Communicating with a person with dementia
Caring for a loved one with dementia can be a very stressful situation as he or she will not be able to communicate like a normal individual. Find out strategies you can use to make your communication better.
BY: Pee Lay Lay
To communicate with a person with dementia or PWD, you need to understand the disease and the losses that a person suffers when he or she has dementia. He losses a chance to access memory, recall words, follow conversations, understand what is being said, and organise information. However, he or she still is a human being.
Getting the person’s attention
With this in mind, how does one get the person’s attention. Here are some ways:
- Approach the person from the front.
- Do not talk from another room.
- Introduce yourself, address the person by name.
- Make eye contact.
- Speak one-on-one.
- Touch arm or hand to get his or her attention.
- Use simple words.
- Speak to the person as an adult.
- Lower the pitch of your voice and be calm.
- Use short sentences, one thought one sentence – KISS (Keep It Short and Simple approach).
PWD are able to experience pleasant or unpleasant moments. You cannot convince someone with dementia to see it your way as he or she tends to go into his or her reality, not ours. Also keep in mind everyone with dementia is different.
Here are some strategies that I compiled from various websites that I think can help you communicate better with someone with dementia:
Tip 1: Try not to ask questions that rely on memory as it can be humiliating for some
If the PWD can’t remember, use reassurance.
Tip 2: Forget quizzing and try encouraging the PWD. Provide reassurance and comfort – let the individual know you care and understand.
If the PWD refuses to participate, acknowledge his or her emotions.
TIP 3: Slow down the conversation. Be patient, repeat where necessary
TIP 5: Break task into steps, one thought one sentence.
• Acknowledge successes.
• Express feelings with your body.
• Warm tone of voice.
TIP 6: Emphasise strengths, not weaknesses. Focus on the positive as opposed to the negative. Praise the PWD but do not be condescending. Try not to criticise or assign blame, as it will only result in angry feelings.
TIP 7: Do not ask open-ended questions such as, “Do you want to go outside today?”
TIP 8: Develop the “art of being wrong”. If the PWD attempts to blame you for something you did not say or do, simply respond with “I am sorry”. This may be tough, but it is worth it and will eliminate arguments. Let things go.
TIP 9: Get into the PWD’s reality. People may make up stories about certain activities they did or places they visited. Get into their story, ask questions and provide reassurance.
Look for behaviours, actions or gestures that may convey the feelings or the problem the person is trying to express.
TIP 10: Check out your environment. Certain places may provide too much noise, which will be distracting to the PWD and make communication more difficult.
Set the stage – glasses, hearing aids, dentures, etc.
TIP 11: Limit information. If you see the PWD looks confused during the course of a conversation, you might be providing too much information. Simplify the conversation by presenting one idea at a time.
TIP 12: Listen for the underlying message.
Things not to do
- Do not order the person – there should be mutual respect.
- Do not attempt to talk louder when the person does not understand.
- Do not ask too many questions or challenging questions.
- Do not set up unrealistic expectations.
- Do not talk about the person in front of them.
- Do not argue.
In addition to these tips, caregivers can also get support from many places including the Alzheimer’s Disease Association (Singapore), Agency for Integrated Care and Centre for Enabled Living.
Pee Lay Lay is a senior social worker at The Salvation Army’s Bedok Multiservice Centre. She recently spoke at the Alzheimer’s Disease Association’s public forum on dementia.
(** PHOTO CREDITS: Pictures courtesy of the Alzheimer’s Disease Association)