How To Communicate When Caring For Dementia Patients
Navigating the stages of dementia can be challenging for caregivers. Learn how to effectively communicate with dementia patients by understanding the symptoms, remaining calm and patient, and using visual cues and a reassuring tone.
Techniques for Effective Communication
Dementia caregivers find communicating with dementia patients to be challenging. Communication is an exchange of information. We send and receive ideas, and express emotions. There are different levels of communication. We communicate verbally, through words and tone of voice Non- verbally through body language.
Techniques for effective communication reflect what we are trying to communicate to the person with dementia.
As someone with dementia progresses through the stages of Alzheimer’s disease or other related dementia, their communication skills erode. Your caregiving skills will need to include becoming a better communicator. Caregiver will need to investigate and try different communication techniques. Someone with dementia will need visual cues, a reassuring tone and in later stages of dementia care you will need to speak slowly.
Stages of dementia affect everyone differently. As dementia symptoms progress, the aging adult will change in their communication ability. This becomes a challenge for both the caregiver as well as with the aging adult with dementia. The aging senior may have as much trouble understanding what you are communicating. Just as you are having difficulty understanding them.
The levels and changes of communication change over time. As the disease progresses the communications become challenging.
Before You Start to Communicate
Symptoms of dementia that you may begin to recognize as the person with dementia declines:
Struggling to find the right word. You will see this in the early stages of Alzheimer’s disease. They will have difficulty finding the correct word. Family members that care for a loved one with other related dementia, you may not see the erosion of communication skills until the middle stages of dementia. This is because different dementia disorders affect different regions of the brain. Each region of the brain are responsible for different things, such as speech, our decision making process, problem solving skills and short term memory.
The aging senior struggles to organize the words in a logical order. They may replace or make up words to replace the forgotten word with a made up word that makes no sense.
They quickly are distracted and lose their train of thought.
They will repeat a word, phrase or the same question over and over again.
They require more time to process what you are saying to them. This is an important point. caregivers need to give a person with dementia time to process and respond. In the middle stages of dementia, you will need to break down directions to one or two words as a time.
People with dementia may begin to use offensive language, even if they never spoke like that before. I had a pastors wife that used to swear like a drunken sailor as her disease progressed. This troubling behavior caused the church members to stop visiting. They felt upset seeing this normally quiet and very soft spoken female become loud and aggressive.
This behavior caused conflicting emotions in everyone. So many could not accept that a person living with these disorders affecting brain health and the resulting behaviors were not under her control. Especially the older adults in the community. Many have a hard time understanding that a person with dementia has no control over their words or actions.
They begin to have nonsensical conversations that you do not understand. This will start earlier in those with Alzheimer's disease. In another related dementia, this may being in the middle stages
Over time, there are decreased attempts to speak and interact.
Let's Talk About Your Communication Skills
The most effective communication technique is to remain calm and relaxed throughout your caregiving journey. Being patient can be difficult as tempers can flair. This just creates frustration and anxiety and makes communication more difficult. It is important to understand that a person with dementia , by the time the disease progresses, the short term memory loss is the first to go. Long term memory loss will be next. A person living with any type of dementia is living in the moment. They are living mindfully. A person with a dementia diagnosis lives in the present. They will pick up on your emotions and will take cues from your body language.
Work at keeping your voice calm and your body relaxed. Visual cues will send a clearer message that the words you say.
A technique that is important is how you approach your loved one with dementia. Dementia caregiver’s should always approach the aging senior from the front. Take into consideration if they have sight or hearing problems. You do not want to startle them.
Maintaining eye contact and be supportive by remaining close and listen. It is important for the Alzheimer caregiver to reassure that, you are trying to understand.
It is appropriate to encourage and assist the aging senior to focus on words. Cueing a word or phrase can be a technique that is effective in assisting communications.
Dementia caregiver’s should consider props or visuals to assist in recognition. Remember the person living with Alzheimer's disease, has a brain that is slowly shrinking. Consider using picture. Or sit the aging adult at a table with food, before asking if they are hungry or not. These little tips can make communication easier, and make your life easier on the road ahead .
The caregiver must remain positive. Do not argue. Just agree. Reasoning and judgment decline over time. It is more important to maintain calm to maintain your loved ones well being. Avoid a situation that can increase anger and agitation.
