The pain you feel from watching a parent or loved one deteriorate because of dementia is indescribable. As the disease progresses, you notice that minor forgetfulness morphs into a loss of personality and severe impairment.
As a progressive illness, dementia affects a person’s ability to understand basic facts or remember specific things such as places, names or dates. It also affects their ability to communicate or clearly present rational ideas. As the disease progresses, it becomes more difficult to process information and response is delayed.
Caring for a loved one with dementia can be extremely challenging. Understanding effective means of communication makes it easier to be a better caregiver. It fosters a good relationship, which is essential for navigating difficult days and tough episodes that are sure to come down the road.
Encourage a person with dementia to communicate
It's common for people with dementia not to start a conversation. When you notice this, try to encourage them to start conversations. A few recommendations from the UK NHS include
- When speaking to them, use short sentences and maintain eye contact.
- They might feel pressured, so give them time to respond.
- During group conversations, encourage them to pipe in where possible.
- Let them answer questions about their health and welfare.
- Even when they don’t answer a question you’ve asked, acknowledge every word they say to encourage them to say more.
- Avoid giving them complicated choices that could overwhelm them.
- If they don’t answer a question, rephrase it.
Ask simple questions
Even for adults, too many choices make it more difficult for them. For people with dementia, it frustrates and confuses them. If you’re at an ice cream parlour, you could ask them to choose from two flavours, instead of all the options. Stick to yes or no questions. “Do you want sugar in your tea?” “Do you want to go out for a walk?”
State your message clearly
Imagine you’re speaking to a young child under 10 years old. What kind of words do you use to communicate your message? We’re not saying you should speak to them like a child, but use similar words when speaking to someone with dementia.
Maintain a reassuring tone. Do not raise your voice and always repeat your message if you notice they are struggling with an answer.
Don’t bother correcting someone who has dementia, especially when it relates to past events. Telling them that an event happened last week and not 10 years ago frustrates them and puts them in a sour mood. When they put things in the wrong place, they don’t want you to correct them because it makes them feel bad. Go along with them to boost their self-confidence.
Create and stick to a routine
A person with dementia will be confused by a change in routine or environment. They are happier when they wake up at the same time, eat meals, go for walks and perform regular activities. They might become confused when you change their routine, such as going to the doctor’s or travelling on holiday. A regular routine is settling and more grounded.
Get their attention
If there is anything that could distract them when you’re trying to communicate, turn it off. This includes noise from outside, sights from the window and sounds from the TV or radio. Address the patient by name. Identify yourself in relation and name. Touch them and use nonverbal clues to keep their attention on you.
Break down activities
Tasks are more manageable when you break them down into a series of steps. If they forget steps during a board game or activity, gently remind them of the steps and assist them to complete it on their own. Use visual clues to show them what to do next. It could be pointing to the dishwasher or laundry basket.
Respond with reassurance and affection
A person living with dementia is often unsure, anxious and confused about their surroundings. They could recall events that never happened and get really confused. Focus on the feelings they display and respond with a verbal expression of reassurance, support and comfort. Simple things like hugging, holding hands, praising them and touching makes all the difference when other methods fail.
How to speak
Start at a slow pace and allow a bit of time between conversations so they process the information and formulate a response. Don’t talk about them in the third person, speak to them with respect. Laugh together when there are mistakes and misunderstandings. Humour brings you closer and relieves pressure. No matter what they do, don’t laugh at them.
Understand that there will be bad days
The general trend of dementia is a downward decline. They have good days where they are upbeat and bad days where they are in a sour mood all day. It is inevitable that dementia will get worse. Mentally preparing yourself for those tough days makes the journey easier to navigate.
Find support for yourself
Caring for someone with dementia is sometimes overwhelming for the carer. Look for carer support groups where you can share and be encouraged by others in a similar situation. Seek legal advice to manage legal affairs and ensure you have lasting power of attorney.