Talking with someone who has Alzheimer’s or dementia can be challenging. They may have difficulty understanding you, and you may have a hard time understanding what he or she is trying to communicate. There’s potential for misunderstanding, confusion or frustration in both directions — making communication even more difficult.
A person with dementia may have difficulty remembering words or communicating clearly. Problems you can expect to see throughout the progression of the disease include:
- Difficulty finding the right words
- Using familiar words repeatedly
- Describing familiar objects rather than calling them by name
- Easily losing a train of thought
- Difficulty organizing words logically
- Reverting to speaking a native language
- Speaking less often
- Relying on gestures more than speaking
Improving your communication skills will help make caregiving less stressful and will likely improve the quality of your relationship with your loved one. Learning a few dementia communication techniques makes it easier to connect with them and enjoy meaningful time together.
The Family Caregiver Alliance & National Center of Caregiving recommend these 10 tips for communications with seniors with dementia:
- Set a positive mood for interaction. Your attitude and body language communicate your feelings and thoughts more strongly than your words do. Set a positive mood by speaking to your loved one in a pleasant and respectful manner. Use facial expressions, tone of voice, and physical touch to help convey your message and show your feelings of affection.
- Get the person’s attention. Limit distractions and noise—turn off the radio or TV, close the curtains or shut the door, or move to quieter surroundings. Before speaking, make sure you have their attention; address them by name, identify yourself by name and relation, and use nonverbal cues and touch to help keep them focused. If they are seated, get down to their level and maintain eye contact.
- State your message clearly. Use simple words and sentences. Speak slowly, distinctly, and in a reassuring tone. Refrain from raising your voice higher or louder; instead, pitch your voice lower. If they don’t understand the first time, use the same wording to repeat your message or question. If they still doesn’t understand, wait a few minutes and rephrase the question. Use the names of people and places instead of pronouns (he, she, they) or abbreviations.
- Ask simple, answerable questions. Ask one question at a time; those with yes or no answers work best. Refrain from asking open-ended questions or giving too many choices. For example, ask, “Would you like to wear your white shirt or your blue shirt?” Better still, show them the choices—visual prompts and cues also help clarify your question and can guide their response.
- Listen with your ears, eyes, and heart. Be patient in waiting for your loved one’s reply. If they are struggling for an answer, it’s okay to suggest words. Watch for nonverbal cues and body language, and respond appropriately. Always strive to listen for the meaning and feelings that underlie the words.
- Break down activities into a series of steps. This makes many tasks much more manageable. You can encourage your loved one to do what they can, gently remind them of steps they tend to forget, and assist with steps they are no longer able to accomplish on their own. Using visual cues, such as showing them with your hand where to place the dinner plate, can be very helpful.
- When the going gets tough, distract and redirect. If your loved one becomes upset or agitated, try changing the subject or the environment. For example, ask them for help or suggest going for a walk. It is important to connect with the person on a feeling level, before you redirect. You might say, “I see you’re feeling sad—I’m sorry you’re upset. Let’s go get something to eat.”
- Respond with affection and reassurance. People with dementia often feel confused, anxious, and unsure of themselves. Further, they often get reality confused and may recall things that never really occurred. Avoid trying to convince them they are wrong. Stay focused on the feelings they are demonstrating (which are real) and respond with verbal and physical expressions of comfort, support, and reassurance. Sometimes holding hands, touching, hugging, and praise will get the person to respond when all else fails.
- Remember the good old days. Remembering the past is often a soothing and affirming activity. Many people with dementia may not remember what happened 45 minutes ago, but they can clearly recall their lives 45 years earlier. Therefore, avoid asking questions that rely on short-term memory, such as asking the person what they had for lunch. Instead, try asking general questions about the person’s distant past—this information is more likely to be retained.
- Maintain your sense of humor. Use humor whenever possible, though not at the person’s expense. People with dementia tend to retain their social skills and are usually delighted to laugh along with you.
Watching a loved one live with dementia is never easy. It’s important to work with a certified dementia care advisor with ample experience in the industry.