Effective Communication Key to Managing Dementia Patients in Hospitals

Hospitals, particularly acute wards, present a challenging environment for patients living with dementia. With approximately a quarter of acute hospital beds in the UK occupied by individuals with dementia, the need for effective communication strategies is paramount. Research has revealed that traditional approaches, such as confronting a patient’s reality or resorting to “therapeutic lying,” are often counterproductive. Instead, two more effective methods have emerged: finding a shareable aspect of the patient’s reality and using diversion.

Dementia affects language comprehension and memory, leading to “competing realities” where patients believe they are in a different time or place. This can cause significant distress, especially in acute wards where staff may lack familiarity with the patient’s background.

A recent study, analyzing video recordings of ward interactions, identified four common staff responses to these competing realities. However, only two proved effective in reducing patient distress.

Ineffective Approaches:

• Confronting Reality: Telling a patient they are mistaken about their location or situation often exacerbates their distress.
• Going Along with Reality (Therapeutic Lying): While temporarily soothing, this approach can lead to increased distress when the promised event, such as a visit from a deceased relative, does not occur.

Effective Approaches:

• Finding a Shareable Aspect: This involves acknowledging the emotional tone of the patient’s reality without fully validating it. For example, instead of confirming a deceased parent’s arrival, staff can ask, “Do you miss your dad?” This allows for emotional connection without deception. If a patient is worried about a pet or child at home, the staff can reassure them by saying that a neighbor is taking care of things. If a patient is asking to go home the staff can ask what they would be doing at home, and attempt to provide that activity in the hospital.
• Diversion: Shifting the conversation to a different topic or activity can redirect the patient’s focus away from the distressing issue. This can involve engaging with the environment, suggesting an alternative activity, or initiating a new conversation.

These techniques are applicable across various care settings, emphasizing the significant impact of communication on the well-being of individuals with dementia. In busy hospital environments, these small shifts in communication can make a profound difference.

Disclaimer: This article is based on research findings and should not be considered a substitute for professional medical advice. The information provided is intended for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult¹ with qualified healthcare professionals for diagnosis and treatment of any medical condition. Individual experiences and outcomes may vary.