Communication and Dementia: The Do’s and Don’ts
Dementia profoundly impacts people’s lives – emotionally, physically, and socially. It also takes a toll on those providing care. Dementia care is often not intuitive, especially when it comes to communication and dementia. What seems like a perfectly acceptable communication tactic in any other scenario can backfire and lead to disastrous results when dementia is at play.
Effectively communicating with a loved one with dementia requires first understanding the condition.
What is dementia?
Contrary to popular belief, dementia is not a diagnosis, but rather a set of symptoms, such as:
- Compromised memory
- Poor decision-making and judgment
- Impaired safety awareness
- Personality changes
Dementia is a catchall phrase that can lead to a clinical diagnosis of a particular type of dementia, such as Alzheimer’s disease, Lewy body dementia, Parkinson’s, or alcohol- or drug-induced dementia.
Why is it so important to focus on communication?
Communicating with a person with dementia can either escalate aggravation and other difficult emotions, or it can calm them. The world is a very different place for someone with dementia. Trying to step into the person’s shoes to better understand his or her reality is key.
Following are some common situations that occur when communicating with someone with dementia, and how best to manage them.
- The senior with dementia is insisting on taking the car for a drive, even though driving is no longer safe. Your first instinct may be to look the senior in the eye and remind him or her that driving isn’t an option anymore. There are two things wrong with this approach. First, facing a person can be adversarial. Simply standing sideways can indicate that you’re not going to argue. Secondly, it’s never a good approach to ask a senior with dementia to remember something. Rather, reflect back what the senior is feeling for a calming effect, and then try redirecting the senior. “I hear that you’re really upset because you want to drive the car. That has to be hard. Let’s go outside and water your favorite rose bushes, and we can plan an outing for later this afternoon.”
- You’ve asked the senior several times if he or she wants to eat lunch, and the answer is always NO. It’s a good rule of thumb to avoid asking someone with dementia yes-or-no questions. Regardless of what the person may be thinking, the automatic response is typically going to be NO. Instead, offer two A/B choices: “Do you want tuna or chicken salad for lunch?” Be sure to keep the choices simple.
- The senior is struggling with memory loss, and family members are quizzing him. Often, family members will ask Grandpa if he remembers how many grandchildren he has, what their names and ages are, etc. to try to help him recall the information. The only outcome this tactic will achieve is aggravation. A better method for helping the senior is by looking through family photos and reminiscing together. Since long-term memory remains intact longer than short-term memory, photos from the senior’s past are often more meaningful.
Keep in mind that gradually the world shrinks as the dementia progresses. People turn inward and lose the capacity for empathy/sympathy. They might not say they love you. They don’t think about what you might need from them. It’s simply not obvious anymore.
You, however, can bridge the communication gap in a number of ways:
- Say, “I love you,” often.
- Recount the important life lessons the person has taught you and how valuable they are.
- Tell the senior he’s a great dad, or she’s a great mom.
- Hold the person’s hand and give a hand massage if welcomed.
- Put some towels in the dryer to warm them, and then fold them together while sharing a memory: “Mom, I remember when you used to hang all the clothes on the line when you didn’t have a dryer.”
- Incorporate music as much as possible, especially when verbal skills become limited. Even those who are nonverbal may hum or sing along with favorite music, especially music connected to the past, such as holiday or religious songs.
How can home care help?
Home care is a vital component in caring for someone with dementia, for several reasons:
- It promotes safety. A caregiver will make sure that the oven is turned off, medications are being taken properly, the senior is getting proper nutrition and hydration, and more.
- It gives family caregivers a break. Taking regular, scheduled breaks is incredibly important for family caregivers. In order to take care of someone else effectively, you have to take care of yourself.
- It fosters familiarity. We can’t overemphasize the importance of maintaining the comfort and familiarity of home and routines for someone with dementia. An in-home caregiver can mean the difference between a senior continuing to live at home or having to move to a long-term care facility.
- It allows for continuity of quality care. Caregivers who are trained in specialized, highly effective approaches to dementia care, and who are consistently there for the senior, lead to a better quality of life.
Communicating well with a person with dementia isn’t easy. It is well worth the time to learn and practice the techniques that allow you to stay connected in a positive way.