well, after describing many of the conversations I had with patients “living with dementia” I came back to the passcode number, 553807, reminding them that it did not unlock a door but using that number very much unlocked a corridor to good communication! So that:
55% of communication is body language,
38% is tone of voice, and only
07% is word content.
I have proved this to be the case, having a 5-to-8-minute conversation with a lady patient from Uzbekistan who spoke no words of English. Nor indeed did I speak or understand Uzbekistan. But I sat near to her, face to face, at eye level and demonstrated with my facial gestures and upper body arm gestures that I was indeed listening to her and comprehending what she was saying. I would nod, frown, raise eyebrows, say “yes”, shake my head, open my mouth and go through a whole range of expressions. Really trying to mirror her tone of voice and mannerisms.
When new volunteers are asked to shadow me, I usually tell them to “listen with your eyes” and “switch your lights on”. When a patient can see that that you are really interested in what they are saying (even though they may have died yesterday) then you are more than halfway there to sharing a meaningful communication. The patient may not remember who you are, or why you were there with them, but the “afterglow” of that conversation with remain with them for longer. 😀😁🤔🤪🤐😗☺️☹️😨😣😡🤡🫡😜😁🥴🧐😱😢
