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Using Redirection as a Calming Communication Technique for Alzheimer’s

When a loved one or close friend is upset or concerned about something, it’s part of our nature to listen, empathize, and possibly help them resolve the situation. As caring people, we do what we can to make those close to us feel valued and respected.

However, when someone is diagnosed with Alzheimer’s disease or dementia, another dimension to feelings of anger, confusion, and fear in the affected person is added to the situation, due to impaired memory and altered cognitive abilities.

Alzheimer’s disease or dementia can blur the lines between imagination and reality. Although your intentions to help are grounded in good intentions, trying to explain to the person why their perceived reality isn’t true won’t help the situation, and can be taken by your loved one as an attack. This can escalate already heightened emotions and increased volatility in their behaviour, and cause frustration among family and friends who aren’t sure how to respond to unexpected outbursts.

Staying connected to a loved one is a matter of understanding what’s rooted in their anxiety, and taking positive action towards a desirable outcome that not only changes the negative behavioural expressions, but also leaves them feeling supported, respected, and listened to.

At CareHop, we regularly employ a technique known as redirection with our clients, which helps them transition from an unsafe or unpleasant frame of mind to a place a joy and contentment. 

What is redirection in elder care?

Redirection is a technique that shifts the focus of the loved one away from a situation that causes them fear, anger, anxiety, or from engaging in dangerous and unsafe behaviour, toward a situation that’s more calm and pleasant.

We accomplish redirection in 4 simple steps:

1.     Validating their concern: Your loved one with dementia simply wants to know that they’ve been heard and acknowledged. It’s often helpful to repeat what they told, and show that you’re taking their concerns seriously.

2.     Joining in their reality: Helping the person with their request builds trust and communication, and will provide you the opportunity to lead them to a positive distraction.

3.     Leading them to a distraction: We proactively create an environment with creative activities, snacks, drinks, music, puzzles, and other meaningful activities that the person enjoys. This step is especially effective with people who have severe memory or attention issues.

4.     Redirecting their attention: Invite them to participate in one of the activities to adjust their focus and de-escalate the situation.  

We successfully use redirection on a regular basis, which brings our client’s families peace of mind that their loved one will always be treated with dignity and respect. When we had the pleasure of working with David*, who had been diagnosed with dementia, we found redirection an effective tool in de-escalating a situation that was causing him significant anxiety.

David: A case study in redirection

Our caregiver had always enjoyed an excellent relationship with David, who normally enjoyed his vintage years with joy and fulfillment. However, one day David became unexpectedly agitated because he couldn’t find his keys, and accused our caregiver of stealing them. 

Prudently, and with empathy, our caregiver employed our 4-step redirection technique to diffuse the situation in a calm, cool fashion and with a smile:

1.     Validate their concern: Show respect and acknowledgment: “Do you think someone has taken your keys? I can see why you’d be upset about that.”

2.     Join in their reality: Build trust by joining in: “I think we’d better find those keys. You know what? I lost my book too. Let’s look for them together.”

3.     Create a distraction: Lead them to a preplanned distraction: “Let’s try looking by the piano for your keys.”

4.     Redirect their attention: Use the distraction to de-escalate: “I love hearing you play ‘Amazing Grace’ on the piano. Can you play it for me now?”

At this point, David had forgotten all about his missing keys and was participating in a much more positive and enjoyable activity: making beautiful music on the piano.

We understand how important it is to follow these steps with complete diligence, and not let any negative verbal redirection take precedence over our positive approach. Otherwise, an escalation of behavioural expression will be the result.

Take care not use negative verbal redirection

It’s important to always avoid negative verbal redirection in an attempt to simply reassure the person that there isn’t anything wrong at all. As good as your intentions might be when doing this, being dismissive, or negating or ignoring their concerns might actually make matters worse by not joining in their reality, upsetting your loved one even further. 

Let’s look at the unsuccessful outcomes of negative verbal redirection in a case where someone can’t find their purse, and is convinced someone has stolen it.

  • “Your purse hasn’t been stolen. You must have misplaced it.” Dismissing their reality of the missing purse shows that you are invalidating their feelings, negatively impacting their trust in you and possibly upsetting them further. It also fails to resolve their concern, as they still believe their purse to have been stolen. 
  • “You don’t need your purse right now anyway.” This is negating their need to know where their purse is. Most people always need to know where their purses or wallets are, as they contain our identification, money, credit cards, and other important items. What matters is that their purse is important to them right now, and if we create doubt in its value to the person, we risk upsetting and frustrating them.
  • “Don’t worry about your purse right now. Come have some lunch and I’ll look for it later.” This approach ignores their immediate need and communicates that their concern is of little importance to us. However, in their reality, the purse is still missing and they will likely continue to look for it.”

The common thread through these scenarios is that it doesn’t matter if the purse is missing or not. What matters is that the person believes it to be missing – this is their reality. That’s why we use the redirection technique to de-escalate the situation and return the person to a much better state with positive, enjoyable activities that bring them happiness.

An important part of successful elder care

CareHop puts the happiness and contentment of your loved one at the heart of everything we do. Our mission is to treat our clients with the respect, care, and dignity you expect under all circumstances. Alzheimer’s disease and dementia diagnoses are journeys we take together, celebrating every special moment along the way.    

I’m always happy to answer any questions you have about our empathetic approach to elder care. Please reach out to me or anyone on my team anytime.*Name and other details changed to protect the privacy of our client

About the Author

Michael Lu is the founder of CareHop, specializing in providing compassionate support for individuals and families touched by Alzheimer’s disease and dementia.

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