By Linda Lauzon, Park Ridge Health Home Health                                

Caring for someone with dementia presents many challenges. People with dementia from conditions such as Alzheimer’s and related diseases have a progressive biological brain disorder that makes it difficult for them to take care of themselves, think clearly, remember things, or communicate with others. The following are some useful communication strategies to use when caring for a person with dementia.


Effective communication is not a skill that we are born with—but we can learn to communicate with a person who is suffering from dementia. Developing effective communication skills will help make caregiving less stressful and may improve your interactions with the person you are caring for. Effective communication skills will also increase your ability to handle difficult behaviors you may encounter as you care for a person with dementia.

1. Limit distractions and noise. Turn off the TV or the radio. Close the curtains or shut the door, or move to quieter surroundings. Before you speak, make sure you have his or her attention; call him or her by name, identify yourself by name and relationship to the person, and use nonverbal cues and touch to help keep him or her focused. If the person is seated, squat or sit down to his or her level and maintain eye contact.

2. Be positive. Your body language and your attitude will communicate your feelings and thoughts stronger than what you actually say. Speak in a pleasant and considerate manner and remember to use their name. Use facial expressions, tone of voice, and touch to help show your feelings of affection and convey your message.

3. Clearly state your message. Use simple words and sentences. Speak slowly, in a reassuring tone. Do not raise your voice higher or louder; instead, make your voice lower. Should he or she not understand the first time, use the same wording and repeat your message or question. If there is still no understanding, wait a few minutes then rephrase the message or question. Use specific names of people and limit abbreviations.

4. Ask simple questions, one at a time. Questions with yes or no answers work best. Try not to ask open-ended questions or give too many choices. For example, ask, “Would you like to eat white potatoes or sweet potatoes?” Using visual cues and prompts to show the choices can clarify your language and guide a response.

5. Be patient while waiting for your loved one’s reply. If he or she is struggling for an answer, you can suggest words. Be alert for nonverbal cues and body language, and respond appropriately. You want to understand the meaning and feelings that underlie the words.
6. Make tasks more manageable – break tasks into steps. Encourage your loved one to do what he or she can, by reminding him or her of steps that are forgotten, and assist with steps he or she is no longer able to do by themselves. For example, using visual cues, such as using your hand to show where to place a toothbrush, can be very helpful.

7. Distract and redirect when upset or agitated. Try changing the subject or the environment. For example, ask for help or suggest moving to another room. Remember to connect with the person on a feeling level before you redirect. For example, you could say, “I see you’re feeling sad. I’m sorry you’re upset. Let’s go get something to eat.”

8. Behave with confidence and kindness. People with dementia often feel confused, anxious and unsure of themselves. Also, they often get confused and may recall things that never happened. Do not try to convince them they are wrong, but stay focused on the feelings they are displaying (which are real) and respond with physical and verbal expressions that comfort, support and reassure. Holding hands, hugging, touching and praise will sometimes get the person to respond when all else fails.

9. Remembering the past. People with dementia often find this a soothing and affirming activity. While he or she may not remember what happened 45 minutes ago, they can often clearly recall their lives 45 years earlier. Avoid asking questions that rely on short-term memory. Instead, ask questions about the person’s distant past.

10. Use 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.

 

Credits and Recommended Reading:

Family Caregiver Alliance, 235 Montgomery St., Ste. 950, San Francisco, CA 94104
Bathing Without a Battl
Ann Louise Barrick, Joanne Rader, Beverly Hoeffer y Philip Sloane, Springer Publishing, 2002
36 Hour Day: Family Guide to Caring for People who have Alzheimer’s Disease, Related Dementias and Memory Loss; Johns Hopkins Press Health Book, 2011
Steps to enhancing communications: Interacting with persons with Alzheimer’s disease 
Alzheimer’s Association, 2012
The Validation Breakthrough: Simple Techniques for Communicating with People with Alzheimer’s-Type Dementia; Naomi Feil, Health Professions Press, Baltimore, MD, 2.ª edición, 2002
Understanding Difficult Behaviors: Some practical suggestions for coping with Alzheimer’s disease and related illnesses 
A. Robinson, B. Spencer y L. White, Eastern Michigan University, Ypsilanti, MI, 2001