Communication
Ongoing communication is crucial for both the person with dementia and their family caregivers. When accommodations are made, the person with dementia will be more comfortable and the family will be much more satisfied in the caregiving role.
As Arizona's leading provider of Alzheimer's clinical resources, Banner Alzheimer's Institute offers these communication strategies.
Common communication problems and strategies to deal with them:
Word Finding: Difficulty remembering certain words or names is one of the first symptoms of dementia. It will become more difficult as the disease progresses.
The person often recognizes their difficulty and may become very frustrated or less communicative. Some individuals may willingly accept people's help, while others may become very defensive and angry.
- Strategies:
- Eliminate background distractions such as the TV, too many people talking at once, etc.
- Make sure glasses, hearing aids and dentures are working
- Allow the person time to communicate his message.
- When he has difficulty finding a word, consider asking him to explain in a different way. You may also try to guess the meaning and ask if you are correct.
- If he can't think of the right word, try giving clues instead of immediately supplying it, e.g. 'cup of ....'. You can also try giving a description, e.g., 'You clean your teeth with it'.
- Ask him to show you what he is referring to. Pointing to an object may also help him get the message across.
Receptive Language: The person with dementia will also have difficulty understanding what is being said to him over time. Caregivers may not recognize this as a change, rather may think their loved one is either ignoring or disregarding them. Nonverbal messages, however, will often be well received.
- Strategies:
- Remain calm and talk in a gentle, matter-of-fact way without raising your voice.
- Keep sentences short and simple, focusing on one idea at a time. Talk about familiar events that may be remembered or everyday things like weather.
- Avoid “talking down” to him or using childlike voice tones.
- Try using different words as you repeat what you are asking or communicating.
- Try more “yes” and “no” questions.
- Take your time in speaking and listening.
- Touching and holding his hand may help keep his attention as well as showing him that you care.
Worsening Memory: Continued loss of both short-term and long-term memory will further impact the person’s ability to communicate over time. Even during short sentences, the person may forget what he/she was about to say. Favorite stories told repeatedly by the person may become more challenging.
- Strategies:
- Rely more heavily on non-verbal cues such as the tone of voice, touch, and facial expressions to convey how you feel.
- Keep modifying your expectations so you remain realistic. However, keep trying new ways to connect or ask others for help.
- Listen for and learn to recognize the feelings and emotions rather than the words.
- Continue sharing familiar activities, listening to favorite music, watching a favorite movie or old comedy show, looking at a picture book, or enjoying a favorite sweet treat.
- Never discuss the person in front of others as if they were not present, even if you think they do not understand.
When the Going Gets Rough: Being “on call” 24/7 can wear a caregiver down. When you feel yourself getting frustrated or impatient, it is time for a quick break so that you can compose yourself to get through the day. Try not to be too hard on yourself. Structure and routine is very important to the person with dementia and will provide more predictability and sense of security.
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Strategies:
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Avoid upsetting arguments or allowing your own stress and exasperation to show. There is an expression, “no one ever wins an argument with a person with dementia!’
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Use distraction when possible to help overcome upsets and frustration
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Incorporate information in your conversation which tells him where he is, what is happening around him and who he is with, can make him feel more secure and less confused.
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Use orienting names whenever you can such as 'your son, Jack'.
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When talking in a group, make sure the he is not on the end of the row. It is better to place him so that the conversation is around him and he will not feel 'left out'.
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Exercise forgiveness. You will make mistakes and so will he. But, he will forget and you won’t. Find a confidant who will allow you to openly share your feelings. Or, consider joining a support group.
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Self expression is vital to well being. Your efforts in assisting and adapting to your loved one’s communication abilities will make a difference!
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For more information
This advice was adapted from "When Memory Fades. . . The Caregiver's Challenge Begins,'' offered by Banner Alzheimer's Institute.
