Participants will practice using effective communication and de-escalation techniques to manage a challenging patient interaction. The focus is on building trust with a dementia patient who is refusing a necessary medical procedure.

Revise or brainstorm as a group the symptoms of dementia and typical problems in communication with patients with dementia.

The nurse must take a blood sample from a dementia patient who is confused, frightened, and uncooperative. The nurse must apply dementia care strategies to reassure the patient and gain her cooperation.

Patient:

Behaviours:

Display physical resistance, such as pulling her arm away or waving her hands to avoid the blood test. Express fear or suspicion. Show confusion by asking repetitive questions.

Respond positively to calm and empathetic communication.

Tone:

Initially fearful, high-pitched or defensive. May become calmer if reassured and spoken to kindly.

Attitude:

Distrustful and disoriented, but capable of feeling reassured and cooperating if trust is established. Sensitive to tone and body language.

Nurse:

Behaviours:

Approach Margaret slowly and at her eye level, using open and non-threatening body language. Use calm and empathetic verbal communication, such as addressing her by name, explaining each step simply and avoiding medical jargon.

Reassure Margaret by validating her feelings and offering choices when possible.

Redirect Margaret’s attention with distraction techniques.

Stay patient and persistent, avoiding any signs of frustration or rushing.

Tone:

Gentle, warm, and slow-paced to reduce agitation.

Reassuring and steady, maintaining professionalism while being approachable.

Attitude:

Focuses on communication skills, empathy, and calming strategies to handle resistance and gain trust.

Setting

Hospital room

Simulation Flow

Setup

Prepare the hospital room with the bed, chair, table and medical supplies. Create a calm, quiet and well-lit setting to minimize disorientation.

The patient is dressed in a hospital gown and positioned in the bed or sitting nearby.

Introduction

Brief participants privately on the characters, their behaviours, and the goals of the simulation. Reinforce that the objective is not only to complete the blood test but also to ensure the patient feels safe and supported.

Execution

The simulation starts with the nurse entering the room and introducing herself: “Hello, Margaret. My name is Sarah, and I’m here to help you feel better.”

Margaret immediately expresses fear and suspicion.

Resolution

The simulation concludes when Margaret allows the nurse to take the blood sample.

By the end of the simulation, the participants should be able to:

1. Apply stress management techniques in challenging interactions
2. Recognise dementia symptoms
3. Apply empathy, active listening, clear and simple communication, and non-verbal communication (maintaining eye contact, gentle body language, calm tone of voice) to reduce patient fear and confusion
4. Demonstrate patience, flexibility and de-escalation techniques when managing resistance to care.
5. Respond appropriately to a patient’s disoriented behaviours.
6. Validate the patient’s feelings, identify and use comfort items or familiar routines to calm a distressed patient.

1. Self-reflection – the participants express their immediate emotional reactions to the simulation.
2. Analysis - explore together what happened during the simulation and why.
3. Highlight strengths and areas for improvement.
4. Summarise main takeaways from the session