Working with patients who are severely anxious, agitated, or in the throes of dementia-related delusions can trigger our own anxiety and self-doubt. In such cases, understanding the clinical underpinnings of a patient’s diagnosis, and the different communication skills they require, is key to effective treatment. In this two-part video we see contrasting scenarios featuring both ineffective and effective approaches with an elderly Alzheimer’s patient and a woman in residential treatment for anxiety. Here, you’ll witness the different skills involved in engaging each type of patient, and learn how one counterintuitive technique can dramatically improve clinical outcomes.

The first vignette features a nurse treating an elderly man with Alzheimer’s disease who believes he is still a farmer. Becoming increasingly agitated because he believes no one is attending to his farm, he pleads with his nurse to escape the facility. The novice nurse attempts to bring him to reality, which only aggravates his fears; in contrast, the proficient nurse joins with the patient by entering into his world, even adding to the story in order to bring a sense of resolution to his needs.

In the second vignette, you’ll watch a nurse work with a visibly anxious woman demanding additional medication. The novice nurse responds coolly to her distress and then becomes agitated himself, invalidating her emotional experience and avoiding eye contact. Later, you’ll see the more experienced nurse take time to speak with his patient in a quieter setting, where he engages her in therapeutic conversation and invites her to practice breathing exercises with him. After delivering gentle psychoeducation on the pros and cons of medication, he ultimately gains her trust and agreement to use inner coping skills.

This video helps demystify the challenges of working with patients who need firm, nuanced support to manage their agitation. If you’re looking to enhance your own skills in this area, add this title to your library today.