Positive Approach to Care (Part 1 of a 2-part series)
Positive Approach to Care 1

To constantly maintain the professional high standards of staff, we sent two of our employees to be certified by Teepa Snow to facilitate teaching the Positive Approach to Care for people living with dementia.

For many people living with dementia, their first primary caregiver or care partner is their spouse. For many reasons this is ideal. The spouse is generally the one who knows the most about them and their needs, has a shared history, and is comfortable when it comes to personal topics and care.

When it comes to day-in-our-life activities, we can often go on autopilot. Our routine is so natural, we don’t think about what we are doing; let alone what our spouse is doing. However, when a spouse develops a form of dementia, that autopilot switch is turned OFF, and they may turn and ask …

What do I do now? What am I supposed to be doing? Can you help me?

We build routines over time, and even when we are doing a shared activity, we will have separate tasks. After dinner, I clean the table and put the leftovers away while you do the dishes. I mow the grass and you tend the flower garden. You carry in the groceries, and I put them away.

When the daily routine is no longer routine, what can guide you to help your spouse/care partner stay engaged? Here are four tips to keep in mind. We will provide four more in next month’s article:

  1. Take a deep breath. It doesn’t sound like much, but it works. Your first reaction when you hear those questions like What do we do now? What am I supposed to be doing?…might be What are you talking about? We’ve always done our after-dinner tasks this way. Then you have issues. Your spouse is trying. If s/he doesn’t remember, it’s not their fault.

Teepa Snow tells us: Dementia doesn’t rob someone of their dignity, it’s our reaction to them that does. So, take a deep breath, and then remember the following job.


  1. Think about their What is it that they normally do? Is it something that they just need a little help getting started? Or have their abilities changed to the point that they cannot do it on their own? If they are not able to do it by themselves, can both people do both jobs together? Often, it can be a verbal request such as Can you get the water hot for the dirty dishes? As the disease progresses, you may need to use fewer words and more visual prompts.


  1. Practice Positive Action Starters. This phrase was developed by Teepa Snow as a more positive way to ask someone to do something. You’re good at this; will you help me? or I could use a second opinion; could you take a look at something for me? Or I just noticed something pretty neat; come take a look. Most people want to be helpful and needed or just to share in something interesting. The opposite of this is what kind of reaction would you have if someone said something like You need to do this? You are not supposed to do that. Why aren’t you doing it the way you are supposed to? Most people don’t care for that, regardless of dementia. Using words or phrases that can pique interest and truly provide value will almost always lead to acceptance.


  1. Think about their GEMS State – and yours. You can read more about this online by going to: GEMS State and GEMS Model at TeepaSnow.com. Our brains are in constant change, whether or not we are living with dementia, and that will affect our abilities at any given moment in time. If looking through the lens of dementia, Teepa’s GEMS State Model allows us to focus on what abilities are present at the moment and helps us to create ideas and activities that can all a person living with dementia be successful. As a caregiver/care partner or spouse, we all need to be aware of our own GEMS State. If I am in what is called a Diamond State, I may be less able to accept things that are different than I expected, and I may be more cutting in my reactions and responses. Also, check out the information on the GEMS State website and work on becoming a Sapphire.


All of these tips for the Positive Approach to Care are a part of the curriculum we share with our caregivers and nurses who are a part of our team at DayBreak Adult Care Services in Aiken. We offer training of this kind in many forms. If we have larger groups, we are available to teach them to the public. We also have an Alzheimer’s Caregiver Support Group that meets every second Tuesday at 11 a.m. at the Lessie Price Senior Center. If you need another layer of support for our family member or just need a respite, contact us at Daybreakaiken.com or call 803-226-0288.


Linda H. Lucas and Kara B. Flanders

DayBreak Marketing Team