A Clash of Agendas: Tips from Teepa Snow

Have you ever had an interaction with a person living with dementia with whom you live or otherwise provide care for that didn’t go precisely as you wanted it to go?  Maybe we have a full agenda of personal care tasks we need to get done with them, and the person resists our care.  Maybe the person is frustrated and angry and we’re trying our best to calm them down, but what worked yesterday isn’t working today for some reason, and now this person who we care for like they might just lash out at us physically at any moment?

So often care partners get immediately into “fix-it” mode.  We want the “problem” in front of us to go away, so we may rush through a task to get it over with, and the person we are working with may end up feeling upset, unheard and unseen.  We, their care partner, may feel sorely unappreciated, at at our wit’s end.  We’re working so hard, after all, and this ain’t easy!  It’s a lonely feeling, to be sure.   

When we see a problem going on “over there” with a person who is living with dementia, what to do? 

If you have a person living with dementia in your life, you may have already experienced many complicated and/or challenging situations.  Dementia trainer and practitioner Teepa Snow advises us to turn the mirror on ourselves in these circumstances in order to realize that WE may need to do things DIFFERENTLY in order to make a positive change for that person in front of us. 

Please don’t confuse “doing things differently” with “FIXING IT” right away.  Teepa points out that we may well need to take a step back and PAUSE, in order to figure out our next move.  We may need to QUIT approaching the person for a few moments (or more).  The person might need a little space from us if they are upset.  WE might need a little space for OURSELVES to think through what is going on for the individual and to figure out how we might truly help them.

We need to be CURIOUS in these moments.  We need to look at the situation from more than our own point of view. We must consider the perspective of the person who is living with dementia.

If our verbal directions are not being followed, we must accept that for some reason our directions ARE NOT WORKING.  Perhaps we are talking too fast, or too softly.  Maybe we are using too many words for this person. Maybe we didn’t take enough time, or ANY time, to CONNECT first before our task, before pushing our agenda on them.  Keep in mind that that a person living with dementia has an agenda too.  If we can stop, think, and observe the person, we may gain valuable insight that will actually benefit THEIR agenda as well as ours.                                                                                                   

Teepa suggests that as we pause and take a step back, we take the opportunity to just BREATHE.  Go ahead, try that now.  Suck in a big breath of air, then blow it out as far as you can…Breathing in this way can actually help your brain become more flexible. It can get you OUT of that panicky adrenalin-fueled mode which often takes over when you are not sure what to do in a challenging situation.

What if, on your exhale, you said the word “WOW!” like this:  (Just say this word to yourself now, on an exhale, drawing out the vowel sound), “WOOOOOOW!”.  Think about saying it as though you are discovering something…Maybe like you are discovering and understanding that the person over there has a perspective that DOESN’T quite match YOUR agenda.  Big inhale….and again say “WOOOOOOW!”

Teepa also suggests that we watch our body language.  Turn sideways in relation to the person you are caring for, if you haven’t already done so, so that you’re not facing the person head on in a confrontive stance.  This will make it clear that that you are giving the person some space.  An added benefit is that you are giving YOURSELF some space by turning sideways, space in which you can more easily come up with an APOLOGY. Perhaps you’ll say…(Feel free to try the following apologies on for size.)

“I’m sorry.”

“I can see I upset you.”

“I’m sorry. I was trying to help.”

“It didn’t work.”

“I made a mistake.”

Then, you might offer a hand to see if you are allowed back into the person’s space.  If the person refuses your hand, you might want to come back to whatever the task was a bit later.  But if they accept your hand, great!  You might say, “Tell me more about how I upset you.” Let the person express their feelings and be sure to VALIDATE whatever you hear. Use some of the SAME words that the person uses to reflect back what you understand.  If the person says,  “You move too fast.”  You might respond with:

“I get it. I was moving too fast for you.”

“You’d like me to slow down.”

If the person tells you, “I was frustrated and you didn’t seem to care”, how might you respond to that?  Here’s  one idea:

“Yes, you were frustrated. You felt like I didn’t care about your feelings.”

What might you say next?... How about…

“Thank you for helping me learn what works for you.  I want to do better, and I will slow down.”

We sure don’t have to be perfect in dementia care, but if we can learn to go with the person’s flow, and own it when our approach isn’t working, we will more quickly learn from that person in front of us what might work better to fill their need and get done whatever needs to be done.     

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The info in this blog entry came from a live webinar given by Teepa Snow, Positive Approach to Care, sponsored by Agrace, July 26, 2022. If you are not familiar with Teepa, check out the many helpful resources on her website – www.teepasnow.com

--Marysue Moses, Ebenezer Dimensions Program Coordinator