Visiting parents or family members with advanced cognitive decline may be somewhat disconcerting at best and requires some advance planning. Often family members leave a visit feeling lost and confused because they weren’t able to effectively communicate to their loved one. Verbal communication is not necessarily the only means to effective visitation practices. Conducting an effective visit warrants a few helpful tips for assisting family members.
Recently I had a visit with a friend whose father and step mother live in a community of care complex. Sue’s dad is currently living in independent living while her step mother has moved to complex care due to advanced dementia. She has also become non-verbal. It is not difficult for dad to visit with his wife, but Sue confides that he is often tired and depressed from the visits and wishes that her adult children who live nearby could take on a weekly visit or two to offer him some respite. Sue shares how awkward they feel when they sit with their mother. She doesn’t speak – they don’t know what to do or where to look, frequently looking at their watch to see how soon they can check out of the appointment. She asked if I had any suggestions for effective visiting for her dad. The following are 6 tips to conducting a successful and effective visit with close family members with cognitive deficits.
1. Sit close, touch, and be still.
It is enough to have contact, to be still and touch, or hug without saying a word. Sitting quietly need not be awkward. Softly rubbing your parents’ shoulder, touching a cheek or holding their hand is more contact than your parent has had in days. Hum a tune, listen to some meaningful music (if tolerated) or watch a music video of a concert – it will give you a reference point to speak from. You may not extract much in the way of verbal communication from your parent; however they may respond with a sigh, a shrug or some facial recognition based on what it is you are sharing.
2. Use cognitive reminders.
Does your parent know it’s you, their son or daughter that is with them? Take out a photo album, and slowly go down memory lane, indicating each photograph and making a story of what happened during the photo. Whether it is a favorite vacation, a new family car, a wedding or family reunion, there will many notable memories to point out and discuss. Point out yourself and them in the picture to remind your parent of who you are.
3. Read to the person.
Bring a book of short stories, simply but direct. There are some great short stories offering reflective and contemplative material to share – lovely stories of the heart that your parent might relate to. Bring something to share from their cohort.
4. Look at nature books.
Especially those pertaining to places your parent may have visited during family vacations such camping, hiking, visiting special parks and places. These pictures may spark interest or bring some memory from the past they might wish to remark upon or share or simply digest.
5. Walk, drive or have coffee out.
Take your parent for a walk in their wheelchair or walk with them with their walker. Talk about what you are seeing in the walk and bring up stories of the past week of your own family and children. Smell, touch and hear what is around you and comment on it.
6. Visiting with other family member or pet.
Often a visit is made easier by having another person or even a small pet to divert some of the conversation towards. Bringing a pet to visit seniors opens them up to love and connection on a much different leveI, especially if your parent is fond of animals. Bring one of the grandchildren to visit – so gratifying for your parent.
By breaking up your visit into various components of time, you will notice that time has actually passed by rather quickly and you feel quite gratified about the success of your visit. To summarize, structure the visit – take 10 minutes just to sit and touch, then take out a book and photo album, go for a walk or drive, walk to the coffee shop in the care home, and before you know it, your visit is over and you actually feel great leaving.
Once you have established a pattern for visiting, your parent will come to expect what is routine. Establishing a routine and an itinerary for visitation is the first step to gratifying and effective visiting practises. It is not enough to arrive at a family visit and think that it will take itself on and simply evolve. Just as a meeting with a colleague or business partner requires careful advance planning to determine the outcomes you wish for, so will your visit with a parent with advanced stages of dementia or cognitive decline. Connect well with heart and soul, touch and be touched; you will have imparted much and received more without realizing it just by being a little prepared.