[A version of this item appears in: Dementia: the Latest Evidence Newsletter (RWHT), Volume 2 Issue 12, July 2012].
This article, published in the Royal College of Nursing’s “Nursing Older People”, covers the effective communication skills essential for nurses to be able to meet the needs of patients with dementia and improve the quality of their care in acute hospitals.
The time spent carrying out personal care, clinical observations and wound dressings etc. offers nurses valuable opportunities to interact with vulnerable patients. People with dementia usually retain some ability to communicate, non-verbally if not verbally. Efforts should be made to adapt strategies to the needs of the individual. Eye contact and touch, for example, become increasingly important when a patient’s ability to communicate verbally diminishes. Practical strategies to aid communication are summarised by the author.
The benefits of a person-centred approach to care for enhancing effective communication are discussed in the context of the New Cross Hospital Dementia Project at the Royal Wolverhampton Hospitals NHS Trust. The “About Me” document helps to gather information about each person and achieve a better insight into their viewpoint. Communication, a safe and orientating environment, plus adequate nutrition and hydration comprise the three fundamental elements of the “Reach Out” care bundle which has been developed at New Cross Hospital to offer a composite approach to excellence in dementia care.
Behavioural symptoms of dementia such as restlessness, agitation and aggression, often express unmet needs, arising for example from disorientation, physical discomfort, untreated pain, emotional distress, hunger, thirst or a need for the toilet. A person-centred approach to care helps to identify these needs and ensure they are addressed sympathetically. Example communication strategies and interventions to ameliorate the behavioural and psychological symptoms of dementia (BPSD) are supplied.
The challenge of communicating effectively with a patient with dementia may be assisted by remembering the person and the ways in which that individual has been affected by illness. A person-centred approach to care helps to engage with the person’s remaining ability to communicate, whether verbally or non-verbally.
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Willoughby, J. (2012). Practice Question. Communicating with cognitively impaired patients: How can I communicate effectively with patients who have dementia in hospital? Nursing Older People, June 2012, Vol.24(5), p.14.