The Whitworths of Arizona, bringing science to you in everyday language.

Friday, March 29, 2013

Socializing Issues and Suggestions

Casual socializing, i.e., visiting and sharing thoughts, helps to make a person feel normal—and it stimulates  the brain too. Spend some time with your loved one each day just visiting. If they are in a care facility, this will be extra important. Staff members are very good at providing physical care but they don’t have a lot of time to be sociable. Most interactions will be care-oriented or during leader-centered group discussions. Such one-way transactions do not meet a person’s need for socialization.

As LBD encroaches, socializing, and especially verbal communication becomes more difficult. Here are some of the problems you will face and some suggested fixes:

Movement issues. If there is also Parkinson’s, involuntary movements can cause self-consciousness, embarrassment and other negative feelings.

Fix: A good exercise program will help to retain movement as long as possible. Physical therapy programs like “Big and Loud” also help.

Fix: Presenting a matter-of-fact attitude showing acceptance helps your loved one deal with handicaps more easily. It also provides a model for the people you meet to follow, lowering your loved one’s anxieties even more.

Negative feelings. Feelings such as fear, frustration, anxiety and anger cause stress, which increases LBD symptoms, making the ability to socialize even more difficult.

Fix: Search out and identify what is triggering the negative feelings and make changes to decrease the triggers.

Weakened facial muscles. These can cause a low, soft voice, even when the speaker believes he is quite loud.

Fix: Programs like the above Big and Loud help to strengthen these muscles by encouraging patients to practice shouting in a fun atmosphere.

Fix: Keep your attention focused on what your loved one is saying and listen carefully.

Language difficulties. Your loved one may not be able to find the right word or may use the wrong word, often without even being aware of the substitution.

Fix: Look for non-verbal cues. These may be more accurate than words.

Fix: Use your familiarity. Caregivers who have been with their loved one for a long time will often find that they understand with very little communication-- the food they prefer, the way to situate the chair for most comfort, etc. You have probably been communicating thoughts with no more than a glance for years. Keep on doing it.

Fix: Ignore the mistakes. Do not call your loved one on their inaccurate substitutions. Or at least, don’t do it unless it is important. Usually, you can figure out what is meant. Accept that and move on.

Interpretations may be inaccurate. Your loved one doesn’t have the ability to choose a meaning for an unclear word, based on the rest of your sentence. Also, negatives may be missed. “Don’t sit” can easily be interpreted as “Sit.”

Fix: Talk clearly and avoid complex statements. If there seems to be confusion, say it again using different words.

Fix: Talk at a normal level. Shouting causes words to vibrate and become unclear. It can also cause anxiety.

Fix: Phrase your sentences positively: “Sit here” or “Stay standing.” The healthy subconscious brain tends to ignore negative prefixes to a directive—hypnotists learn that “sit” and “don’t sit” often generate the same response. Likewise, your loved one’s weakened ability to discriminate may cause these two directives to sound the same.

Thinking is slower. It can take 30 seconds or more to process a question and come up with an answer. Although this may seem like forever to you, your loved one is very busy processing and it doesn’t seem long at all to them.

Fix: Be patient. Count to 30 before expecting an answer.

Fix: Practice patience with a smile. You need to act willing, even happy to do so. No one likes to be a bother.

Distractions. LBD makes it very difficult to focus on more than one thing at a time. Anything can take the focus away from the conversation: TV, a bird flashing by outside, children playing, and so on.

Fix: Do a survey of your area before you try a conversation. Eliminate as many distractions as possible. Distractions can be varied—audio from the TV in another room, visual from a loud blouse you are wearing, movements from the wind blowing the trees outside the window, etc.

Fix: Make sure that YOU are the center of your loved one’s focus. Be face to face and use touch to keep your loved one’s attention focused on you.

Other issues. Poor hearing or poor vision make communication more difficult. Depression and apathy make it harder to make the effort to communicate. Pain, infections and other illnesses will take priority and remove focus away from communication.

Fix: If you suspect any of these have them checked. Even a healthy person can become isolated by deafness, for instance.

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