I’ve shared parts of this story before. It’s an afternoon in October 2015. Mom appears to be asleep in the recliner when I arrive at the LTCF to visit. I lean over and put my hands on either side of the chair. My face is about arms length from hers.
“Patti?” I say to check if she’s really sleeping or just resting. When she opens her eyes, I know immediately she’s unhappy. I also know exactly what to do to minimize the likelihood of things deteriorating further. In the space of about an hour and a half, I created conditions under which Mom and I could move from bad to good instead of from bad to worse. There’s nothing magic about what I did, anyone can do it.
One way is using the BANGS model I developed to help care partners and care workers effectively engage people who are living with dementia. Here’s what I did: 1) took several deep breaths 2) assessed, accepted and agreed, 3) didn’t argue or correct, 4) went with Mom’s flow, and 5) said I was sorry (a lot!).
I thought it might help others to be able to hear our real-life conversation and the transformation we effected together. The five-minute audio below is divided into three segments. The first one is when I arrive to visit Mom; the second is about an hour later when her mood is shifting; and in the last segment we’ve gone all the way from sad to glad.
From sad to glad: an example of BANGS in action
Click here to listen (I highly recommend listening while reading to fully “get it”):
Read here:
Susan: We were both talking about nothing
Mom: Well that’s stupid.
Susan: That was stupid. (laughs) That was stupid, Mom.
(Susan turns down the loud music, which may have been contributing to Mom’s angry demeanour)
Susan: Pardon me?
Mom: You don’t lalalalala look stupid things.
Susan: I’m a silly Billy eh mom?
Mom: Yeah, and you’re stupid.
Susan: Am I? What have you got on your face here? It’s cake. (laughs) I’m happy to see you.
Mom: Well I’m not happy to see you.
Susan: No?
Mom: No. I’m not happy at all.
Susan: Are you mad at me?
Mom: Yeah, I am mad at you. Very mad.
Susan: Are you?
Mom: Yeah.
Susan: What have done?
Mom: Well it’s stupid.
Susan: I did a stupid thing?
Mom: Yeah.
Susan: Oh. Sorry about that.
Mom: Yeah, well it is stupid.
Susan: I didn’t mean it. I didn’t mean it. Is there anything I can do to fix it?
Mom: Well no, there’s nothing I can do to fix it. (Mom starts to “tap” Susan quite hard)
Susan: Oh god, you just whacked me. (The taps get lighter) Are those love taps or mad taps?
Mom: Mad taps.
Susan: Okay. Well at least they’re not very hard.
Mom: What do you mean hard?
Susan: Oh my goodness.
Mom: That’s awful thing to do.
Susan: I don’t know what I did, but whatever it is, I’m sorry I did it.
Mom: Well why did you do whatever stupid it was?
Susan: I don’t know. I made a mistake. I’m sorry.
Mom: Well, it’s sort of stupid that you didn’t –
Susan: I know I admit it. I admit it. I was stupid. I know. I don’t know why I did it Mom. It was a mistake. Is there anything I can do to fix it?
Mom: No!
Susan: Oh. Okay. Because if there was something, I would do it.
Mom: Yeah.
Susan: Yeah that’s what happened. Sorry about that. But maybe it’ll fade over time.
Mom: Well I don’t think so.
Susan: No? Okay. Is it okay if I sit here with you for awhile? How about if we do your nails?
Mom: Well, the nails are beautiful.
Susan: Well, they could be redone I think. Shall I redo them for you?
Mom: Na na na na no I don’t want to.
(About an hour later:)
Susan: Those are nice taps.
Mom: Yeah.
Susan: Are those love taps?
Mom: Yeah, they are nice taps.
Susan: Before you were giving me mad taps. You were mad at me before Mom.
Mom: Mad at you when?
Susan: About an hour ago.
Mom: Oh well, so what.
Susan: (laughs) That’s what I said Mom – so what? It’s okay. You have a right to be mad when you wanna, Mom.
Mom: Yeah, I guess I better.
Susan: Yeah. Life is short. Do what you want.
Mom: Yeah.
Susan: Eh?
Mom: I guess.
Susan: Yep. That’s right.
(About another half hour later:)
Susan: And then we sang “Mary had a little lamb, little lamb, little lamb…
Together: it’s fleece was white as snow…etc.
Susan: I like that nursery rhyme, it’s cute.
Mom: Well, it was a nice story.
Susan: Yeah it was a nice story, Mom. How about baa, baa..
Together: Baa baa black sheep, have you any wool…
This approach worked wonders for me on many occasions. That’s not to say it always worked, because, just as we all do, Mom had days when she was just plain unhappy — who wouldn’t have been in her circumstances? No one is happy all the time — or at least no one I know, including myself! The point is, this way of engaging someone living with dementia has a much better chance of working than arguing, correcting, and dismissing. Try it and see for yourself.
See also: Teepa Snow demos 10 ways to calm a crisis with a person with dementia
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My Alzheimer's Story 
Such a brilliant approach, Susan. It was so wise of you to make recordings – we can learn so much from your experiences. Thank you!
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Thanks Alice. Do you use recordings as well I wonder…?
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Yes the feeding back of conversation, engaging with them, calm, but the key Susan, look at how long you persisted an engaged with your mother, one hour, half an hour later, then another 30, 60 mins. The answer time. This one-to-one interaction is the key. Not many families understand the importance of being! They don’t understand the disease and most don’t want to acknowledge their loved one has dementia. In lifestyle, diversional therapy simulation for one visit per week of 10, 15 minutes. I’m on my own for 120 residents spread over 8 homes of 15 people. I can only do this with volunteers and having pastoral carers. Family and friends have responsibilities , staff cannot do this on their own
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I’m 100% with you Jennie. It takes time, as well as patience, training, knowledge, an open mind, and, as you rightly say, support!
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