Caregiver Teleconnection, a service of WellMed Charitable Foundation,
hosts periodic conference calls on caregiving topics. Last week, the
topic was “Aikido communication – Align, agree, redirect, and
resolve.” The speaker was a gerontologist with the Texas Extension
Service, Andy Crocker.
With Aikido, one listens for areas of agreement or common ground and
uses “I” messages, which are particularly effective when emotions run
high. With “I” messages, rather than “You” messages, caregivers can
de-escalate potentially confrontational situations between themselves
and family members or healthcare providers. This approach is also
useful in de-escalating situations between caregivers and care
recipients, even if the care recipient has cognitive impairment.
The conference recording (audio only) is available here:
https://soundcloud.com/caregiverteleconnection/finding-common-ground-aikido-communication-with-andy-crocker-91018
Brain Support Network uber-volunteer Denise Dagan listened to the
conference call and shared her notes below.
To sign up for email announcements about these conference calls, check out:
http://caregiversos.org/caregiver-teleconnection/
Check out the many examples. This approach is definitely worth trying.
Robin
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Notes by Denise Dagan, Brain Support Network volunteer
Finding Common Ground: Aikido Communication
Speaker: Andy Crocker, Gerontologist, University of Texas Extension Service
Caregiver Teleconnection
September 10, 2018
Communication is a process or cycle. When I speak, you respond based
on your individual interpretation of what I said (based on your
experience). Your sensory perception, health, patience, etc. impacts
your response to my comment(s).
The process begins with how I choose to phrase what I say. “I”
messages increase the chances of being heard with a positive tone.
“You” messages are confrontational and may result in conflict.
Example: Conversation between siblings (Andy and Katie) caring for their Mom.
Andy: “You need to help around the house.” The tone is accusing Katie
of not doing enough around the house and may result in conflict.
Andy: “I need help around the house.” The tone is stating his need
for help around the house and is not accusing or blaming.
Another example:
Andy: “You made me so angry!” Blaming Katie for Andy’s anger.
Andy: “I feel angry that you…” Blaming Betsy’s action for Andy’s
anger. One level removed is less confrontational.
Sometimes, it is best to make an appointment to speak about something
and actually plan what you will say to get your message across with a
level head.
* Take out “You” messages in the plan for how to communicate your
message or your ask.
* Keep out irrelevant factors from your history together from the discussion.
* Never say, “You always…,” or “You never.…”
* Be sure to express your appreciation for assistance others provide
in your caregiving so they feel appreciated.
Aikido Communication
Tenets / 4 Steps:
Align – find the other person’s perspective. See the situation from
in the other person’s shoes.
* How would I feel if I were in their shoes
* What does this person need form me? Praise, appreciation, control?
– Ask: Give me an example of something I can do? If I could do one
thing to help you, what would that be?
– Rather than saying, “What do you want from me?!” or “What am I
supposed to be doing?!”
Agree – identify issue and concerns with common ground (goals, needs,
feelings) to get on the same page
* I share your concern about…, I agree we need to do something about…,
Redirect – move to productivity
We both want to do what’s best for…
Resolve –
I think we should explore…, I think…would be helpful for…
Sometimes, you have to agree that there is no resolution or solution
to the problem at hand. That, in itself, is progress.
Aikido can be used in communicating with a person who has cognitive
impairment or dementia, where higher order functioning is not present.
Example: Grandson caring for grandfather with dementia who was a
Marine Colonel. Every morning he rises at 4am and get the day
started. You can’t tell him he’s no longer a Marine and has no place
to go because being a Marine is his experience of the world. You must
align, agree, redirect and resolve to understand his motivation for
what he’s doing. To help him maintain his dignity, activity,
independence as much as possible without adding fuel to verbal or
physical conflict.
* Align – he believes he is a Marine so you must cooperate with what
you can do at home within his ‘world’. You cannot keep him in bed
longer.
* Agree – you know he always started with shaving, dressing,
breakfast, exercise – all things you can assist him with that align
with his belief that he is a Marine and are things he can do
productively at home.
* Redirect – ask for his help around the house today and direct his
attention to KP duty / cleaning up breakfast. You know he always
shaved twice daily, so be sure to include that activity to the daily
schedule.
* Resolve – In dealing with someone who has dementia, resolution is
that grandpa sleeps through the night and accepting that he rises as
4am, obtaining grandpa’s cooperation, calm demeanor, emotional calm
throughout the day. Recognizing that what works one day may not work
the next day – just give your initial inclination / plan a try and see
how effective it is.
Aikido Communication is one more tool in your toolbox to help get
through your day, along with:
* Mindfulness & relaxation techniques
* Respite resources
* Caregiving or Home maintenance assistance (volunteer friends/family
or hired help)
Question and Answer
Q. Aikido is like Naomi Feil Validation.
A. Both her method and Aikido have the same understanding of how to
understand and manage someone with dementia, but Validation is less
useful for direct communication. We can be assertive without being
aggressive or confrontational. Using the “I” messages to identify how
you feel and what you need and suggest what needs to be done without
the conversation devolving. It is not easy because it does not come
naturally to us, but it is effective.
Q. I found I always did what my father told me, but now that he has
dementia I find I am the one who needs to tell him what to do and how
to do it to keep him healthy and safe. There is a big disconnect when
your eyes see your father, but your mind tells you he is not the same
man he was. The disconnect is painful and challenging.
A. Good future topics are role loss or role change. There is a good
amount of loss and grief when the person you used to look to for
direction and advice is no longer available to you because of their
cognitive changes. At the same time, you need to take charge and do
what’s necessary to look after him.
A. There are family members surrounding the primary caregiver and care
recipient who are all struggling with grief before the care
recipient’s death (anticipatory grief). There is grief with the loss
of each of the care recipient’s abilities. Often there is a family
member who doesn’t want to help or visit because they don’t want to
see the care recipient in ’that’ state. That’s anticipatory grief.
Sometimes, it is helpful to identify it as grief in a conversation
with them to try to help them work through their grief and garner
their help in caring until the person actually does pass away. They
may be adamant that they don’t want to see their family member in
’that’ state. It is sad but you must respect that avoidance is their
way of dealing with their grief.
