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Therapeutic Communication Between Nurses and Dementia Patients

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Therapeutic Communication Between Nurses and Dementia Patients
Table of Contents
  1. Introduction. Giving reassurance
  2. Rejecting
  3. Approving or disapproving
  4. Agreeing or disagreeing
  5. Giving advice
  6. Probing
  7. Introducing an unrelated topic
  8. References

Introduction. Giving reassurance

  • NP provides the client with a fake reassurance that there is no need to worry over an issue.
  • The client’s feelings are undermined as the client becomes reassured there is no need to feel anxious.
  • The client feels more anxious about problems that have seemingly no impact on others.
  • NP is unwilling to define the stimuli of the problem by “curing” the client with reassurance (Van Noppen et al., 2021).
  • Possible replacement: Strong empathy with the client and collaboration.


  • NPs create taboos for discussion, limiting the patient’s ability to define the stimuli for the problem.
  • The client feels there are “right” and “wrong” topics to discuss during the dialogue.
  • The client tries to control their thoughts and loses emotional connection to their story.
  • In fear of judgment, the client either stops interacting with NP or increases the distance with the practitioner.
  • Possible replacement: encouraging the client to talk by showing genuine interest and empathy.

Approving or disapproving

  • NP becomes a self-proclaimed moral compass for the client by approving or disapproving of their actions.
  • Some clients can feel the need to “please” the NP in pursuit of a reward in the form of approval.
  • Other clients, on the other hand, can be discouraged by disapproval and become more distanced than usual.
  • The clients lack understanding of why some of their actions can be frowned upon by others, so they are prone to repeat such behavior in the future.
  • Possible replacement: Encouraging a discussion on why others respond positively/negatively to certain behaviors.

Agreeing or disagreeing

  • NP explicitly shows agreement or disagreement with the client’s thoughts.
  • NP tries to take control over the client’s feelings by labeling them as inherently right or wrong, enabling anxiety and distress.
  • The client feels judged by the NP and tries to find the wording that would potentially satisfy the NP, thus, distancing themselves from the emotion.
  • While the client feels like they are lectured on their behavior, they fail to understand the underlying reason for their behavior.
  • Possible replacement: Initiating an open discussion while letting the client judge their actions afterward.

Giving advice

  • NP becomes a behavioral guide for the client by advising them on their actions.
  • NP can feel that giving advice is easier as it does not require detailed explanation and discussion with the client.
  • The client becomes overly dependent on the NP’s reasoning and directions, limiting their autonomy.
  • In the long term, the client finds it hard to operate and think on their own as they seek external directions.
  • Possible replacement: Encouraging the client to generate possible responses to a situation and discussing why a particular solution is the best one in a given situation.


  • NP encourages the client to discuss certain aspects of their personal lives despite their readiness to disclose sensitive information.
  • The client feels that their personal space is violated, so they feel extremely uncomfortable and anxious.
  • Initiating an unpleasant discussion can trigger another psychological trauma for the client (Kalaloi, 2021).
  • In the future, the client can become more uncomfortable and reserved, so the progress made so far becomes irrelevant; the client is scared of sharing.
  • Possible replacement: Making sure that the topics tackled by the NP do not present any discomfort to a client; in case the client is unwilling to share, the direction of the interaction should be changed immediately.

Introducing an unrelated topic

  • The NP changes the topic of discussion when they feel that the current interaction is irrelevant to the issue.
  • The NP takes full control of the discussion with no regard to the client’s feelings.
  • The client feels like the interaction has a form of an interview rather than a dialogue; they become more cautious about their responses.
  • Client feels uncomfortable when they notice that their thoughts provoke a negative NP’s response (Unhjem et al., 2018).
  • Possible replacement: Allowing the client to talk about anything that concerns them, putting the client’s well-being above NP’s comfort.


Kalaloi, A. F. (2021). Therapeutic communication between nurses and dementia patients at psychiatric hospital. Jurnal Penelitian Komunikasi, 24(2), 117-128. Web.

Unhjem, J. V., Vatne, S., & Hem, M. H. (2018). Transforming nurse–patient relationship: A qualitative study of nurse self‐disclosure in mental health care. Journal of Clinical Nursing, 27(5-6), 798-807. Web.

Van Noppen, B., Sassano-Higgins, S., Appasani, R., & Sapp, F. (2021). Cognitive-behavioral therapy for obsessive-compulsive disorder: 2021 update. Focus, 19(4), 430-443. Web.

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