How Building Trust Affects Behaviors for Our Loved Ones Living with Dementia
How Building Trust Affects Behaviors for Our Loved Ones Living with Dementia
When caring for our loved one with dementia at home, sometimes some daily activities can be challenging due to resistance. In some cases, someone might become resistant to hygiene activities such as accepting assistance to go to the restroom, change, shower, or for other activities such as eating or walking. Researchers Gjellestad and associates observed how trust building activities can impact one's receptiveness to help when performing these activities for a person living with dementia.
In their research they identified three main themes:
Safeguarding care
Protecting integrity
Optimizing the environment
According to the article, the first theme, Safe guarding care revolves around establishing safety and predictability. This meant having a consistent care team to promote familiarity along with having a care team knowledgeable in dementia care. When you have a consistent team of care partners, everyone is familiar with each other. This helps in identifying communication habits, regular routine, nuanced behaviors, and can be better suited for identifying abnormal changes.
The second theme, protecting integrity is consists of considering person centered care and promoting personhood. This theme demonstrates that when approaching care needs, it is important to consider the person living with dementia care preferences along with the family and care team. While it is important to ensure safety, ensuring our loved one living with dementia has independence and input in their own care wishes can promote less resistance to care. An example would be they always preferred morning showers but disliked evening showers, this may mean they may become more resistive to showers in the evening compared to the morning.
The final theme is optimizing the environment. In the study, they write how having an environment that empowered and enabled independence was found to be helpful in reducing resistance to care. Wayfinding was suggested, which is using signs or indicators to guide one through the environment. Making the restroom easy to find and more inviting can potentially help promote restroom use. Use of bars for someone to pull themselves up if they don’t want someone to touch them or grab them to help them into standing can be another suggestion as well.
In summary, it is important to balance the needs and wants of our loved ones living with dementia. Combining the themes together, a consistent care partner knows the preferred routines and approach to care, and can approach care in a way that is considerate of the person living with dementia. When the environment enables independence and emphasizes on skills that can still be used, it helps promote increased independence for the person living with dementia and potentially minimizing resistive behaviors because the care partner may not need to be too involved. Minimizing resistive behaviors can go a long way in terms of wellbeing for all people involved, but also can reduce burnout.
I hope this video has been helpful, please comment down below any examples you all do or have done for building trust and how that has helped!
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Author: Jose A. Hernandez, PTA, MSDA, CSCS, CPT
Gjellestad, Å., Oksholm, T., Alvsvåg, H., & Bruvik, F. (2022). Trust-building interventions to home-dwelling persons with dementia who resist care. Nursing Ethics, 096973302110417. https://doi.org/10.1177/09697330211041745
