Communication and Relationships

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Communication and Relationships

• Module 5

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Learning objectives Through this workshop you
will be able to

• Define relationship and communication needs of
  older adults
• Identify effective communication strategies
• Examine the complex roles of family members
• Use techniques to build more effective
  communication and partnerships between family
  members
• Examine challenging behaviors and effective
  responses

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Relating to older adults

• Knowing grandparents seems to be a key in
  relating to older adults
• Older adults do not consider themselves older,
  they see themselves without age
• Older adults may experience time stress. The
  world is moving too fast for many older adults
• Everyone needs to be needed and to live the best
  quality of life whatever the circumstances

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Practical steps for relating to older adults

• Listening I stopped talking when people stopped
  listening
• Recognizing their view of their age
• Relating to older adults as a 2-way communication
  bridge
• Treating older adults as individuals not as part
  of a larger group labeled seniors or the
  elderly
• Health care providers Put down your clipboard
  and look at me
• There is a reason that we have one mouth and two
  ears

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Reminiscence A way of reliving,
re-experiencing or savoring events of the past
that are personally significant

• Maintains self-esteem and reinforces a sense of
  identity
• Feels a sense of achievement and pleasure
• Copes with stresses related to aging
• Gains status or acceptance by revealing life
  history
• Places aspects of the past in perspective
• Deals with emotions such as grief
• Establishes a common ground for communication

Caution Some gerontologists believe that lay
persons should not encourage reminiscence since
it can cause unpleasant memories to surface and a
professional should address these memories
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The listener during reminiscenceInstitute of
Gerontology, University of Michigan

• Gains knowledge and understanding of the period
  in which the person lived
• Builds a bridge between the past and present
• Establishes a relationship through sharing
  information and experiences
• Provides a context for gaining insight about the
  persons behavior in the past
• Can be used as a therapeutic tool in care
  planning or identifying assets, needs, and
  resources

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Essentials of good communication

• The difference between the right word and the
  almost right word is the difference between
  lightning and the lightning bug
• -Mark Twain

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Watch your language

• Older adults want and need to be treated with
  dignity and respect
• Referring to people with a medical condition such
  as handicapped, diabetic, or arthritic is
  defining someone by a medical diagnosis, not as
  an individual
• Avoid negative references and the use of words
  such as suffers, afflicted, victim,
  unfortunate, confined to, or bound to a
  wheelchair

Respect
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Communicating with older persons

• Call the person by name
• Assist the persons orientation to time and place
  Here it is Tuesday already
• Really listen
• Pay attention
• Speak distinctly
• Talk directly at the person
• Take your time, one thought at a time

• Use body language/non-verbal cues
• Use tone of voice appropriate to the conversation
• Listen to silence
• Acknowledge feelings even if you dont agree
• Look for hidden meanings
• Encourage and reassure

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Communicating with someone with dementia and
Alzheimer's

• Identify yourself and call the person by name
• Use active listening (check out what they hear)
• Keep sentences short and simple
• Use repetition
• Speak clearly
• Keep terminology simple, avoiding jargon and
  acronyms

• Use concrete statements.
• Speak in a clear, even, normal tone
• Wait for responses to questions
• Dont attempt to finish the persons sentences
  for him or her
• Use humor when appropriate

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Dealing with difficult behavior

• Find out what is causing the behavior.
• Is it a recent behavior?
• If so, see if there is a medical cause Is there
  a treatment?
• If the behavior is caused by dementia or mental
  illness, dont confront Validate the feeling, if
  not the content
• Redirect someone who is getting agitated. Give
  him/her something else to do or to discuss
• Eliminate distractions, if possible
• Dont take the behavior personally if it is
  related to a disease process. Often care
  receivers lash out most at those they trust the
  most They know that certain caregivers will take
  abuse and still be there
• Use I messages

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Impact on relationships in the family

• Relationships will change based on the level of
  need of the aging family member
• Family roles change
• Our feelings and reactions to the aging family
• May be the same as they have always been
• May change depending on family history
• Other family members (children and spouse) may
  feel neglected or ignored

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Is parent-child role reversal possible?

