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Skip to 0 minutes and 7 seconds Well humans, we’re almost pre-programmed to pick up cues, very subtle cues.

Skip to 0 minutes and 17 seconds There’s lots of work– the work of Darwin and so forth– there are some basic emotions. And we’re very good– because we’re social beings– very good at picking up cues very quickly. And what we do know is that there are certain emotional expressions and body positions that will give us important clues to the way you’re thinking. So for example, if I walked into a room of people with dementia, I’d immediately be able to pick up those people who I thought were depressed. I would immediately be able to pick up those people who are anxious and those people who are aggressive, or angry. I wouldn’t have to ask them, are they angry or anxious?

Skip to 1 minute and 5 seconds Their facial expressions and their body posture would tell me immediately. And there’s a psychiatrist called Beck. And what he’s done, he’s done some research looking at the sorts of thoughts or thoughts and beliefs which are associated with those particular facial expressions. So I would know someone who’s depressed, the sorts of thought processes are to do with, I’m worthless. The future’s hopeless. If someone’s angry, the thoughts or processes associated with that are there’s been an injustice done. Again, if you think of the last time you were angry– someone cut you up in a car– you feel your rights are being infringed. If someone’s appearing anxious, the thought processes associated with that are feeling vulnerable.

Skip to 1 minute and 58 seconds The world is chaotic and the future is unpredictable. The good things about adding those thought processes to the actual facial expressions immediately gives me a way– and even if the person’s got very poor communication. So if I perceive you as being anxious, the way of dealing with you is trying to make you feel less vulnerable, make you feel more secure. And that might do with signage. That might be the way I interact with you. I may want to make the environment less chaotic. So you may be in a room with lots and lots of people who are being very noisy. So I perhaps need to take you out of that room to make things more predictable, improve your routine.

Skip to 2 minutes and 40 seconds So one of the good things about the work of Beck and this notion of facial expressions is it gives us way in to quickly try to resolve some problems. I guess it’s not just the person with dementia’s facial expressions. It’s actually the facial expression of the people around them could influence how they feel, what they’re experiencing. Absolutely. And I think this is where the issue about body language is crucial. As dementia progresses, we will lose the ability to understand language. And the primary thing we’re picking up is on body language, the carers.

Skip to 3 minutes and 24 seconds And this is one of the difficulties sometimes, because carers rush into situations. And they may, when there’s a problem, they may say, well I did tell the person what I was going to do. And I was trying to change them. But actually what the person with dementia is picking up is the body language rather than what’s being said. And that will be their main focus. And that’s where you get lots of startle reactions. And that’s why you get a lot of what is called resistive to care actions, which may turn out to be problematic behaviours or label them as behaviours that challenge.

Skip to 4 minutes and 0 seconds But actually understanding from the perspective of what the person with dementia is interpreting is just so helpful to help people have strategies to overcome that, or to avoid it in the first place. I mean for many years, I was very interested in developing psychological techniques for dealing with behaviours that challenge, these problem behaviours. And it took me a long time to recognise that the key skill is actually basic communication skills. So we had all sorts of different therapies we were trying to develop. But the main and the crucial therapy is good interactive abilities. And that’s true if you have dementia or if you don’t have dementia. Yes.

Recognising emotions - a conversation with Dr Ian James

We are social beings - our desire and ability to connect with others makes us who we are.

In this video, Ian explains how important good communication skills are for improving care for people living with dementia. As dementia progresses, a person with dementia may lose their verbal communication skills, but may still be able to recognise our facial expressions and body language.

How we interpret a person’s emotional expressions can also have a huge effect on our ability to connect.

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