Dementia is an umbrella term for symptoms of cognitive decline, including impairment in memory, communication, and thinking. It can be stressful and frustrating to communicate with someone who has dementia, especially as it progresses over time. Dementia compromises one’s ability to express their needs and concerns and relate to others. According to Leisure Care, dementia patients may repeat themselves, have difficulty finding the right words, describe an object instead of naming it, speak less, lose their train of thought easily, or rely on gestures more than words.
Communicating with a person who has dementia requires patience, understanding, and good listening skills. According to the Alzheimer’s Association, understanding what changes may occur can improve communication by helping you “prepare, make adjustments, and know how to respond.” Friends, family members, and caregivers can use the general tips below to connect and communicate with people who are suffering from dementia.
Approach and announce
Forgetting faces and names is one of the most heartbreaking and unfortunate aspects of the later stages of dementia. However, as Leisure Care states, “Being upfront with who you are will help put them at ease.” Dementia decreases a person’s peripheral vision. The Alzheimer’s Association advises approaching the person from the front and identifying yourself by name to get their attention and remind them who you are. Dementia Care Central asserts that approaching the patient from the front gives them time to process, adding that, “If they don’t see you coming, engaging someone with dementia can elicit anxiety or aggression.” So, try not to sneak up on them!
Turn off the radio or TV and remove anything from sight that may be distracting. If possible, sit down face-to-face for a one-on-one conversation in a calm, quiet place. This will allow the person with dementia to focus on the conversation and also affords them the opportunity to formulate and ask questions.
Speak clearly and slowly
Speak plainly, but try not to be condescending. The Alzheimer’s Association advises treating “the person with dignity and respect” and to “avoid talking down to the person or as if he or she isn’t there.” Avoid baby-talk, just annunciate in a natural, warm, calm voice.
Use basic language
Avoid idioms, nicknames, and slang. Dementia Care Central also recommends keeping “anecdotes and stories brief” and offering simple explanations that avoid logic and reasoning, beyond the basics. A Place for Mom cautions against using pronouns like “he,” “she,” and “they” during conversations. Instead, refer to people by name.
Discuss one topic at a time
According to Dementia Care Central, “people with dementia have problems with multiple thoughts at once,” which is why it is important to “focus on one idea or short story at a time.” As A Place for Mom explains, “Someone with dementia may not be able to engage in the mental juggling involved in maintaining a conversation with multiple threads.”
Avoid multi-step instructions
Keep it short and sweet to avoid overwhelming your loved one. Offer clear, step-by-step instructions. Leisure Care suggests going “through tasks one item at a time” and to be “careful not to overwhelm or confuse your loved one.” The Alzheimer’s Association advises encouraging participation by demonstrating a task. They also note that writing things down may help if speaking becomes confusing.
Ask “yes” or “no” questions
Along these same lines, ask one question at a time. Instead of open-ended questions, like “what would you like to eat?” ask, “would you like a ham sandwich?”. Leisure Care elucidates that simple questions will “help them make decisions easier and faster, eliminating confusion and disorientation.”
Words are just one of the tools we use to communicate. According to Leisure Care, communication is a “combination of attitude, tone of voice, facial expressions, and body language.” As dementia progresses, nonverbal communication may be the only form available. However, nonverbal cues, positive body language, and gestures can be utilized even before it gets so advanced.
Dementia Care Central says to nod “yes” and shake your head “no” to reinforce agreement or disagreement. Eye contact shows you’re paying attention. Smiling helps put your loved one at ease, which helps facilitate understanding. Use body language and hand gestures, like pointing. And if you don’t understand what they’re trying to say, politely let them know, and ask them to point or gesture. Also, it’s okay to guess. Considering the emotion behind their words can help you get to the overall message that’s being conveyed.
According to Dementia Care Central, using positive language, like “try it this way” is better than negative expressions, such as “not like that.” Be agreeable–try not to argue. Quibbling with a dementia patient is not only pointless, but it can be counterproductive. If you disagree with something, just change the subject and move on.
Don’t correct or criticize
As Leisure Care states, “Over time, a person with dementia will live in their own reality.” They’re going to get confused–it’s a lot easier if you just expect it. Anticipate the fact that someone with dementia will use words or names incorrectly from time to time. A Place for Mom says it’s “okay to let delusions and misstatements go” and points out that you’re not going to get very far in a conversation by constantly criticizing or correcting them.
Listen and repeat
Listen carefully and try to understand the main point, or meaning, behind what they’re saying. To clarify, you can repeat what was said. It’s also okay to repeat yourself or ask a question again if you didn’t receive a response the first time. According to Dementia Care Central, reminiscing can be healthy, but one thing you do want to avoid is testing their memory by asking, “Do you remember when…?”
For someone with dementia, some days will be better than others. They may have a hard time thinking of a word or processing what was said. When you ask them something, be patient and give them time to respond. Don’t interrupt or get frustrated. As the Alzheimer’s Association instructs, “Offer reassurance. It may encourage the person to explain his or her thoughts.” Dementia Care Central says that encouraging someone to take their time could boost their confidence. They suggest telling the dementia patient, “It’s important to me to hear what you have to say. Just take your time.”
If you’re relaxed, the person with dementia will be relaxed and comfortable. Laugh off what you can. Leisure Care points out that “Humor can lighten the mood, reduce stress, and even bring caregiver and patient closer.”
One thing dementia doesn’t rob the brain of is music and melodies. Dementia Care Central suggests singing as a way to connect with dementia patients. Make a playlist of their favorite songs and/or listen to their favorite albums together.
Don’t pull away
Even if you don’t know what to say to someone who has been diagnosed with dementia, your presence and friendship are important to their well-being. Leisure Care says, “Being honest about your concerns and feelings can help both of you cope with a difficult diagnosis.” Even when they no longer remember who you are, your time, presence and friendship are important.