By Anne M. Windholz
Ian A. James and Laura Gibbons. Communication Skills for Effective Dementia Care: A Practical Guide to Communication and Interaction Training. Philadelphia: Jessica Kingsley, 2019. 142 pp.
I come to this book as someone who has worked with dementia patients in lay ministry and as a professional chaplain since 2003. I am also primary caregiver for my mother, who has lived with me and my husband since being diagnosed with Alzheimer’s in 2016. I open its covers with the awareness that I could develop Alzheimer’s in the next twenty years. I cannot, therefore, claim to be an objective, disinterested observer. Like many of you, I read works like James and Gibbons’ Communication Skills for Effective Dementia Care looking for answers to questions that are as personal as they are professional.
That said, this book by two British healthcare researchers and clinicians is most directly intended for paid caretakers and particularly those who provide hands-on care to people with dementia. It explains communication and interaction training and how to apply it. James and Gibbons offer a person-centered approach that focuses on the basic needs that motivate all human interaction. When we lose our ability to communicate or reason, we can act out or react with what they call “BtC” for behaviors that challenge.
Communication Skills is a rich resource: it offers cogent summaries of studies in the field, provides useful tables and diagrams, and presents case studies to show practical applications of theoretical approaches. Its extensive lists of references will be a boon to any researcher. As a chaplain, I very much appreciated the authors’ emphasis on knowing each individual’s story and using that knowledge to help assess needs and determine interventions. They accentuate creating a relationship with a person rather than doing tasks to a person, a reframing that they hope frees healthcare workers to explore and experiment while reducing patient stress. The value of empathy is celebrated, but James and Gibbons wisely note that empathy by itself does meet a need. They are above all practical, presenting the features of effective interventions and discussing the evidence-based benefits of various allied therapies. They describe how to approach each patient depending on the extent of their dementia; how to speak to them and how to touch them; how to earn trust and learn to love.
This useful reference book should be on the shelves of all skilled nursing facilities, hospices, geriatric wards, and behavioral health hospitals. However, while its style is straightforward, Communication Skills is not an easy read. The writers depend too much on acronyms, which becomes distracting rather than helpful. The book’s strength is it conciseness – and that is perhaps also its weakness. Like a soup that has been boiled too long, all the rich content becomes jumbled together with little broth to smooth digestion. I would only guardedly recommend it to family caregivers, who might find it overwhelming. For professionals, it is a must-read – but I advise judicious use of the index to most efficiently find needed information.
I learned a great deal from James and Gibbons’ research and practical insights and was immediately able to apply their lessons in my spiritual care with patients. But Communication Skills’ most meaningful passages were those that taught me how to better see the world through my mother’s eyes, how to better connect with her, and how to be a better daughter to her at this stage of our lives. As the authors note again and again, the most important thing is to create and nurture relationships. Because the heart knows even when the mind cannot.
Anne M. Windholz, BCC, is staff chaplain at Northwest Community Hospital in Arlington Heights, IL.