I recently enrolled in the Certified Dementia Communications Specialist program offered by two of my colleagues in the senior living industry, Tami Neumann and Cathy Braxton of the Silver Dawn Training Institute. As a senior housing consultant and Certified Geriatric Care Manager, I am almost always hired by the children of the senior. The senior is usually a Person With Dementia (PWD). The child of the senior often asks me to interact with his or her loved one, particularly if the senior needs to be convinced that it is time to move to a long term care community.
What I found invaluable about the Silver Dawn Institute Program is that it is based upon the basic rules of improv, which are: 1) relinquishing your agenda; 2) making your partner look good; 3) Using “Yes…and”; and 4) the gifts.
I recently used the rules of improv to assist the adult child of a person with dementia. Here is what happened:
My client was the child of a PWD. The child lived on the west coast and sought to place her mother in an assisted living community with memory care. The child hired me to partner with her in order to convince her mother to move. She anticipated that the senior was going be extremely resistant to the idea of moving, and my client was turning to me for creative solutions. She felt it was going to take something very compelling to get her Mom to move. The child’s mother was living alone in a private home. The senior was 82 and fully ambulatory. In addition to having issues with dementia, the child’s mother was a hoarder. But she was not a hoarder of books or newspapers. She was a junk food hoarder.
The home was located on a rather busy street. When her mother decided it was time to buy more junk food, which was several times a day, she would have to cross the street at a very busy intersection to get to the liquor store where she purchased the snacks. On several occasions, she had gotten lost and was found wandering on the street several miles from her home. Several Good Samaritans had picked her up, and driven her home in their cars.
Upon meeting my client’s mother and being reintroduced as an old friend of the daughter’s, I found a thin, wiry, personable senior who was more than willing to give me a tour of her home. When I entered the kitchen, I found unopened packages of junk food that were stacked up to the ceiling, and a refrigerator full of rotten food. In addition, the house was not clean due to the fact that the senior would not allow any outside help inside her home.
So how did I use the elements of improv to convince the senior to move? While I realized that my agenda and intended outcome were to get the senior to move, I realized that (improv rule 1) I had to focus on my relationship with the senior, her child, and develop a strategy that would communicate the need for keeping the senior safe. This would be more effective than telling the senior, “You just can’t stay here. It’s dirty and you are crossing a dangerous street!”
Second, I had to identify and affirm my partners (Improv rule 2), who were not only the senior, but also her child. I realized that I had to communicate with both of them in a way that was non-judgmental and devoid of shame and demands on both in order to make my intended strategy work.
Third, and fourth, I would utilize the concept of “yes, and” with her daughter, and utilize the gifts of the senior’s verbal responses and body language (improv rules 3 and 4) to move the communication strategy forward. “Yes… and,” meant listening to, hearing and accepting each woman and her needs while gently directing our discussion to the “And,” of what needed to be done next. The “gifts,” meant picking up the non-verbal cues that revealed the senior’s unspoken fears.
So what ultimately happened?
I had shared that I had been studying for my Certified Dementia Communications Specialist designation and suggested that we might try the use of unrehearsed improv in order to convince her mom to move.
I had learned that the child of the senior had a relative who worked at the Environmental Protection Agency. While the child had suggested at one point that we might ask a uniformed police officer to escort her mother out of her home, I suggested that we use a white lie that would be much less shameful and not prone to invoke a negative reaction in her mother. Instead, I asked the child to enlist the relative who worked with the Environmental Protection Agency to come up with the something like this for a letter:
Dear Ms. X:
The U.S. Environmental Protection Agency (EPA) has been conducting tests of air quality in your neighborhood. Unfortunately, our testing has revealed that your home has excessive levels of Carbon Monoxide gas which may contain uncured diisocyanates which are known to cause severe skin and breathing disorders as well as substantially increase the risk of explosions which may cause severe damage to property and potential injuries and fatalities in humans.
Therefore, under the authority of the Toxic Substances Control Act, we must ask you to immediately evacuate your home. Once vacated, our trained technicians will seal your home to prevent potential harmful contamination of neighboring homes and then, following the EPA guidelines as set forth in the Chemical Management and Remediation Program, proceed to identify the source of the Carbon Monoxide in your home and administer corrective steps to ensure permanent removal of the Carbon Monoxide. We expect all necessary work to be completed within 4 to 5 days. Once your home has been retested and certified to no longer present a danger to yourself, your home or your neighbors, we will notify you that it is safe to return to your home. We sincerely apologize for this temporary, but vitally important, imposition. Please make arrangements to immediately evacuate your home. Thank you for your prompt cooperation.
The child and I returned to her mother’s home and placed the letter in her mother’s mail box.
When we entered the home, her daughter said, “Look Mom. Did you see the letter you received in your mailbox?” As a trusted old friend, I suggested, “Why don’t we sit down and read this together?” So, the daughter opened the letter and read its contents aloud. The senior sank a lit bit deeper in the sofa as she listened, then asked with wide eyes, “Well does this mean I need to move? I really don’t want to. I like it here.” As I could see that my client was becoming a bit nervous, I tapped in, “Yes, and this will mean everything to the preservation of your skin and toward your overall safety and well-being.” Her child, tapping back in to the conversation said, “Yes, and I have some ideas about apartments we can look at. They have just as much space as you have here. Some of them even reminded me of the home where you grew up. Why don’t you go and get your purse, Mom?”
In anticipation, we had a bag of her mom’s clothing ready and moved her to an assisted living community we toured and chosen previously.
So as you see, the rules of improv led my clients to a happy ending. The rules of improv and the loving spirit with which they are offered give great tips for any difficult human situation, not just dementia!
Do you need a second opinion? Let Andrea Donovan Senior Living Advisors help. Call us at (708) 415-2934 or email us. Please visit our website. Please watch my video to learn how the process works and learn what some clients have to say.