How to Communicate with Dementia Patients

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How to Communicate with Dementia Patients

Communicating with a loved one with dementia can be very challenging and often requires patience and good listening skills. You’ll quickly learn that you’ll need to use new strategies to communicate with your loved one and ensure a better communication experience for both of you.

The truth is that your loved one with dementia probably has difficulty understanding you, and even some difficulty in understanding what they are trying to say and communicate when they speak.

There’s much potential for misunderstanding, confusion, and frustration, which makes communication even more difficult.

The key is to understand how your loved one’s dementia is affecting their communication and utilizing communication strategies to help overcome these communication barriers.

Dementia and Communication

According to The Alzheimer’s Society, difficulties with s[eech and language occur in all forms of dementia, but the particular problems experienced by your loved one will vary according to the type of dementia they have and the severity of their disability.

Nevertheless, there are several ways that dementia affects your loved one and their ability to communicate. The most common communication difficulties caused by dementia generally include:

  • “Empty” conversations with fewer ideas
  • Using fewer words and “stereotypical” speech
  • Repetitive language and ideas that persist on the same topic
  • Word-finding difficulties
  • Tangential language
  • Circumlocution (talking around a word or subject when they cannot remember it)
  • Grammatical errors
  • Using jargon and loss of meaningful speech
  • Reading and writing difficulties
  • Difficulty following and maintaining a conversation
  • Poor language comprehension
  • Difficulty following multistep commands
  • Poor inferencing abilities
  • Uses “nonsense” words
  • Repeating questions
  • Echolalia (repetition of words or sentences that are heard)

Poor communication might not just be as a result of your loved one’s dementia and its progression.

Sometimes, there are additional factors that can affect your loved one’s ability to communicate, such as pain, discomfort, illness, or side-effects of medication. It can even be that your loved one isn’t wearing their glasses or their hearing aid isn’t working correctly.

If any of these are the underlying cause of your loved one’s communication difficulty, then they should get better when the problem is addressed with a healthcare professional.

Communication Strategies

There are many ways that you can help improve your communications with your loved one, though I’ve found the following three areas to be the best:

Encourage your loved one to communicate with you

As my Grandpa’s dementia progresses, I find that he is talking less and less and isn’t really initiating conversation the way he used to.

Speech and language are essential for brain health and slowing the progression of dementia, so I make sure that I engage him in conversation as much as possible – even if it means that I’m the one that starts the conversations most of the time.

Here are some ways that I encourage my Grandpa to communicate:

  • I speak clearly and slowly while using short sentences.
  • Whenever I talk to my Grandpa or ask him questions, I make sure that I make eye contact with him while we are communicating.
  • My Grandpa rushes to answer questions when he feels pressured, so I make sure that I give him time to respond and think clearly about what it is that he would like to say.
  • I always encourage my Grandpa to join the conversations happening around him, though I never force him to!
  • Letting my Grandpa speak for himself during discussions (especially about his welfare or health issues) empowers him and encourages him to communicate more.
  • I always offer my Grandpa choices and ensure that I avoid providing him with complicated options, which can be overwhelming.
  • I always acknowledge what my Grandpa says, even if it seems out of context because I want him to know that I care about him and hear him so that he is encouraged to continue communicating with me.
  • If we are really struggling, then I come up with other ways to communicate. I find rephrasing questions instead of merely repeating them is especially helpful.

Communicate with your loved one through body language and physical contact

Communication isn’t just about talking and listening. Though we don’t always realize it, we use gestures, movement, and facial expressions while we speak to help convey our meaning and get our message across.

Body language and physical contact are especially important in people with dementia, as they can be handy tools to help your loved one understand what you’re saying to them.

Here are some ways that I communicate through body language and physical contact with my Grandpa:

  • I always make sure that my facial expressions and body language come across as patient and calm, as this puts my Grandpa at ease and helps him communicate more easily.
  • Using a positive and friendly tone of voice can do wonders for his confidence.
  • When I talk to my Grandpa, I make sure that I do so at a respectful distance to avoid intimidating him. For example, if he sits, then I sit, if he stands, then I stand.
  • My Grandpa has become very insecure since receiving his dementia diagnosis, and I find that patting or holding his hand while talking to him really helps reassure him. Just watch out for your loved one’s body language, as they might not like physical contact.

Listen to your loved one and try to understand them

Communication isn’t just about talking to someone. It’s also about listening to them while being aware of their non-verbal messages.

I’ve had to learn to listen to my Grandpa much more carefully over the years as his dementia has progressed and have found that active listening can help in a few ways:

  • I never interrupt my Grandpa, even if I think I know what he’s going to say or if I am becoming impatient. Actively listening to him and letting him finish what he is saying shows him that I care and make him want to continue communicating with me.
  • I find that stopping what I’m doing to give my Grandpa my full attention when he is speaking to me is very helpful.
  • For both of us to listen actively, there have to be minimal distractions and background noise. If we are having a particularly lengthy conversation, I switch off the TV or radio to help my Grandpa maintain his train of thought and his reason for communicating with me.
  • My Grandpa often says things that don’t make much sense. I repeat what I hear back to him to ask if it’s accurate and if I’ve correctly understood what he said. If I haven’t, then he is usually able to rephrase what he said so that it’s easier for me to understand.

And There You Have It!

I know that this is a lot to take in, and it can be even more challenging to try and implement with your loved one.

The key is to be patient and keep trying. If you make a concerted effort to communicate with your loved one, you’ll find methods that work best for you both and which result in the most successful communications.

I’ll leave you off with the following infographic from Marlena Books, which serves as a nice summary of the top ten tips for communicating with your loved one with dementia:

Image: Marlena Brooks

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