The stages of Dementia, including Alzheimer's disease, gradually diminish a person's ability to communicate. For a caregiver or family member, this means you will require additional patience, understanding and good listening skills. STEPS Home Care has seen families of clients in Westchester, Fairfield and Nassau Counties adopt the strategies below to help them, and with dementia, understand each other better.
General communication 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
- Asking the same question over and over again
- Reverting to speaking a native language
- Speaking less often
- Relying on gestures more than speaking
Here are 10 tips on how to effectively communicate with someone who has moderate to severe dementia.
- Acknowledge the Dementia, knowing that the symptoms inevitably get worse over time and your loved one will have a difficult time understanding you as well as communicating in general.
- Avoid distractions. Try to find a quiet place and time to talk when there are few distractions present. For example, waiting for dinner at a noisy restaurant with grandchildren might not be the best time to discuss anything other than the meal and observing the grandchildren. When in a quiet environment, your loved one can focus their mental energy on a more-detailed conversation.
- Speak clearly, slowly and naturally in a warm and calm voice. Refrain from ‘baby-talk’ as it can be condescending. Also, approach them from the front when speaking as to not startle them from behind.
- Be specific and refer to people by their names. Avoid pronouns like “he,” “she,” and “they” during conversation. Names are also important when greeting a loved one with dementia. For example: “Hi, Grandma. It’s me, Jane,” is more helpful than, “Hi. It’s me.” Also ask close ended Yes and No questions such as “Would you like coffee?” Rather than “What would you like to drink?”
- Focus on one topic at a time. Someone with dementia may not be able to maintain a conversation with multiple threads.
- Use non-verbal cues. For example, maintain eye contact, touch their hand and smile. This helps put your loved one at ease and will facilitate understanding. And when dementia is very advanced, non-verbal communication may be the only option available.
- Listen actively. Even if you don’t understand what your loved one is telling you, politely smile, nod and offer assistance to tease out the details. Be patient and don’t interrupt.
- DO NOT CORRECT inaccurate statements. Your conversations will not go very far if you try to correct every inaccurate statement your loved one makes. It’s okay to let delusions and misstatements go. Repeat what was said to clarify.
- Have patience. Give your loved one extra time to process what you say. If you ask a question, give them a moment to respond or you may have to rephrase the question in a different way they can understand.
- Do not exclude them from the conversation. This includes speaking to them along with their companion or caregiver instead of speaking only to the caregiver when giving instructions.
A good place to start learning more is The Alzheimer’s Association website, which has free e-learning programs, one of them being Effective Communication Strategies https://www.alz.org/help-support/caregiving/daily-care/communications. The program provides tips on how to successfully communicate with your loved one through out all three stages of the disease process. In addition, each regional Alzheimer’s Association chapter offers free care consultations with a social worker, providing an opportunity to access education, referrals and support.
For more information on the stages of dementia and how to handle communications with your loved one, please join STEPS Home Care on Wednesday, February 6 at 11 am for a Dementia Friends Training Session at our Stamford, Connecticut office.