April 26, 2023
As a long-time fan of former FBI hostage negotiator, Chris Voss and his book "Never Split the Difference," I was amazed to discover the broader applications of his techniques beyond high-stakes negotiations. In my work with YouMeCare, I found that some of Voss's strategies could be adapted to manage the unique challenges of caring for individuals with dementia, particularly those who exhibit agitated or aggressive behaviors. While the contexts may differ, the underlying principles of effective communication, empathy, and active listening remain constant. In this article, I'll share how Voss's tactics can be applied to the specific challenges of caring for a person with dementia, and offer practical tips for managing behavioral changes related to agitation and aggression.
Caring for a person with dementia can feel intense at times like a high-stakes negotiation. The person's behavior can be unpredictable and driven by emotions. . But let’s consider applying the same negotiation tactics used in high-pressure situations to the challenges of caring for a person with dementia? Here are some tips inspired by Chris Voss's techniques from "Never Split the Difference."
Active listening requires giving the speaker your full attention, listening for both the content and the emotions behind the words, and responding in a way that demonstrates understanding.
Active listening is a key component of Chris Voss's negotiation strategy, and it's just as important when caring for a person with dementia. Listen carefully to the person's concerns and validate their feelings. By showing empathy and understanding, you can help to de-escalate a situation.
Labeling emotions involves acknowledging the person's feelings and putting those feelings into words. For example, you might say, "It seems like you're feeling frustrated right now." By doing this, you can help the person to feel heard and understood, which can help to calm them down.
Asking "why" questions can put a person on the defensive and make them feel like they have to justify their actions or behavior. For a person experiencing dementia, this can be confusing or frustrating as they may not recall the reasons for a particular response they had to a situation or understand what you are asking “why” about.. Instead, ask open-ended questions or questions with a specific choice that encourage the person to express themselves without feeling judged.
For example, if an individual appears upset or angry, consider asking a question that is unrelated to the situation and may help to divert their attention such as, “What is your favorite flavor of ice cream, vanilla or chocolate?” or “What would you like to do now, “Take a walk outside or finish our conversation sitting on the porch?”
Negotiations can take time, and the same is true when helping a person with dementia. Be patient and avoid rushing the person. Take the time to listen to their concerns and work with them to find a solution that works for both of you.
Chris Voss emphasizes the importance of building a rapport with the person you're negotiating with. The same is true when helping a person with dementia. Focus on building a relationship with the person, rather than just solving the immediate problem. This can help to create a sense of trust and reduce the likelihood of future agitation. Building this rapport may actually not take the form of a conversation, but could mean sitting quietly with someone, showing a warm smile or providing a therapeutic touch in the form of a hug or pat on the back.
Creating a supportive environment can help to prevent agitation and aggression in persons experiencing dementia. This can include maintaining a consistent routine, providing sensory stimulation, and creating a space that is uncluttered, comfortable and quiet.
Maintaining a consistent routine can help to reduce anxiety and confusion in persons experiencing dementia. This can include things like setting regular meal and activity times, and creating a predictable daily schedule. Consider using aides to orient a person to time, place and situation by using a white board in a common area that displays the date, the day of the week and what time you will have breakfast for example. It can also be helpful to ensure that daylight comes through the windows during waking hours and that curtains block out the light when it is time to sleep.
Sensory stimulation can be a powerful tool for calming a person with dementia. This can include things like playing soft music or providing soothing familiar scents, offering tactile objects for the person to hold or touch or offering a warm blanket or sweater.
Creating a safe and calming physical environment can help to reduce the likelihood of agitation and aggression in persons with dementia. This can include things like removing clutter and trip hazards, ensuring appropriate lighting and providing clear signage to frequently used places like the bathroom and kitchen.
Caring for a person who is experiencing dementia can be challenging, but by applying negotiation tactics like active listening, labeling emotions, avoiding "why" questions, being patient, and focusing on the person rather than the problem at hand, you can improve your ability to minimize agitated or aggressive behaviors.