• Although a controversial concept, some people
  believe that a common experience is a role
  reversal when the roles and relationships of a
  lifetime are reversed
• The adult child feels that s/he not only takes
  over the role of caregiver but also becomes the
  primary or sole decision maker
• Complex relationships can create confusion,
  stress, and guilt
• The parent will always be the parent and the
  child will always be the child

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Examples of possible role reversal of the spouse

• One spouse must assume different responsibilities
• The husband, who always managed the family
  finances, is now unable to balance the checkbook,
  pay bills, or make investments due to dementia or
  Alzheimer's Disease
• The wife assumes management of finances in
  addition to other household responsibilities and
  may have a full time job outside of the home
• The wife becomes ill and can no longer manage
  household responsibilities such as cooking and
  cleaning
• The husband must learn how to do laundry, shop,
  prepare meals and also work full time

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Role of siblings

• Adult sibling relationships are diverse and range
  from love to detachment to hatred
• Adult sibling relationships need to be
  reevaluated
• Childhood images of a brother or sister may now
  be outdated
• People change over the years
• The sibling relationship will influence
• the help given to aging parents

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Sibling relationshipsWhy are they important?

• Recognizing feelings and understanding how
  relationships with siblings developed in
  childhood and over time can help siblings to
  negotiate the roles and responsibilities with
  aging parents.

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Siblings and other family members

• Evaluate the needs of the family member
• Take the initiative to be part of decision making
  and to engage other siblings and other family
  members
• Communicate honestly. Stay away from statements
  that typically begin with you and sound like
  you are accusing someone of doing something wrong
• "You are not being responsible!"
• "You obviously don't care about me or our
  parents!
• Use I messages that are your own thoughts,
  opinions, and emotions and communicate them
  calmly

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Family conference

• Have a family conference to include
• Spouse, children, grandchildren, friends,
  neighbors involved involve out-of-town relatives
• Talk about the future including fears, potential
  problems, wishes, individual roles and legal
  issues
• Determine best fit, matching the skills and
  resources of each sibling
• Share resources and partnerships
• Engage other family members or people outside the
  family

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What to say to ask for helpUsing I statements

• I cannot manage this alone
• I feel overwhelmed
• I am concerned that Mom's care requires more
  than I can provide myself
• I feel that the responsibility for Mom's care
  has been left to me and I don't think that's fair
  to either one of us
• I do not mean to complain or criticize, and I
  very much appreciate you listening to me
• I would like to let you know what I have found
  out about what they need and what we can do about
  it so far?
• I need you to call (Mom), (Dad), (other family
  member) at least once a month to help me out

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• Finding Help and Resources

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Resources for caregivers

• Call
• 2-1-1 throughout Texas. Provides information and
  access to health and human service information
  for all ages
• 1-800-252-9240 to find local Texas Area Agency on
  Aging
• 1-800-677-1116 - Elder Care Locator to find help
  throughout the U.S.
• Online
• Family Caregivers Online www.familycaregiversonlin
  e.net
• Online education, resources, links, frequently
  asked questions
• Benefits Check-up www.benefitscheckup.org for an
  online way to determine benefits for which
  someone qualifies.
• To schedule a caregiver presentation contact
  Dedra Haynes,
• [phone]

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www.familycaregiversonline.org
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What assistance is available through the Area
Agency on Aging (AAA)?

• Services for persons age 60 and older
• Benefits Counseling
• Ombudsman assisted living and nursing home
  advocates
• Home Delivered Meals
• Congregate Meals
• Light Housekeeping

• Caregiver Services
• Information and Referral
• Counseling
• Education and Training Support Groups
• Respite
• Service Navigation

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• Written by Zanda Hilger, M Ed, LPC, Family
  Caregiver Education, Area Agency on Aging,
  Revised, 2006
• Includes other materials written or adapted from
• As People Grow Older, revised by Jane Oderberg
  and Sue Smith, 1995
• AARP
• National Family Caregivers Association
• Various web sites
• Resources as cited in the presentation
• This program is one module of a comprehensive
  caregiver education program provided by the area
  agency on aging
• Go to www.familycaregiversonline.net for more
  information about this and
• other training programs,
• internet links,
• frequently asked caregiver questions,
• legal forms,
• phone numbers,
• and more

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Thank You