Enhancing Your Communication With People Who Have Dementia

The loss of the ability to communicate is one of the more painful side affects that people with dementia must experience. It can impact people in many different ways. The onset of communication loss can be gradual and it reveals itself in many ways. Examples include:

  1. Inability to remember or retrieve a word.
  2. Repeatedly telling the same story over and over without being aware of it.
  3. Difficulty grasping abstract ideas and concepts.
  4. Problems expressing ideas.
  5. People will describe objects or what they do when they can’t remember their names.
  6. Having trouble maintaining a particular idea or thought. Forgetting where you left off with an idea.
  7. Some people may lapse into their native language without being aware of it. This is old memory and easier to retrieve.
  8. In later stages of dementia people become less verbal and eventually non-communicative.

When this occurs it can be so challenging and frustrating for both the person experiencing the symptoms and people who are trying to communicate. There are techniques you can use to maximize your communication with someone with dementia. Here are some tips to guide you:

  • When you are trying to communicate something important minimize distractions. Turn off the television or radio. Don’t have more than 1 person in the room.
  • Be in front of the person you are communicating with and speak directly to them. Maintain eye contact. That tells them you are interested in them and what they want to say. They can hear what you are saying and also see non-visual cues like facial expressions or smiles, frowns, smirks, or other body language that will help them in understanding your message.
  • Be patient. Allow the person you are speaking with the time they need to express their ideas, and thoughts. Don’t worry if they use an incorrect word. Just ignore it and try to get the core meaning of what they are trying to express.
  • If you are unable to understand what is being said, or the person delivering the message cannot express it after repeated attempts, take a break. Go on to something else and try to return to it later.
  • Don’t speak around the person as if they are not there. That is not helpful and can cause frustration, agitation, or anger. It may feel dehumanizing or infantilizing to the person you are trying to communicate with.
  • Try to assess which form of communication is most effective or comfortable for the person you are trying to engage. Explore verbal versus written options. A person may be more capable reading information via a letter or email than verbal communication which involves processing both verbal and non-verbal words and cues.
  • Ask yes or no questions. Frame you questions with 2 choices where both would be acceptable to you. For example, would you like water or tea to drink with dinner. Keep the content to one question at a time.
  • Focus on the emotions and gestures that are being communicated. Often that will give you important information when words leave you uncertain regarding the message being delivered.
  • Offer clues and cues to a person who is in later stages of dementia to help them sort out information. For example, have a photo of yourself with your name on it at the bedside of a parent. When you come into the room, remind them of your name and your relationship to them.
  • In the later stages of dementia a person may not be able to communicate verbally. In this situation don’t underestimate the importance of gentle touch. Holding a hand or brushing the hair, or a gentle kiss on the forehead, can be a source of comfort. Also just sitting quietly and being present can also be a way to express love and comfort. A simple smile can say a lot without words.  

 

Remember that the condition of a person with dementia is fluid and will change. Lack of sleep or the time of day you visit may impact the quality of communication and the ability to understand what is being said. Dementia is a progressive disease that impacts each person in different ways.

Be patient and understanding. Don’t be dismayed if you have a bad experience at a given moment. Your next attempt may reveal surprising results.  

Written by Iris Waichler
Iris Waichler, MSW, LCSW is the author of Role Reversal How to Take Care of Yourself and Your Aging Parents. Role Reversal is the winner of 5 major book awards. Ms. Waichler has been a medical social worker and patient advocate for 40 years. She has done freelance writing, counseling, and workshops on patient advocacy and healthcare related issues for 17 years. Find out more at her website http://iriswaichler.wpengine.com

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6 Comments

  1. My dad had dementia and went home to be with his Lord last August. When i finally understood what he was dealing with all I had to say was “It’ll be okay Daddy.” He immediately calmed. I miss him terribly!

    Reply
  2. My husband has Parkinson’s with hallucinations and delusions. Every day is a another story. But the worst part is how broken his mind is. No conversations, so debating decisions. Just talk of “people” who do not exist and plots against him by “creatures” and others. Some days…. it is too much.

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  3. Agree completely

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  4. Non verbal communication goes very far with anyone who cognitive and or language needs such as facial expressions, touch, etc.

    Reply
  5. I’ve found that holding my Mothers hand seems to put her more at ease and gives her more comfort that most anything else we do. We sit for hours sometimes just holding her hand.

    Reply

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