Communicating with people who have dementia is challenging.
Communicating with people who have dementia is challenging. If you are caring for someone with dementia, consider using the tips below to make communication smoother and easier.
1. Speak at a normal pace
You might think that you need to speak slowly to someone who has dementia, but, in fact, it can make communication less effective. This is because, for most people who have dementia, working memory holds information for just seconds. Working Memory is the system we use for temporarily storing new information. If you speak too slowly, words can be forgotten before they are comprehended.
2. Lead with your main point.
If you begin your communication with the main point, there are less demands placed on working memory. For example, instead of saying “Eat your dinner here,” you would say, “Sit here to eat your dinner,” because the most important part of this communication is to first direct the person where to sit. Bottom line: don’t make your listener wait to hear the main point.
3. Minimize background noise
Try to have conversations in quiet places because significant hearing loss among older people is common. Background noise is particularly distractive for people with dementia. If you are having trouble hearing, find another place for the conversation. For those who are ages 65-75, approximately 30-35% suffer from meaningful hearing loss. For those who are older than 75, hearing loss is approximately 40-45%. Ambient noise just makes hearing more challenging.
4. Match your body language with what you are saying.
If our body language doesn’t sync with what we are saying, listeners with dementia can become confused. We provide cues to our thoughts and feelings through nonverbal behavior. Avoid “disconnects” such as walking away from the listener while you are talking. If you want to have a meaningful conversation, give the listener your undivided attention. In other words, don’t talk with the listener and complete another task, such as watching television or washing dishes, at the same time.
5. Mirror the listener.
Both to improve hearing and to communicate that you want to understand, mirror your position with that of the listener. If she is sitting, you sit. If she is standing, you stand. Make sure you are face-to-face. If you are talking to someone in a wheelchair, find your own chair and sit directly in front of the listener.
6. Be direct and brief.
Use short, concrete, and direct statements when talking with an older adult who has dementia because their abstraction abilities have typically eroded. Metaphors, vague statements, and circular reasoning are confusing. Better to say, “Take your pill at night” than, “So you don’t wake up during the night, take your pill before you go to bed.”
7. Check in regularly.
Periodically check in with the listener to make sure he or she understands you. Decoding language and responding in kind is a complex process that requires many functioning parts of our brains — parts that are often disabled by dementia. For perspective, consider this analogy: Understanding a conversation for a person with dementia is like starting a novel on page 100. You have to work very hard to understand the plot.
8. Repetition is good.
If you spend time with an older adult who has
dementia, you will frequently hear the same questions and statements often repeated. This can be frustrating and hard to deal with. We recommend that you think about repetition more positively. Rather than feeling annoyed, interpret repeated statements and questions as the person’s attempt to communicate with you and remember. Try to answer repeated questions using variations in your answers. Repetition is good.
It’s easy to forget how complex language and human communication can be. To communicate more effectively with people with dementia, try to use the eight strategies above. In addition, be on your guard for ageist statements, cultural insensitivities, and negative stereotypes, as they certainly can interfere with meaningful communication. We hope you find the “great eight” useful.