Sometimes, the world can look completely different depending on your vantage point. This past summer, national news reported that an eighty-seven-year-old cognitively impaired woman was brutally tazered in the chest, handcuffed and arrested for trespassing after wandering onto private property holding a knife near a local youth club to gather dandelions.  I suppose that this lady must have left her home that day with the notion of gathering flowers. I wish that I had the benefit of her perspective as the situation unfolded.

Some months ago, a local long term care facility put on a virtual dementia tour so that caregivers and elder care industry professionals could briefly experience the world through the vantage point of an individual with dementia. With mittens on their hands to simulate arthritis, inserts in their shoes to “experience” neuropathy, goggles dimming their vision, and incomprehensible sounds blasting throughout the tour causing frustration and confusion, the participants were given instructions to follow, instructions which made no sense. The experience helped me to appreciate how different our world looks to someone living with dementia and how very emotionally vulnerable they must feel.

Keeping their sensitivity in mind, here are some simple strategies to facilitate communications. The tips were generously shared by Angela Lunde of the Neurology Department of the Mayo Clinic in Rochester, Minnesota.

1. Get down on it. Dementia can be accompanied by a decline in peripheral vision. How much would you understand and how would you feel if you could only see the torso of the person speaking to you? Kneel or sit beside the demented individual to get down to their eye level.
2. Go slow. Individuals with dementia may process sounds at a slower speed and short term memory loss can impede their immediate recall. Pausing as you speak can help these individuals “catch up” and understand your words.
3. Louder does not always mean clearer. Speaking in a loud voice can inadvertently escalate a difficult situation.
4. Combine choice with control. Too many choices can be confusing. Give just two choices instead.
5. Be inclusive. Dementia training should not be confined to long term care facilities, rehabilitation centers and hospitals. Our communities should work to reduce stigmas and train public service employees and business people on how to be “dementia friendly.” This is good for business and contributes to improved safety and quality of life for the cognitively impaired in the community.
6. Keep it Light. Natural light, that is. Keep curtains and blinds open during the day. Watch out for distracting reflections from window panes and glare from artificial lighting and deep pools of bright light, especially on stairs and in bathrooms.
7. Go Outside. Yes, your mother was right! Going outside to enjoy nature is good for you. Exposure to sunlight contributes to good sleep hygiene in setting your circadian rhythms and is linked in studies to decreased blood pressure. This is especially important for individuals ages forty-five to sixty-one, in light of a recent medical study associating mid-life hypertension with an increased risk of dementia, compared to those with no or low hypertension. Abell JG, Dugravot A, et al., European Heart Journal 2018; June 12.

For further information regarding dementia, additional dementia resources can be found online by visiting:

• Tips for First Responders
• Alzheimer’s Association – First Responders Info 
• National Council of Certified Dementia Practitioners – Tips for First Responders 
• ACT Sector Guide – Dementia Friendly Businesses 
• Alzheimer’s Society: Dementia-Friendly Finance

Questions? Let Jane know.

Jane Fearn-Zimmer is an Elder and Disability Law, Taxation, and Trusts and Estates attorney. She dedicates her practice to serving clients in the areas of elder and disability law, special needs planning, asset protection, tax and estate planning and estate administration. She also serves as Chair of the Elder & Disability Law section of the NJSBA.