Why and how to alter this most basic act when greeting seniors

The aging brain changes the way we perceive the world around us. But not everyone ages in the same ways or at the same speed so it’s easy to forget that seniors may have diminished sight, hearing or motor abilities like hand-eye coordination. These skills are often the first of the major brain functions to go. One of the last to leave is the survival instinct. And when the human safety awareness system detects a potential threat it triggers a fight or flight response that puts the body in a sort of high-alert stress mode. As a family member, a care giver or a home service provider you want the people you help to be comfortable, not anxious, in your presence. Emotional connections, positive and negative, continue to be formed during all stages of aging. To be perceived as a threat, on any level, does not serve anyone. How do we get off on the right foot?

Approach seniors from the front.

Imagine that you’re a dog, and you just got stitches, and you’re wearing one of those awkward plastic dog cones around your neck. Is there anything in your peripheral vision? No – you’d have to turn half your body to see what’s beyond your shoulder. As we age, our vision loss is a lot like that. We lose what’s on the periphery and then the circle gradually contracts until all that’s left is literal tunnel vision.

Sight is one of the first skills to leave as we age. So when you greet a senior, assume they have lost some peripheral vision. Don’t approach them from the side. It will startle them to hear you without being able to see you. If this senior has any degree of cognitive impairment his or her reaction may be more exaggerated. Approach seniors from the front.

Introduce yourself every time.

Seniors are slower to process the combination of your face (a visual cue) with your voice (an auditory cue) and come up with your name. It’s a lot of work to access all areas of the brain involved in this data processing exercise. So it’s good practice to say your name every time you greet a senior rather than making them do this work. For a person living with dementia, this is essential. The face-voice-name connection is increasingly challenged as the disease progresses. Introduce yourself every time.

Get their attention first.

Position yourself in front of someone and get their attention before you advance within arms’ distance. Make a simple gesture to cue that you are making a friendly greeting. Smile and hold your open palm next to your face, then say “Hi, my name is Mary.” Then, either What’s your name?” or “It’s good to see you, Ellen.”

When they make eye contact, acknowledging you, reach out your arm as if to shake their hand. Unless they display anger, stress or fear at this moment, you have permission to enter their personal space and shake (or take) their hand.

Show your name tag.

(If you are a family member this may not apply.) The senior or person living with dementia does not have a long history of memories to draw from when it comes to care partners or regular home service providers like housecleaning, carpet cleaning and window washing services. Therefore, be sure to point to your name tag when you say, “I am here to clean for you today” or “I’m going to go with you to the cafeteria”. Now they have seen your face, heard your voice and read your name – the three main ways a person makes sense of data. If you’re right-handed, wear your nametag on your left lapel so it is visible when you shake hands.

Talk with your face and body.

What’s one of the ways people with hearing impairment compensate when in conversation? They lip-read. When humans get auditory info it’s natural to look to the source to better understand what they hear. That’s why we tend to be most comfortable in conversation when it’s face to face. Even with full hearing we rely on facial expression, body language and gesture to comprehend much of our communication. But this instinct is exaggerated in normal aging. Help seniors use all the data processing tools they have, by reinforcing your words with your body.

Start with chatter.

“How are you today?” “Fine. You?” “Fine. Except I wish this rain would end.” You hate it. It’s excruciating and perfunctory. You’ve always hated social chit chat because it’s shallow and meaningless and unfulfilling with people who are important to you. But seniors, and people living with dementia in particular, will lose language skills much earlier than they lose the rhythm of speech. Social chit chat is a way to connect with the senior customer. Use that rhythm to promote positive energy between you while giving them extra time to process who you are.

Talk slow, not loud.

Have you ever searched for something that was sitting right in front of you? You see but don’t see. It usually happens when you are under stress or have a lot on your mind. The aging brain is under stress too. It sees but doesn’t see – it hears but doesn’t comprehend – at least not right away. So if this customer doesn’t comprehend you the first time, don’t raise your voice. Slow your speech.

Say one thing at a time.

That doesn’t mean talking in slow motion. But do take more time in between sentences. The senior does need more time to process what you said.

To apply this to the house cleaning service, the cleaners wouldn’t state a list of tasks they would perform. It’s too much for many seniors to process, at least that quickly. Instead the cleaning technicians should say, “We are here to dust.” Then mime dusting until the senior acknowledged understanding. Then, proceed with “Then we will vacuum,” miming the action until understood. And last, “We’ll finish by mopping.” For people living with dementia, often stating one task is all they can process. Only when practical and safe, use or point to equipment as you convey these tasks.

Use what they still have to work with.

It’s a philosophical stance, but with practical implications. With normal aging there is loss of sight, hearing and motor skills but they don’t all decline at the same rate. Draw on all three main areas (visual, verbal/auditory, touch/do) and let the stronger parts of the aging brain cover for the weaker parts. Use what they have to work with is an approach that sets your interactions up for success.

When you are in the living quarters of a senior or person living with dementia these tips will help you reduce stress and its influences on both of you as you go about your daily activities. Adopting the use what they have philosophy is at the foundation of promoting a general state of well-being for both you and the senior you serve.

Awareness training is available and can be tailored to your staff and service model. For more information, please visit Senior and Dementia Care Awareness Training.