TEN tips for communicating with a person with Dementia

TEN TIPS FOR COMMUNICATING WITH A PERSON WITH DEMENTIA

We were not born knowing how to communicate with a person with dementia; however, we can learn. Improving communication skills will help make caregiving less stressful and will likely improve the quality of your relationship with your loved one. It may help to remember that your loved one is ill and therefore cannot help his or her actions and reactions. Yet good communication skills will also enhance your ability to handle the difficult behaviors you may encounter as you care for a person with a dementing illness.

 1.      Before interacting, set a positive mood. Your attitude and body language communicate your feelings and thoughts stronger than your words. 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.

 2.      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 his/her attention; address him/her by name, identify yourself by name and relation, and use nonverbal cues and touch to help keep her focused. If she is seated, get down to his/her level and maintain eye contact.

 3.      Clearly state your message. 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 s/he doesn’t understand the first time, use the same wording to repeat your message or question. If s/he still doesn’t understand, wait a few minutes and rephrase the question. Use the names of people and places instead of pronouns or abbreviations.

 4.      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 him/her the choices—visual prompts and cues also help clarify your question and can guide his/her response.

 5.      Listen with your ears, eyes and heart.  Be patient in waiting for your loved one’s reply. If s/he is 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.

6.      Break down activities into a series of steps. This makes many tasks much more manageable. You can encourage your loved one to do what s/he can, gently remind him/her of steps s/he tends to forget, and assist with steps s/he’s no longer able to accomplish on his/her own. Using visual cues, such as showing him/her with your hand where to place the dinner plate, can be very helpful.

 7.      When the going gets tough, distract and redirect. When your loved one becomes upset, try changing the subject or the environment. For example, ask him/her 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.”

 8.      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.

 9.      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.

 10.  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.

The following Video was originally posted on Blogspot: “My Mothers Journey with Dementia” by Hannah

 

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Comments

  1. I need advise on how to respond to my mom ( who is now in a nursing facility long term for dementia) when she speaks of her ready to go home. For 6 months I have handled everything but this one , I’m not so sure how to answer or respond to when she brings it up. She has no idea her house has been sold etc. I don’t know how to hopefully make her understand that living alone is not an option, and I don’t want to upset her, as she was very independent , lived alone for many years and was very active.

    • Thank you for reaching out, Vickie. There are a few facts missing from your inquiry, however I will answer it as follows: Have you ever had discussions about where your mother may want to die? Was the answer “at home” or in a “Hospital”? If those discussion did not take place, then perhaps your mother is doing what most people at the end stage of her life request; namely, “Get me out of here” or “I want to go home.” In both cases, what they are generally saying or requesting is “off the planet” or “home” to their life in the hereafter.
      If the latter is the case, please feel comfort in letting her know she can go home as she wishes, it’s all up to her. If she is not in Hospice yet, she should be evaluated for it because reputable hospice companies are the most caring and knowledgeable about end of life; a precious time in both the patient’s life as well as the families’ life. On this website in the WELLNESS VILLAGE you may be able to find a vetted Hospice Company near you. Hospice services are covered under Medicare if a doctor diagnoses that the individual will likely die within six months or less.
      I hope this helps.
      If your mother is going through typical dementia, where she makes these types of statements or requests, but then forgets about them shortly after, please take comfort in answering her by stating something like, “let’s discuss that later today” or “let’s discuss that the next time I come to visit” or even “I am working on that Mom, I’ll keep you posted.” She typically will forget the discussion and bring it up again at another time, but may be relieved that you gave her an answer.
      Please feel comfort in your substituted judgment (The standard to be used by surrogate decision makers who have specific knowledge of the patient’s values and wishes pertaining to health care choices). If you feel you want more information, please feel free to contact us by phone.

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