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A technique for effective communication is to consistently word things... from a positive perspective. It is important to understand that people with dementia, do not process the way we process things. For example, instead of saying “Don’t go out that door”, learn to rephrase and say “Let’s go here'”.
As a caregiver, it is important to be mindful of the different approaches needed when interacting with a person with dementia. For caregivers, understanding that one’s loved one may not communicate as they once did can be difficult at first.
Instead of asking questions such as
‘Do you remember when?'
'Mother/Father, May I'
Questions could cause distress or confusion.
Instead try allowing them independence by giving open-ended choices like:
"Would you like this or that?" Limit choices. If you're caring for someone with dementia, it's important not to overwhelm them. Ask one question at a time and provide ample opportunity for thinking. This will help the person better respond without becoming frustrated or withdrawing from daily activities.
It might even be useful to observe their nonverbal communication like facial expressions and body gestures. These can also reveal understanding of tasks or comprehension level during conversations. In addition, don't forget that there are enjoyable activities available which could potentially boost appetite as well as make sure they stay engaged in conversation! Eating with other family members will encourage a person living with dementia to eat more nutritious foods. Eating with others will increase their appetite and improve their sense of well being.
In the middle stages of Alzheimer's disease and other related dementia when finger foods and high calorie protein drinks are important to offer. This is when you have to get creative in your dementia care approaches. Both you and your loved one with dementia will need to focus on keeping a person living with dementia to drink and eat.
This is this is a time when you offer snacks, drinks and other nutritious foods frequently. The daily routine and familiar objects may become more important in the later stages of dementia.
Personal activities may become challenging. Family caregiver's need to understand a person with Alzheimer's disease or other related dementia have lost the ability to turn negative thoughts around. You need to be aware of the warning signs of escalating troubling behavior, when you interact. A person living with dementia has lost their self management abilities as the disease progresses.
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“How do I connect with my wife and get her to connect with me? This is always a constant desperation on my part especially because she doesn't speak. I am always afraid she will stop connecting with me, especially when I get that blank look, that daze into no man's land. That is the day I am trying to avoid. Everyday, every moment I can, I try to create an opportunity to “connect” to avoid her shutdown.”
― Sammie Marsalli, Preventing Her Shutdown
More Communication Tips To Make The Road Ahead Easier
As the stages of dementia progresses, it will become more important to... repeat a phrase or word, slowly and calmly.
Family members may have to repeat something ten times or more. Maybe in as many minutes. This is because the person living with dementia cannot remember what you have already told them. Each time you repeat something, it is like receiving new information to them.
Your caregiving journey is going to be difficult. You must remember that your loved one is not acting this way intentionally. It is the dementia, not your loved one responding. So, please , learn to not take anything personally. Many families have to take a short break from their loved one, because of hurt feelings. Many are experiencing anticipatory grief, as they start to provide personal care and begin to have safety concerns about their loved one.
As symptoms of the disease progresses you will observe:
Increased sensitivity to noise. Troubling behaviors will occur as your loved one will start to struggle with everyday tasks. A person living with dementia in the middle stages with have difficulty with concentration. In these stages of dementia, you can redirect your loved one, when they are struggling with a task.
The sensitivity to noise requires an environment with minimal background noise. Even lowering the ring tone on the phone will avoid an unnecessary distraction.
Communicating with dementia patients can be challenging for any caregiver. Providing consistency, in a loving and caring environment it recommended. Regardless of how difficult the communication becomes, this will allow you ... moments of successful connection.
There will be moments when your loved one comes out of the fog. It may be only a brief moment. . They will show glimpses of the person you once knew. Those are the moments every dementia caregiver strives for. And gives them the strength to take on another day.
Recommended reading for Caregivers:
Dementia Behaviors-One of the most difficult challenges any of us face with dementia care is not knowing what to do when difficult behaviors occur. An individual’s personality is basically the way a person views and approaches the world. It is their natural disposition.
Some individuals are always confident and outgoing. Their positive attitude allows them to try new things and adapt easily. Other individuals are more reserved and introspective. These individuals may be more timid about change. They may feel uncomfortable around unfamiliar people. A person living with dementia will have personality changes. Be prepared for the road ahead and explore ways to make life easier during your caregiving journey.
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Diane Carbo
Diane Carbo
