The Pearl State of Dementia

{Play}These characteristics present many possible challenging situations when it comes to personal care. Here are some tips for having successful interactions with a Pearl.

Appropriately greeting a Pearl. If your person living with dementia’s (PLWD) eyes are closed as you approach, you may consider touching a non-threatening area of the body. Gently placing your hand on their knee or on their hand and telling them your name will help introduce your presence, and reduce combative reflexes. Too many quick movements may cause your PLWD to become stressed and their primitive instinctual reflex to protect oneself may kick in.

Go SLOW. Pearls are ruled by reflexes and can be startled easily. Stabilize unsteady equipment like rocking chairs or recliners. With little to no control over their body weight, a Pearl may experience increased anxiety if they’re rocking back and forth. Verbalize your movements and let  the Pearl know what you plan to do with them next. For example, if you are feeding a Pearl, you may narrate each thought you have: “Let’s scoop up some rice; here it comes to your mouth; open big; bite; yummm; let’s try some veggies now.”

Use the Hand-under-Hand (HuH) technique. This simple hand technique can be used for doing tasks “with” your PLWD rather than “to” your PLWD. We can connect with an individual by using HuH to minimize combative behaviors and provide a sense of independence. Although a Pearl may have range of motion limitations, we can still involve them in their self-care activities.

Non-verbal behaviors are clues! A PLWD in the Pearl state has a very limited word bank when it comes to communicating wants and needs.

Instead of using words to describe the feeling of pain, a Pearl might scream, attempt to hit, bite or make agonizing facial expressions. Whether we are causing the pain or it stems from an open wound, behaviors are another way of communicating. As a care partner, we can use these behaviors as clues and choose to take a time out to reassess a new approach.

Caregiver Education & Consultation
Mapuana Taamu, Certified PAC Trainer
808-469-5330 |
Learn more about dementia at our upcoming 2020 workshops. Contact Hawaii Memory Friends LLC for details.


Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.