Successful communication is a special challenge when we are caring for a loved one with dementia.
The best foundation for communication with a person with dementia is compassion. We must understand that they are coping with cognitive and sensory deficits, but we must also understand that they are still functional on an emotional level. Their “feelings” are very much intact, and how they respond to what we say depends to a great extent on how we make them feel.
Here are a few tips for effective communication:
Try to use statements rather than questions. People with dementia first lose their short-term memory, and even the simplest question that puts their memory to the test can seem confrontational. Instead of “What did you have for breakfast?” try saying “I bet you had a nice breakfast.”
Questions should be brief, without choices. If you must ask questions, try to avoid too many options. Don’t say, “Would you like steak or chicken tonight?” This requires a choice, which suggests they can make a wrong choice. On an emotional level, they understand this and do not want to make mistakes. Try saying, “I’m having chicken. I bet you would like that too.” And nod your head to encourage agreement. If they don’t agree, they are likely to just tell you so, and then you can propose another option.
Do not repeat. If a statement or comment seems to confuse them, repeating it is likely to just make things worse. Slow down and try to make your point in a different way.
Keep it simple. Your person’s auditory intake can be impaired. They may hear constant white noise and find it difficult to determine the direction from which a sound came. Also, their cognitive ability to process what they hear may be impaired. For example, a person with dementia may miss one out of every four words, so make your statements as brief and simple as possible.
Speak slowly. A person with dementia cannot process incoming information as quickly as you. Speak slowly, and maintain eye contact to see if you are getting through.
Never contradict or argue. Your person is living in a different reality, but it is the only reality they have. So, don’t try! When they say things that don’t fit your interpretation of the world, just go with it. Validate their thoughts and feelings. You will gain nothing by trying to make them see things your way.
Communication is an art; not a science! Keep reminding yourself that dementia care is an art, not a science. Because our loved ones with dementia keep changing with the progression of the disease, our challenges as care partners keep changing as well. What worked yesterday may not work today. But this does not mean you failed or made a mistake.
Just keep following the principles of patience and compassion, and look for ways to connect with your loved one not on a rational level, but on an emotional level. Keep trying, and keep reminding yourself that we all deserve the best.
Debbie Selsavage is a certified trainer and consultant in the Positive Approach to Care, and a certified dementia practitioner. Her company, Coping with Dementia LLC, is dedicated to making life better for individuals living with dementia. Contact her at firstname.lastname@example.org to learn about free support groups online.