CONFLICT IN COMMUNICATION CAN MAKE CAREGIVING FOR DEMENTIA DIFFICULT
Looking to help the person with dementia communicate better? Looking to make yourself understood? People with Alzheimer's and other dementias have more difficulty expressing thoughts and emotions and they also have more trouble understanding others. When communication is difficult, stress levels rise, frustration builds, and focus degenerates. Here are some recommended communication techniques, tools, and strategies to try.
Alzheimer's disease and other dementias are known for memory loss but also gradually diminish a person's ability to communicate. Communication with a person with dementia requires patience, understanding and good listening skills. Remember dementia can also bring on confusion, poor concentration, disorientation, and an inability to make a decision. Please note that in addition to changes in the brain caused by Alzheimer's, a number of physical conditions and medications can affect a person's ability to communicate. If all of a sudden you notice a big change in speech, behavior or agitation, call the doctor!
Changes in the ability to communicate are unique to each person with dementia and change with each stage of the disease. In the early stages of dementia, the person might repeat stories or not be able to find a word. Later on you may recognize other changes such as:
- Using familiar words repeatedly
- Using inappropriate words to describe familiar objects
- Easily losing train of thought
- Speaking in a native tongue
- Difficulty organizing words logically
- Being unusually quiet
Here are some ways you can help the person with dementia to communicate:
Limit distractions - Reduce noise and visual stimulus. A nice, quiet place is the perfect place to try and talk with someone living with dementia.
Identify yourself - Approach the person slowly from the front and say your name and who you are. Keep good eye contact. If the person is seated or reclining, go down to that level.
Hold their attention – For some people it may not be easy to keep their focus. Using a person’s name is often a strong way of keeping their mind focused on you. Engage with touch, a gesture on the hand or arm, and stay in their line of sight while you have your discussion. Photos and hand movements can be useful for holding attention.
Keep it simple - Use short, simple words and sentences. Speak slowly and distinctively. Be aware of speed and clarity. Use a gentle and relaxed tone — a lower pitch is more calming.
Take it one step at a time - Lengthy requests or stories can be overwhelming. Ask one question at a time. If you have a task, give the instructions step by step instead of laying a plan out entirely. One thing at a time is far easier to understand and avoid issues like mixing up the order of steps that need taking. To help demonstrate the task, point or touch the item you want the individual to use or begin the task for the person.
Avoid criticizing or correcting - Don't tell the person what they are saying is wrong. Instead, listen and try to find the meaning in what is being said, what need has to be attended to. If the person uses the wrong word or cannot find a word, try guessing the right one. If you understand what the person means, don’t correct them you will just cause unnecessary frustration.
Avoid arguing - If the person says something you don't agree with, let it be. Arguing usually only makes things worse — often heightening the level of agitation for the person with dementia. If they are agitated, uncooperative and argumentative, distraction works better than anything. (See note below about aggression**)
Encourage gestures - If you don't understand what is being said, encourage unspoken communication. Ask the person to point or gesture. Give visual cues.
Focus on feelings - Sometimes the emotion being expressed, not the facts, are more important than what is being said. Tone of voice and other actions may provide clues.
Be patient - The person may need extra time to process what you said. Wait a moment or two for a response. If the person doesn't respond, wait a moment and ask again. Let the person know you're listening and trying to understand. Be careful not to interrupt.
Provide the solution - Turn questions into answers. For example, say "The bathroom is right here," instead of asking, "Do you need to use the bathroom?"
Avoid being vague - When communicating with a person with dementia, it's especially important to be specific and choose your words carefully. Describe the action you want them to take: "Please come here. Your shower is ready." Instead of using "it" or "that," name the object or place. Instead of here it is, say here is your bath towel to dry off.
Offer reassurance - Let the person know that it's okay if they are having trouble communicating. Encourage them to continue explaining. Avoid quizzing them.
Be positive - Turn negatives into positives. Instead of saying, "Don't go in there," say, "Let's go over here."
Be aware of your attitude — you communicate through your tone of voice. Convey an easygoing manner. Use positive, friendly facial expressions and nonverbal communication. Treat the person with dignity and respect. Avoid talking down to the person or talking as if he or she isn't there.
We Can Help. Our goal is not only to provide care for people living with dementia, but also help them to thrive and not just survive. If you are looking for dementia care support where the care is truly genuine, look to Visiting Angels dementia-trained professionals. While a person with later-stage Alzheimer's may not always respond, they still require and benefit from continued communication.
**You may want to read this article as well if your loved one is aggressive: https://www.visitingangels.com/palmbeaches/how-to-address-agitation-and-aggression-weekly-message_1470
Till next time!
Irv Seldin, JD., Owner and CEO of Visiting Angels of the Palm Beaches
*Article not intended as medical advice.