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Negotiating is possible with a person with dementia

Negotiation is usually associated with industrial disputes. However, we all negotiate in small ways every day. What would you like for dinner? I’d like this and you want that. Somehow we come to agreement and we are both happy with the result. This is negotiation.

Can you do it with people with dementia? I think we can and should.

People with dementia are just that—people first. As people or persons, every person has a right to be treated with respect and equality. If this is true for people with dementia then they too have a right to be negotiated with.

What can we negotiate about? Try negotiating about time of shower, what to have for lunch, what to do next, where would you like to sit? We should be negotiating with people who have dementia at every opportunity.

Negotiation enhances a person’s sense of well-being by showing them that you recognise their importance. They matter enough to ask them what they want. People with dementia, even in the more advanced stages of cognitive impairment can indicate preferences. Small signs of preference can include a smile, a frown, a turn of the head, dropping the eyes. You have to be alert to these signs to pick them up and give them the significance they deserve.

We can negotiate much more than we usually do. Much of our care routine is focused on the staff needs—not the needs or preferences of the people we care for.

Such care is not person-centred care, it is staff centred care. Routines and rosters should be governed by the preferences of the residents in negotiation with staff and families etc..

By negotiating with people in our care we treat them with respect and equality. It signals to them that they are important and valuable. These messages are vital to maintain a person’s well-being in the face of the challenges of dementia.

The challenge is before us to shape our care according to the beat of a different drum in the 21st century, the beat of person-centred care.

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