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Communicating with Someone in the Ruby GEMS State: Slowing Down to Stay Connected

When your loved one is in the Ruby state, they are physically strong but cognitively fragile — like a gem that can shatter under pressure. Their brain processes information much more slowly, and they may resist help or become easily overwhelmed. The key is to slow your own pace, use simple one-step requests, and respect their need for quiet and space. This article gives you concrete words to say, step-by-step actions, and tools to make communication feel safe and doable for both of you.

Key points

  • Slow down your own pace — speed causes panic and shutdown in the Ruby state.
  • Use one-step, simple directions and wait for them to finish before speaking or acting.
  • Avoid arguing or correcting; join their reality and gently redirect.
  • Use music, gentle touch (with warning), and two-choice options to connect.
  • Respect their need for quiet and space — do not fill every moment with talk.
  • Practice the 'pause and assess' technique before every interaction.

What the Ruby State Feels Like for Your Loved One

In the Ruby state, your loved one is still physically capable — they can walk, rake leaves, sing, or rock in a chair — but their ability to process language, follow multi-step directions, or handle fast-paced interaction has dropped dramatically. Teepa Snow describes it as being 'strong but not having a lot of skills.' They may make big mistakes without realizing it, like putting a fork in the wrong place or walking into a wall. Their brain is working hard just to keep up with the present moment, and any extra speed or complexity from you can feel like a panic attack. They might say 'I don't want anybody touching me' or 'I just want to rake the yard' — not out of meanness, but because their system is overwhelmed.

Why Slowing Down Is the Single Most Important Shift

Your brain naturally wants to stay busy and do multiple things at once. But for someone in the Ruby state, your speed is their enemy. When you talk too fast, move too quickly, or try to do two things at once (like hand them a cup while asking a question), they freeze or become 'squirrelly' — Teepa's word for that panicked, flustered feeling. They may stop eating, refuse care, or walk away. The fix is simple but hard for caregivers: you must slow your own pace to match theirs. That means pausing longer between sentences, waiting for them to finish a movement before you speak, and giving them time to process. Think of it like learning a new language — it feels awkward at first, but it works.

Redirection in Ruby: Speaking Their Language

When you need to redirect someone in the Ruby state — for example, from raking leaves to coming inside for lunch — you cannot use logic or long explanations. They are living in a different reality, and you have to speak their language. That means using simple, concrete words, matching their tone and energy, and using gentle touch or gestures to guide rather than command. The goal is not to convince them of your reality, but to join theirs and then gently shift. For instance, instead of saying 'It's time to eat, please put down the rake,' you might say 'I see you're working hard. Let's take a break and have a snack together' while holding out a cookie. This approach feels unnatural at first, but with practice it becomes a powerful tool.

General caregiving information, not medical advice. Check medications and major care changes with your clinician.

Step-by-step

  1. Step 1: Pause and take a deep breath before you approach. Your own calm sets the tone. If you are rushed or frustrated, they will feel it and resist.

  2. Step 2: Move slowly and deliberately. Avoid sudden gestures or loud noises. Approach from the front or side, not from behind, so you don't startle them.

  3. Step 3: Use a soft, low-pitched voice. Speak in short, simple sentences — one idea at a time. For example, 'Time to eat' instead of 'Let's go to the kitchen and have some lunch because you haven't eaten since breakfast.'

  4. Step 4: Wait for them to finish what they are doing before you speak or hand them something. If they are raking, let them finish that stroke. If they are rocking, let the rock complete. Then say your piece.

  5. Step 5: Use gentle touch on the arm or shoulder to get their attention, but only if they are not already agitated. If they pull away, respect that and try again later.

  6. Step 6: Offer choices only when you can accept either answer. For example, 'Would you like water or juice?' not 'What do you want to drink?' Keep it to two options max.

  7. Step 7: If they resist a task (like bathing or eating), stop and try a different approach. For example, if they won't eat at the table, try a snack while they are sitting in their favorite chair. Flexibility is key.

  8. Step 8: Use music or singing to connect. Many Ruby-state individuals can sing along to familiar songs even when they cannot hold a conversation. Start humming a tune they love and see if they join in.

  9. Step 9: After any interaction, give them quiet time. Their brain needs to recover from the effort of communicating. Do not fill the silence with chatter.

  10. Step 10: Observe their body language. If they turn away, close their eyes, or stop responding, they are overwhelmed. Back off and try again later with a slower pace.

What not to do

  • Do not rush them. If you talk or move quickly, they will panic and shut down. Instead, slow your pace to match theirs — even if it feels painfully slow to you.

  • Do not use multi-step instructions. Saying 'Please put your shoes on, then come to the kitchen, and bring your cup' will cause confusion and frustration. Instead, give one step at a time: 'Let's put on your shoes.' Wait. Then 'Let's go to the kitchen.'

  • Do not argue or correct them. If they say 'I already ate' when they haven't, do not say 'No, you didn't.' Instead, join their reality: 'Oh, you must be hungry again. Let's have a little snack.'

  • Do not touch them without warning. A sudden hand on the shoulder can feel like an attack. Instead, approach slowly, make eye contact, and say 'I'm going to touch your arm now' before doing so.

  • Do not try to reason or explain. Their brain cannot process logic in this state. Instead, use simple redirection: 'Let's go see what's in the garden' rather than 'We need to go inside because it's raining.'

  • Do not take their resistance personally. When they say 'Leave me alone,' it is the Ruby state talking, not your loved one. Give them space and try again later with a different approach.

Practical tools

  • The 'Slow Down' Mantra

    Before any interaction, say to yourself: 'Slow down. One step. Wait.' This three-word reminder helps you match their pace. Practice it until it becomes automatic.

  • The 'Pause and Assess' Checklist

    Before speaking or acting, ask yourself: Is she busy with something? Are her hands full? Is she looking at me? If she is busy, wait until she is done or has both hands free. This prevents the 'squirrelly' feeling.

  • Simple One-Step Phrases to Say

    Keep a mental list of short, clear phrases: 'Time to eat.' 'Let's sit.' 'Here is your cup.' 'Walk with me.' 'Listen to this song.' Avoid questions that start with 'Do you want...' unless you are okay with 'no.'

  • The 'Music Bridge' Technique

    Use a familiar song to transition between activities. For example, hum 'You Are My Sunshine' while guiding them from the yard to the kitchen. Singing together can lower anxiety and create connection without words.

  • The 'Two-Choice' Card

    Hold up two objects (like a red cup and a blue cup) and say 'This one or that one?' Point to each as you name it. This reduces the cognitive load of remembering options and makes choice feel safe.

  • The 'Quiet Zone' Setup

    Create a calm space with minimal noise and clutter. Turn off the TV, close the blinds, and sit at eye level. This environment helps their brain focus on you instead of being overwhelmed by sensory input.

Discuss with your clinician

If your loved one is refusing all food or water, ask the doctor about safe hydration strategies or whether a feeding evaluation is needed.

If they are falling frequently due to their physical strength outpacing their cognitive awareness, ask about a fall risk assessment and home safety modifications.

If they are having new or worsening hallucinations or delusions, discuss whether medication adjustments might help reduce distress.

If they are showing signs of pain (like grimacing or moaning) but cannot communicate it, ask about a pain assessment tool for non-verbal individuals.

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