When your loved one has a type of dementia such as Alzheimer’s disease, communicating with them can be challenging. Because the progressive nature of dementia slowly erodes their abilities including communication skills, your loved one’s expressions and words may soon become confusing or untranslatable to you. At the same time, your loved one may start having difficulty understanding what you’re saying or meaning, which can cause anxiety, aggravated tempers and more difficult communication overall.
“Because dementias such as Alzheimer’s disease damage pathways in the brain, it makes comprehension difficult because the ability to ‘translate’ them simply isn’t there,” says Jennifer Trout, Executive Director of Bridges® by EPOCH at Hingham. People with dementia may also lose their train of thought, repeat the same word or question over and over, speak less often, struggle to make coherent and logical phrases or even revert to a native childhood language.
Jennifer says it’s important to remember that your loved one isn’t doing this on purpose, and that it’s essential for you as a caregiver to not take it personally. “Patience and understanding will be your best tools for helping get through communication difficulties and helping your loved one feel secure, confident and safe,” she says.
Tips for Communicating Effectively
1. Pause and take a breath.
Before you start any conversation with your loved one, take a minute and center yourself. It can be challenging to care for someone with dementia, and it’s easy to let emotions overwhelm you at times. By grounding yourself before beginning a conversation, it’s easier to remind yourself that the person you love is still the same person inside – and that, no matter what, you both care for each other.
2. Remain positive, calm and warm.
Even if your loved one can’t understand your words, they can understand your emotions and tone very easily. Try to not get frustrated or upset, which will cause them to become upset or anxious. Remember, this is a person you love and care about.
3. Remove anything that could prove a distraction.
Dementia makes it harder for an individual to filter out distractions like the radio, television or other ambient noise. Before beginning a conversation, make sure that electronics are turned off. You can also move your loved one to a quiet area if there are other people nearby. Depending on your loved one’s personality, there may be other distractions that should be removed.
4. Speak slowly and clearly.
Enunciate, slow down and use small words. Speaking too fast will be confusing, and taking your time will give your loved one a chance to absorb what you’re saying. Try to avoid run-on sentences and lots of questions. Ask simple questions and focus on one thing at a time. Be sure to observe your loved one to make sure they’re understanding you.
5. Be direct.
Use nouns, pronouns and specifics in order to help your loved one know exactly what you mean. If you’re talking about an object, point to it and use the proper noun. If you are speaking about a person, say their name and their relationship to you instead of pronouns.
6. Be an active listener.
Showing that you’re really listening to what the other person is saying – nodding, responding in encouraging ways, showing that you want to hear more – validates what your loved one is saying. Figure out what works best for your loved one that will encourage them to keep speaking.
7. Use yes or no questions, or provide edited choices.
When it comes to choosing what to do, what to wear or getting answers from your loved one, it’s best to avoid open-ended questions. Too many choices can be overwhelming and may cause them to shut down. Instead of asking, “what do you want to do today?” say “do you want to go to the park or watch TV?” Your goal is to make it as easy as possible for your loved one to answer the question, which will be helpful for you – and encouraging for them.
8. Redirect if necessary
Your loved one may get stuck in a “groove” and keep asking the same question or saying the same thing over and over. Some repetition is okay, but if your loved one seems stuck on something, gently redirect their attention to something else by asking a different question or distracting them with an activity. On the flip side, you may ask your loved one a question several times and they’re unable to answer for whatever reason. In that case, come back to the question later – it may be that now is just not a good time for your loved one.
9. Remember the importance of body language.
Just like your tone of voice, individuals with dementia can pick up on your body language. Be sure that you’re not inadvertently sending threatening or negative messages with your body language (turning away from them, crossing your arms, scowling). It’s common for loved ones to mirror what they’re seeing you do, so smile and be positive!
10. Use non-verbal communication.
Different parts of our brain control different kinds of communication. If your loved one is struggling with words, you can still communicate through different forms. Pointing and showing is a great way to get your message across, or music can be used to help soothe your loved one. Don’t forget the messages that a hug, a pat on the hand or a warm smile can give someone else.
“The most important thing to remember when it comes to communicating with individuals with dementia is helping them understand and be understood,” says Jennifer. While the above tips are great starting points, she recommends that caregivers try different tactics to see what works best for their loved ones. “Your loved one is a unique individual, and you may find that some techniques work better than others. Just remember that there’s no wrong way to communicate.”
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