Emphasizing Patient Strengths
The TANDEM program is based on emphasizing patient strengths over the four steps of successful communication:
The authors of this paper explain that every communication has a content aspect and a relationship aspect. The content aspect is the meaning of words, while the relationship aspect is the emotion or underlying feeling that the person intends. In Alzheimer's disease, the content aspect is significantly impaired while the relationship aspect is mostly spared. Other communication strengths and weaknesses are listed below:
- Presentation of information
- Attention to the information
- Comprehension of information
- Remembering information
The authors of this paper explain that every communication has a content aspect and a relationship aspect. The content aspect is the meaning of words, while the relationship aspect is the emotion or underlying feeling that the person intends. In Alzheimer's disease, the content aspect is significantly impaired while the relationship aspect is mostly spared. Other communication strengths and weaknesses are listed below:
Strengths
|
Weaknesses
|
How to support strengths in each step
Presentation:
- Talk about topics important in the person's life.
- Create a memory book outlining important people and events in the person's life to support interaction.
- Focus on reading emotional expressions instead of relying on words to convey emotion. Look for signals like lifting the corner of the mouth (smile) or caressing a hand as an expression and comprehension of relationship information.
- Read between the lines. Think about the emotion behind the words rather than the words themselves and respond to this, rather than the incorrect content information.
Attention:
- Eliminate distractions (TV, radio), provided that this will not upset the person.
- Facilitate attention by being fully present during interactions. Approach the person slowly, interact face-to-face as much as possible, establish and maintain eye contact.
- One thing at a time! Try to avoid splitting attention between tasks such as walking and talking. Ask one question at a time, and only give one instruction at a time.
Comprehension:
- Use short, simple, and direct sentences. Avoid child-like speech to maintain self-worth.
- Match your facial expressions and gestures with your language (pair content and relationship information to support meaning.) Avoid giving mixed messages or ambiguous information.
Remembering:
- While it may seem difficult at times, remember that repeated questions are attempts at communication and should be valued as such. Try to avoid pointing out that the question was already asked and appreciate the initiation of interaction.
- Connect new information to old, using words that express familiar concepts.
Haberstroh, J., Neumeyer, K., Krause, K., Franzmann, J., & Pantel, J. (2011). TANDEM: Communication training for informal caregivers of people with dementia. Aging & Mental Health, 15(3), 405-413. doi:10.1080/13607863.2010.536135
Copyright © 2013, 2014 Lee Ann Faria. All rights reserved.