Working with the 90-second rule

dancsfo · June 14

I realize it depends on the stage, but has anyone worked with the 90-second rule and made it work effectively?

"Give patient’s at least 90 seconds to process what you are asking and allow them to react"

I feel that if the caregiver is waiting for 90-seconds (or whatever is appropriate), the PWD may forget what was asked by the end of that period.

I feel it is better to look at the PWD's face to see if there is some sense of understanding or acknowledgement. The web sites below state that if a caregiver repeats a question too soon, it resets the PWD's processing, so the interaction can turn into a loop. I am trying to see if there's some middle ground.

https://foxrehab.org/patients-dementia-communication-tips/

https://thenoteninjas.com/blog/f/90-second-rule?blogcategory=dementia

SusanB-dil · June 15

Interesting - We do give her time to 'adjust' to what's been said.

The point on reminiscent therapy - We found that kind of by accident. She is more receptive to things when her favorite singer (from years ago) is on. We had her favorite old genre of music on, and this singer came on… she grinned and even started tapping along. We were surprised, and she became more receptive to food, conversation. Like a light bulb flickered back on, albeit briefly.

dancsfo · June 15

I think familiar things relax and comfort a PWD. Unfamiliar new TV show plots that are hard to follow, or distressing news may cause a person to withdraw if it takes effort to process. I understand a PWD can be under constant stress. even with regular stimuli & I didn't really appreciate that fully.

Perhaps reminiscing allows a PWD to be within a relaxing comfort zone?

H1235 · June 16

With my mom I’m thinking more of finding the right words vs answering a question. I don’t like to leave her struggling for too long. I feel like it must be frustrating for her, so I usually fill in the word for her without waiting too long. I guess this is different than waiting for the answer to a question.

dancsfo · June 16

https://alzconnected.org/discussion/comment/274988#Comment_274988

I think what you're doing is kind. I see a PWD struggling to find words and helping to move thing along would be a relief for both the PWD and the caregiver who sees the struggle. I sense that not finding the right words must be very vexing for a PWD, even if they can't explain the pain, but you can see it in their face.

SusanB-dil · June 16

Agree - when that happens, we ask a totally different question and perhaps redirect the whole subject. At MIL's stage, we try to make sure the answers can be simple. But sometimes, that just isn't enough.

My mother will sometimes look at you funny, then change the subject herself, or just give an answer totally off the wall. Well, Ok then, whatever works.

Working with the 90-second rule

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