Communication and Relationships

Date: Revised 5/24/06 Module #5

Date 2

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

Date 3

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”

Date 4

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”

Date 5

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

Date 6

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 person’s behavior in the past

• Can be used as a therapeutic tool in care planning or identifying assets, needs, and resources

Date 7

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

Date 8

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

Date 9

Communicating with older persons

• Call the person by name

• Assist the person’s 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 don’t agree

• Look for hidden meanings

• Encourage and reassure

Date 10

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

• Don’t attempt to finish the person’s sentences for him or her

• Use humor when appropriate

Date 11

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, don’t 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

• Don’t 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

Date 12

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

Date 13

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

Date 14

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

Date 15

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

Date 16

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.

Date 17

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

Date 18

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

Date 19

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”

Date 20

Finding Help and Resources

Date 21

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.familycaregiversonline.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,

(817) 258-8173

Date 22

www.familycaregiversonline.net

Date 23

What assistance is available through the Area Agency on Aging (AAA)?

Caregiver Services

• Caregiver Education and Training

• Information and Referral

• Caregiver Respite

• Caregiver Support Coordination

• Case Management

• Transportation

Services for persons age 60 and older

• Benefits Counseling

• Ombudsman assisted living and nursing home advocates

• Home Delivered Meals

• Congregate Meals

• Light Housekeeping

Date 24

Written by: Zanda Hilger, M Ed, LPC, Family Caregiver Education, Area Agency on Aging, Revised, 2005

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

Date 25

Thank You