USING THE DEMENTIA TWO-STEP TO MANAGE DEMENTIA BEHAVIORS
July 3, 2019
Those who work with patients, or others with dementia, are familiar with the unpredictable behavior, extreme emotional displays, resistance to care, and failing mental abilities that frequently accompany this disease. And they know it causes exhaustion, stress, and chaos for far too many people.
Writing in the CSA Journal, Deborah Bier, Ph. D, a dementia educator and speaker, wrote about a method to prevent, reduce or even eliminate the behaviors through specialized, low- or no-drug approaches. These methods, dubbed “The Dementia Two-Step,” are not widely known, and therefore not in broad practice. But they are easy to learn, and Bier believes they and should be a part of every family’s or helping professional’s toolbox.
The Dementia Two-Step refers to the back-and-forth interaction between a care partner and the person living with dementia. The Two-Step is performed before every interaction with a person living with dementia, resulting in numerous opportunities to practice and become proficient in this method.
The first step is called “Leave Your Baggage at the Door.” People living with many types of dementia, especially Alzheimer’s disease, can still successfully and accurately read the emotions of others. And it seems, unguarded emotions displayed by care partners turn out to be a substantial trigger for dementia behaviors. Because people with dementia can have poor emotional control, the emotions they see are typically displayed more vividly.
This step requires the caregiver spend a few seconds checking and adjusting their body language, facial expression, and the pitch and speed of their voice. They are urged to bring into their interactions only the emotions they would like to see mirrored in the person living with dementia.
The second step is called “Spread Some Sweetness.” This requires the caregiver to spend a sweet, warm moment with the person before any care tasks are taken. This brief connection could be as simple as sitting beside the person, giving a squeeze of the hand and a loving look. It can involve a brief sharing about a topic, story, or objects the care recipient enjoys, including abut the family, hobbies, career, wildlife visible out the window, or music. There are no demands placed on the person with dementia, and there should be no sense of hurry coming from the care partner. This doesn’t need to take more than a couple of minutes and often is even briefer.
Again, this method should be used before every interaction or care task. But Beir also suggests the Two-Step be used whenever the behavior of the person with dementia suddenly becomes an issue mid-interaction or during a care task. Sometimes, the thoughts of the care partner creep into that person’s consciousness, and the caregiver begins showing the kind of body language that can trigger dementia behaviors. This is a reminder to stop and start the Two Step again.
Why does this work? It seems that no matter how confused they are, people living with dementia know the difference between being treated as valuable or as an obstacle to a care task that must be handled quickly. They are naturally more open to receiving a caregiver’s help when a familiar bond between them has been renewed in the Two Step.
This method is not intuitive and takes training and practice. One way to learn these skills can be found in the Dementia Behavior Bootcamp program created by Bier. Other similar dementia behavior courses can be found online.