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Communication Tips for Dementia Caregivers

Remember how fun it was as children to play the telephone game?  Try as we might, no matter how well we listened to the secret “message” whispered from ear to ear, the end result most always caused a stir of laughter when the jumbled words were shared.  What was it that caused the breakdown of the message to occur?  Multiple factors can be blamed including reduced speech volume, game rules preventing the message from being repeated, and the lack of ability to see the person’s face as they communicate.  

For communication to be effective there is much more to consider beyond the intended message.  Most of us have heard how important body language is in communication, but did you know that only 7% of communication is the spoken word? The remaining 93% has to do with voice inflection, tone, posture and other forms of body language. 

When communicating with persons living with dementia, it is especially important to understand the physical and neurological changes caused by dementias and how these changes affect communication. Due to the way Alzheimer’s disease and other dementias affect the brain, we receive communication best when it is offered in a simple, specific and uncomplicated manner.  Opened ended questions can overwhelm while a specific choice can lead to success.  For example: Rather than ask “What would you like to wear today?” a better approach would be “Would you like to wear the red dress or the blue the dress?” Both examples include the person living with dementia in decision making, yet the latter gives an “either/or” scenario and allows the ability to focus without overwhelming.

Having a positive, patient and reassuring demeanor is also required for successful communication. Remember to wear a smile, and always approach from the front with a soft, positive tone.  Practice patience at all times.  Allow time for the person living with dementia to respond before moving on to the next sentence.  Use auditory, visual and tactile (physical) communication as much as possible to help get messages through.

Sometimes communication fails because we fail to listen to what the person living with dementia is trying to tell us.  We can be so eager to communicate that we may miss certain non-verbal communication from the dementia patient. Are their eyes connecting with ours, or do they seem to stare far away?  Do they appear anxious or distracted? Dementia can cause one to believe they are in a place and time different than they are physically in at the moment.  These moments are quite real for the person experiencing them.  Ask the person who seems upset or anxious if they can tell you what they are thinking about?  You may be surprised to find they were deep in thoughts of yesterday, missing a loved one, or an object believed to be lost.  Once their concerns and/or anxieties are addressed, they may be more relaxed and able to receive what you are attempting to communicate.

Additional tips for communicating with persons living with dementia to help them live their best each day include:

  1. Never Argue – Instead Agree
  2. Never REASON, instead DIVERT.
  3. Never SHAME, instead DISTRACT.
  4. Never LECTURE, instead REASSURE.
  5. Never say REMEMBER, instead say REMINISCE.
  6. Never say I TOLD YOU, instead REPEAT.
  7. Never say YOU CAN’T, instead say DO WHAT YOU CAN.
  8. Never COMMAND or DEMAND, instead ASK or MODEL.
  9. Never CONDESCEND, instead ENCOURAGE and PRAISE.
  10. Never FORCE, instead REINFORCE.

Posted in Perspectives on Alzheimer's on May 21, 2019

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