The aim of this content focus area is to outline the role of the health care
practitioner in supporting effective communication with the person with dementia
and their family.
Outcome
By the end of this content focus area students will be able to discuss ways in
which the health care practitioner supports effective communication with a person
with dementia.
The Role of the Health Care Practitioner in Supporting Effective Communication with the
Person with Dementia
Health care practitioners have a legal and ethical duty to promote the rights of
their clients. For example, Registered Nurses are expected to uphold the
Code of Ethics for Nurses, as well as the
Professional Code of Conduct for nurses in Australia and Medical Practitioners are guided by
the AMA Code
of Ethics. As you have learnt from the module What is dementia the increasing
age of the population has brought with it an increasing prevalence of
various forms of dementia, of which Alzheimer's disease has the highest
prevalence. As you learnt, Alzheimer's disease is characterised by the progressive and
relentless destruction of organic brain tissue, eventually resulting in the complete
loss of a person's cognitive and functional abilities. Thus, associated with the
progression of the disease, comes an inevitable loss of communication ability.
It is clear then that the person with dementia is placed in an increasingly
vulnerable position because of their increasing difficulty to communicate their
wishes and needs to others. For this reason, health care practitioners need to
have an excellent understanding of the progressive limitations for communication
imposed by the disease and plan care that takes into account the communication abilities
that the person with dementia retains. In so doing, health care practitioners promote
the dignity and quality of life of the person with dementia.
Resources and References
[1] Rural Health Education Foundation (2007).Program 314c Dementia:
What difference does person centred care make.[Streamed Media Broadcast]. Accessed
October 8, 2007, from
http://www.rhef.com.au/programs/314c/314c.html
[2] Brooker, D. (2003). What is person-centred care in dementia? Reviews in Clinical
Gerontology, 13(3), 215-222. Accessed October 8, 2007, from
http://journals.cambridge.org/../id=230595
Instructions:
Watch the following short streamed video segment from the Rural Health Education
Foundation (2003) where a man with early dementia (Brian) and his wife (Lois) are
interviewed about receiving the diagnosis of dementia. This video segment
graphically illustrates the importance for all health care practitioners of effective
communication skills to meet the needs of a person with dementia, and their family.
[If you would like further information about early onset dementia visit: Alzheimer's
Australia (2005c). What is younger onset dementia. Accessed October 8, 2007, from
http://www.alzheimers.org.au/upload/HS7.1.pdf]
Question 1 : Using knowledge of the disease process in dementia, and
the communication strategies that are required, review the video taped scenario and decide
if Brian and Lois were told about the diagnosis of dementia in an appropriate way. Please
write down reasons for your decision, citing examples from the scenario to assist your
explanation. Outline the communication strategies that might have been used in this
situation to promote more effective communication.
Answers: It is clear that Brian was not told about this diagnosis of
dementia in an appropriate way. Brian's presence was ignored by the
medical practitioner who concentrated on speaking to Lois. The medical
practitioner should have spoken directly to Brian about his diagnosis,
in the presence of Lois, rather than ignoring him. It is clear that
Brian was acutely aware of being treated "as if he was not there".
Question 2 : Reflect on other ways your future professional practice
could be strengthened when you communicate with a person with dementia. If you have the
opportunity, aim to incorporate these strategies into your future clinical practice then
reflect on the outcomes.
Answers: This is very personal answer and depends on your current level of
comfort when communicating with a person with dementia. Pivotal to your
answer would be the strengthening of professional practice by treating
every person with dementia as an individual who is deserving of dignity
and respect. Additionally, being aware of the importance of using appropriate
verbal and non-verbal communication is an important requirement for excellence
in professional practice.
Question 3 : Reflect on how you might involve the family when
communicating with a person with dementia and document the strategies that you could
use to enable effective communication.
Answers: Ask the family about the life history of the person with dementia,
for example, where they were born and the names of their family. Ask the
family about any past interests and hobbies. Document this information using
for example the life history booklet outlined in the resource below. Use other
strategies to enhance communication such as showing the person with dementia
photos of important people and events in their past life as well as significant
objects that may remind the person with dementia about their past interests.
Document the response of these strategies by the person with dementia and
discuss this response with the family.
Question 4 : Think about situations where you have observed in
clinical practice, films, theatre or television or in written materials health care
practitioners in communication with a person who may be cognitively impaired. Identify
the strengths and weaknesses of this communication using the key points of effective
communication that you have outlined above to assist you.
Answers: This answer will vary depending on your past experiences. It is useful
to think back to a situation and the ways in which health care practitioners
communicated with the person with a cognitive impairment. Ask yourself if they:
Treated the person with respect and dignity and used a caring approach
Introduced themselves
Took care to use simple sentences that contained only one idea at a time.
Gave the person with a cognitive impairment sufficient time to respond
Used touch and body language appropriately to engage the person in the
communication and show empathy and warmth
Structured the environment in such a way to promote effective communication
Question 5 : Obtaining detailed information of the social and cultural
background, together with the life story of the person with dementia, aids effective,
purposeful and meaningful communication.
Communication in Dementia Care