We all have needs. They may change at different times of our life given circumstances, but there always seems to be a few core ones that never go away or lessen in our lifetime. If we pay attention to them and speak up and they are met (either by others or ourselves), then we tend to feel good, safe, secure or content. If our needs are not met, if we aren’t aware it is a need, if we are too shy to speak up- then we don’t feel good. We may look outward and blame, get angry or sad. We may look inward and think we are not worthy. When needs are not met, I am sure you would agree- that we feel bad.
What if you could no longer effectively communicate what your needs are? If you spoke and others who could help you, didn’t understand and so they didn’t/ couldn’t help? What if they did understand but didn’t know how to meet what you were needing? It would be like asking someone to scratch an itch on your back and they don’t get that spot even with your directions. It would be frustrating and most likely would cause upset. IE: Out of frustration you might think: Why can’t you understand? Are you stupid? Or outbursts IE: slapping a person’s hand away, leaving upset, yelling or sour looks. It would be agonizing and exhausting for both the person with the unmet need and the person trying to help.
Speaking up is only one part of the story when communicating needs. A person with dementia may not be able to communicate their needs verbally and so we need to look at the larger picture. Put your detective hat on and investigate the clues. In addition to what the person is saying, what is this person feeling? How is this person behaving? What do I know about this person’s life story? Consider too what was going on just prior to the upset. Perhaps there are additional clues and insights there.
Visiting another lady in a care facility, I was wheeling her through the empty dining room- we were just touring around to see what we could find. She started to become agitated and said “I can’t do it! I can’t do it!” She was really stressed. When we passed through to a quiet area, I turned to face her. I knelt down and took her hands in mine looked her in the eye and with a smile said “There is nothing to do. We got it all done and thank you so much for your help!” I didn’t know for sure what caused her upset, but I had a hunch. Going through the dining room with all the tables nicely set with tablecloths, place settings and such may have triggered a memory or past feeling of preparing for a social gathering- I knew that was a big part of her life. Feeling like it was too overwhelming a task to do now, she expressed anxiety and upset. She needed reassurance, that all was taken care of and even acknowledgement of her contribution for a job well done. Her smile and softened shoulders confirmed my hunch was right and we both carried on.
Empowering Another Without Interfering
I recall visiting a lady living in a care facility years ago. I met her in the hall and we sat to look outside at the spring flowers coming up. A series of small strokes in the past had resulted in her limited speech. She could answer yes/no and occasionally a short, clearly spoken phrase. I had been visiting her twice a week regularly for about 8 months or so and we had gotten to know each other quite well.
On this day, she grimaced, and her hand went low on her stomach. “Are you in pain?” –Yes. “Is it an ache or like someone stabbing you?” Nothing. “Is it an ache?” –No. “A stabbing?” –Yes. “Well that doesn’t sound good. Why don’t we go to the nurse’s station and see what she has to say?” –Yes. I wheeled her there and called the nurse’s attention. She came over and ask us “What is wrong?” I crouched down next to my lady and looked at her. I provided the context of what had just happened and my lady’s decision to come to the nurse’s station. I gave them the space to communicate from there. As needed, I filled in more specifics as to what I saw and what I understood from my lady being careful to not diagnose or step in where it was not my role.
Those clues helped the nurse ask more specific questions which my lady was better able to answer. The three of us contributed to effective communication. The nurse could make a plan to help her now as well as a plan to monitor her later. A couple of days later, I learned from my lady’s family that she had a Urinary Tract Infection (UTI) and was being treated. Good to catch that early. I was glad to be able to help my lady access the assistance she needed.
When our loved one is in pain, we want to do everything we can to help her. Sometimes the most efficient and effective thing we can do is to listen, to acknowledge what she is saying and observe what is going on. By doing so, we empower our loved one as well as those around them, allowing for better understanding and assistance.
How can I help my mom without taking away her independence?
Whoa! Are we talking about teenagers here or an aging parent who is having some difficulties and clearly needs some supports in place? Unfortunately for the well-meaning daughter or son, their advice, demands, or pre-determined arrangements can be met with criticism, anxiety and down-right stubborn refusal! That doesn’t benefit anyone and it can hurt your relationship.
Take inventory of the situation. You learned from a previous article to document all incidences and struggles your loved one is dealing with. You may have arranged to speak with her doctor and/or Home Care to learn more about what she is dealing with and the range of supports available. You may have talked with other family Caregivers as well. You have educated yourself about the options and the question remains: Will mom be on board?
Turn the tables. Consider if you were struggling with something, would you be receptive to a family member coming in and saying “Hey! You need help and so I have this help set up for you! Oh, and it starts tomorrow!” There is a good chance you might be put off- not knowing the details and the impact on your privacy, on your life. You might be in denial that there is even a problem at all! You may think any “help” would be intrusive and make you look/feel incapable. That doesn’t feel good. No thanks!
A simple 3 step approach is better and it starts with initiating a relaxed conversation.
1: Choose a time that is good for both of you. Where she is well rested and neither of you are preoccupied with anything else.
2: Be curious and uncover what is real for her. Talk about different areas in her life and ask how they are working for her. What is not working/challenging for her? What stresses her out? Is she fearful of anything? Witness her and acknowledge her answers. Let her know you understand what she is saying and how she feels. This is not the time to “fix” but to listen and gather information from her perspective. This is a huge gift. [if you are unsure about that, turn the tables to see how you would feel to be heard this way] You may find this is also the opportunity to ask her questions about her experiences about when she supported her own parents.
3: Come prepared with the information you have gathered about one or two specific supports needed. (You can include options but for now, limit the concerns to one or two) Have your thoughts in order before speaking. Watch your non-verbal gestures and ensure they are in line with the goal of the conversation which is ultimately about her well-being. Share with her what you were feeling concerned about [one concern at a time] and that you wanted to be proactive and see what possibilities are available. Share with her the information you gathered in a short, concise manner so as to not overwhelm or confuse. Paint the picture of what her day would be like with this support, remind her of the concerns she had already expressed to you. Focus on the benefits to her and how they address those concerns. Decide together what the next steps are. It may be to call for a consultation from the company and ask questions or to do a trial run.
Working together, gathering accurate information and providing opportunities for open, honest communication helps maintain a healthy relationship. If tables were turned, wouldn’t you want the same consideration?