About the Best Friends™ Approach

The Best Friends™ Approach was developed in the 1990’s by Virginia Bell and David Troxel while they were working at the University of Kentucky Alzheimer’s Disease Research Center.

Virginia and David developed the Best Friends™ Approach based upon their experiences with persons with dementia, family members and adult day center care.

Simply put, they suggest that what a person with dementia needs most of all is a friend, a “Best Friend.” This can be a family member, friend, or staff member who empathizes with their situation, remains loving and positive, and is dedicated to helping the person feel safe, secure and valued.

The Best Friends Approach starts with seven basic ‘building blocks’ that can help you learn to “see” persons with dementia differently and begin implementing a Best Friends Approach in your work:

1. Recognizing the basic rights of a person with dementia. Embracing the points in our Dementia Bill of Rights helps us see and acknowledge the person beneath the cloak of dementia, who deserves our best care and support and has the right to live with choice and dignity.

2. Understanding what it’s like to have dementia. Behaviors seem less strange or unreasonable when you understand that dementia impacts the brain. Understanding what it’s like to have dementia helps us develop empathy, become more accepting and patient, and better meet the needs of the person with compassion.

3. Knowing and using the person’s Life Story. When persons with dementia forget their past, it’s up to their Best Friends to do the remembering. Collecting key social and personal history into a form—what we call the Life Story—helps us help the person to recall happy times and successes (a hole-in-one on the golf course or a community award) and gives us tools for redirection when the person is having a bad day (asking a woman who loves to bake to teach you how to make an apple pie).

4. Knowing just what to say when communication is breaking down. Dementia damages a person’s ability to “make conversation,” express their wishes verbally, understand requests, or remember directions. Best Friends understand the importance of slowing down and being present for the person with dementia, using good communication skills.

5. Developing the ‘Knack’ of great dementia care. Knack is the “art of doing difficult things with ease,” or “clever tricks and strategies.” Acting as a Best Friend, our world view changes. We can practice patience and understanding. If the person says that she likes the current President, George Bush, we don’t correct her. Instead we might say, “I like him too.”

6. Experiencing meaningful engagement throughout the day. Persons with dementia who no longer can take part in favorite activities or initiate new ones can easily become isolated, bored, and frustrated. Best Friends understand that socialization is therapeutic, and can fight depression, keep persons physically fit, and foster feelings of happiness and success. Best Friends balance formal activities with unstructured, “in the moment” times that fill our days: taking a short walk, chatting, offering hand massages or doing simple chores together.

7. Recasting the relationship and your language from staff to Best Friend. Use the language of friendship throughout your day. When a team meeting is called to discuss a behavior, ask how the staff can be a Best Friend to that resident. Rework job descriptions to emphasis the importance of relationship. During one-on-one time, let the person know that you appreciate the friendship. Using the phrase “Best Friends” and developing authentic relationships ultimately helps the person feel safe, secure and valued—and creates a caring community where all benefit.

Individuals, organizations and government agencies have endorsed the philosophy of care including Jack Canfield of the famed Chicken Soup for the Soul series; futurist and noted writer Ken Dychtwald; National Institute on Aging founder and Pulitzer Prize winner, the late Robert Butler; and hundreds of family members, professionals in the field of aging, and persons with dementia, some of whom are featured in the Best Friends series of books.