Communication with a Dementia Patient

Human existence would be unimaginable without being able to communicate.

When communicating with someone who has dementia, the challenge is much greater.

Dementias like Alzheimer’s disease affect language skills in many ways.

There may be difficulty finding words, or substituting the wrong word, or using “nonsense words” (neologisms).

Dementia sufferers can forget the names of familiar people or objects, or confuse generations, mistaking their wife for their mother.

In the later stages, they can lose all ability to communicate verbally. Using non-verbal behaviors is critical to effective communication in dementia.

Because dementia sufferers may be trying to interpret a world that no longer makes sense to them, misunderstandings and communication difficulties are both common and frustrating for everyone.

Fortunately, there are many ways to increase understanding.

The Importance of Listening

Listening is the first step in good communication, and it shows you care.

Listen actively and give plenty of encouragement.

If the person with dementia has trouble finding words, ask him or her to explain differently.

Use what you know about the speaker to help interpret his or her meaning.

Self-expression is vital to our well-being, so allow the person to talk without interruption.

It may be necessary to suggest words at times, but avoid finishing the speaker’s sentences.

Instead, check for understanding by paraphrasing.

Let the speaker express feelings without trying to “jolly” him or her along.

Attracting and Keeping Attention

Make sure you have the person’s attention from the start.

Turn up the lights to allow for good vision, and make sure eyeglasses and/or hearing aids are in place. Make eye contact.

Try to control distractions such as radio, TV, or other competing conversations.

The Importance of Body Language

Being calm and still during communication shows that you are giving your full attention.

Never stand over someone, but instead position yourself at eye level.

Standing too close can also feel intimidating, so always respect personal space.

Picking up cues from the dementia sufferer’s body language can help if words fail the person.

For example, facial expressions, movements, and body postures can convey how the person is feeling.

Finally, patting the person’s hand or putting your arm around them can be reassuring and comforting.

Keeping it Simple

Dementia causes people to lose the ability to initiate conversation, so you will have to take more initiative.

Speak clearly and calmly; avoid sharp or shrill tones.

Choose short and simple sentences. Allow plenty of time for the person to process information.

Rather than using open-ended questions, which can be confusing, ask direct questions phrased in a way that allows for a “yes” or “no” answer.

Break down tasks into simple steps instead of giving multi-part instructions.

Try not to ask the person to make complicated decisions. When you are having trouble making yourself understood, find other ways to say what you mean rather than just repeating yourself.

Being Respectful

As dementia progresses, fact and fantasy can become confused.

If the person says something you know isn’t true, try to find ways around the situation rather than responding with a flat contradiction.

Always avoid making the person with dementia feel foolish in front of others.

Don’t talk down or take a patronizing tone.

Try to include the person in conversations with others, adjusting your communication style if needed.

Socialization can help a person with dementia to preserve his or her sense of identity, which can become fragile as dementia progresses.

It also reduces feelings of exclusion and isolation.