RESPECT: The Goal of the Cognitive Disabilities Model

RESPECT: The Goal of the Cognitive Disabilities Model
What does it mean to respect another person?

We can show respect through the words we use, our body language, and our actions toward others. Respect is defined as a feeling of deep admiration for someone or something elicited by their abilities, qualities, or achievements.

The title of this article was the theme of the 11th Cognitive Symposium sponsored by the Allen Cognitive Network, whose vision is that the Cognitive Disabilities Model will be available to people all over the world. How powerful to think that we have a model that enables us to respect persons with cognitive impairments!

This concept of respect is part of the paradigm shift we discuss in our Foundation training when we ask ourselves to look at persons with dementia in terms of abilities, qualities, and achievements. Do we see only what the person can’t do anymore, or do we see what remaining abilities or qualities they do have?

Using the model, by learning what stage of dementia a person is at and how to match their remaining abilities with the proper care approach, is part of how we practice respect.

How else does the Cognitive Disabilities Model guide us in respecting persons with dementia?

We can take an honest look at how we think about and respond to a person with dementia on a day-to-day basis.
 

Behaviors


A person with dementia may be losing the ability to communicate unmet needs or wants verbally. To communicate a need or want, they may use bodily behaviors. Unfortunately, in my travels to organizations caring for persons with dementia, I still see a lot of antipsychotic use when a behavioral expression is seen in a negative light.

But if we respect the individual as a person with abilities, qualities, and achievements, our response is much different.
  • We seek to understand the cause of the bodily behavior.
  • We seek to understand the person’s level of dementia and how to best match our response to their ability.
  • We seek to understand and identify: What is the unmet need/want?
  • How can we serve this individual versus just stopping a behavior we deem as negative?
We can give this person choice and control as much as possible, ensure that basic needs are met, and LISTEN to what the bodily behavioral expression is telling us.

Then it is our responsibility to put plans in place to ensure that these needs are met proactively so the person doesn’t have to resort to perceived negative behaviors to get our attention.

Understanding the developmental age comparison, discussed in Foundation training, can help us anticipate behaviors and find the right care approach to use to prevent the behavior—in other words, respecting the individual where they are at behaviorally in the disease process.
 

Communication


A person with dementia may be losing the ability to find the words they want or to put sentences or phrases together. Sometimes our communication starts to slip into a patronizing type of approach. Yet this is a person who has lived a full life rich with achievements and experiences. Our communication may need to be simplified to match their ability to process and understand spoken words, but it should be no less respectful.

An article in the American Journal of Alzheimer’s Disease and Other Dementias studied resident reactions to person-centered communication. All residents in the study had a diagnosis of dementia. Sometimes when persons with dementia start to lose communication abilities we slip into elderspeak, defined as a form of patronizing communication. An example might be talking over the resident to the resident’s adult child because we assume the resident cannot understand.

But if we respect the individual as a person with abilities, qualities, and achievements, our response is much different.

We use techniques learned in our Foundation training such as:
  • Waiting for a response.
  • Decreasing extraneous stimuli so the resident can attend to what is being said.
  • Slowing down and taking the time to listen to the person.
We do those things for people we respect. Why wouldn’t our seniors with dementia be included in that group?

The study measured resident cooperation, self-disclosure, conversation engagement, politeness, resistance to care, and distress.

The study found that person-centered communication resulted in residents cooperating, revealing personal information about themselves (trust and security), contributing to conversations, asking for clarification, and increasing politeness toward staff.

The study also revealed that residents are then more likely to be regarded positively by staff. So it becomes a positive feedback loop. Person-centered communication begets positive resident behavior and responses, which begets positive regard of care staff toward the residents.

Wow! How powerful our words are! What a wonderful way to respect persons with dementia.

Our society is slowly changing and becoming more aware of dementia. Hopefully, with further education and discussion, our society will respect the individual as a person with abilities, qualities, and achievements, and this will continue to drive the creation of a Dementia Capable Society.
 
Comments

You might also be interested in

Feedback