I was introduced to redirection in dementia patients about a year ago. I have watched experts do it and have done (or tried to do) it myself. As you might guess practice is a bit different from theory.
What is redirection? In a way it is a different way of saying “change the subject.” In dementia patients, it’s a little more complicated. First of all, a dementia patient can become fixated on a topic. It takes time and skill to get that fixation changed. Second, you have to know subjects that the patient will understand in order to redirect them.
What is validation? This takes a part of what a dementia patient is saying, validating that it’s true and using that to change the conversation to a better channel.
Can’t Focus: When there is a lot going on around a dementia patient they lose the ability to focus. This can cause agitation which is not something you want to deal with. I have been in that situation. Finding something physical helps. As an example, offering a favorite treat can distract enough to move the patient away from the more chaotic area.
Finding Topics: Our elder’s facility has a brilliant way of allowing caregivers to know what subjects can be used for redirection. Each member has a hutch. The family brings pictures, trophies and other objects that mean a lot to the elder. The caregivers can then ask questions based on what they’ve seen in the hutches.
That does mean that we in the family have to know what will work. Having walked around the facility to see what others had, we concentrated mostly on photographs of our elder during her working life. She was an actress on Broadway, a member of the USO during WWII and a very successful real estate agent. She also has two grandchildren and two great grandchildren. All of these subjects work for her.
“I am not a child!” This is a phrase you will probably hear. We hear it almost every time we visit. Our elder is high functioning and does not like the restrictions on her. This is the prelude to some very nasty comments, some aimed at us and some aimed at caregivers. It is a strong sign that redirection and validation is required.
I have tried saying, “speaking of children, your great grandchild did such and such.” That does not work, at least not for our elder. She knows when someone is trying to change the subject and she feels very strongly about what she sees as insults to her intelligence. This is where validation theory comes into play.
The best thing to do here is to agree that she is not a child. Then we can go on to explain why this or that rule is in place before we change the subject. It’s sometimes hard, but this has worked. “I agree you aren’t a child, but the medical techs could get fired if they gave you extra medications. By the way did you know that (fill in the blank) is going to medical school?” Usually that works.
How we handle our elders with dementia is important. I have seen families that more or less abandon their relatives and other families that spend time every day with them. At least as far as our elder is concerned, she is better off when we visit…and we know what to say to help her stay calm.