Tag: caregiver behaviors

Steps to a Positive Physical Approach

Building Caregiving Skills for Dementia Care

caring-matters-home-care-4It’s important to remember that people with dementia are doing the best they can; their behaviors are a result of the condition, not a choice. As family and caregivers, we are able to choose our behaviors and approach for their care. The Positive Approach to Care™ developed by Teepa Snow is a step-by-step method for developing positive and meaningful relationships with loved ones with Alzheimer’s and other forms of dementia.

Understanding the Positive Physical Approach can help families improve their ability to approach, connect and provide care with those living with dementia. By understanding the best ways to approach care, you can build a better connection that enables safety, comfortability and happiness.


Below is a step-by-step positive physical approach for someone with Dementia.

Announce and approach:

  1. Knock on a door or table to get attention and signal your approach.
  2. Pause at 6 feet: Stop moving at the boundary between public and personal space.
  3. Acknowledge a person’s ownership of personal space and get permission to enter or approach.
  4. Approach the person from the front, come in within 45 degrees of center.
  5. Move slowly – one step per second.
  6. Stand tall, don’t crouch down or lean in as you move toward the person.

Gesture and Greet:

  1. Bring a flat, open palm near your face.
  2. Look friendly by smiling and making eye contact.
  3. Wait for acknowledgment: make sure you have a connection before your start your message.
  4. Call the person by preferred name OR say “Hi!”
  5. Avoid endearments.

Shake Hands:

  1. Move your hand out from near your face to a greeting handshake position.
  2. Move toward the right side of the person and offer your hand.
  3. Give the person time to look at your hand and reach for it, if s/he is doing something else – offer, don’t force.
  4. Make sure they notice your hand out to shake, then stand tall and move forward slowly.

Offer Support:

  1. Move from the front to the side: Turn your trunk sideways to the person.
  2. Stay at arm’s length: Respect intimate space and be supportive not confrontational.
  3. Slide your hand from a ‘shake’ position to hand-under-hand position – for safety, connection and function.

Get to Eye Level and Deliver Message:

  1. Get to the person’s level to talk – sit, squat, or kneel if the person is seated and stand beside the person if s/he is standing.
  2. Give your name and greet – “I’m (name). It’s good to see you!”
  3. Deliver your message – simple, short, friendly.

Changes in the behavior of people with dementia are very common. Every person is an individual who will react to circumstances in their own way. Knowing how to approach a loved one when they are distressed can help you deliver successful care.

Here is a step-by-step guide to approaching a person distressed.

  1. Let the person move toward you, keeping your body turned to the side (supportive, not confrontational).
  2. If the person is seated and you do not get permission to enter personal space – turn sideways and kneel at six inches out.
  3. Offer greeting and shake hands again.

Look for an OK to come into their personal space. (submissive posture)

After greeting, try one of two options:

  1. “Sounds like you are (give an emotion or feeling that seems to be true)”
  2. Repeat the person’s words to you:
    • If s/he says, “Where’s my mom?” you would respond – “You’re looking for your mom?” (pause) “Tell me about your mom.”
    • “If the person said “I want to go home!” you would say -“You want to go home? (pause) “Tell me about your home.”

Caring for a loved one with Alzheimer’s disease or dementia can be a challenging journey. We understand that dementia poses many changes that requires personalized care, expertise and understanding. At NursePartners, we work with each family to enable safety, comfortability and happiness through home-care services.

If your loved one need home care assistance or relief, our team would love to help. Contact us today.