As a person’s dementia progresses, difficulties with conversation and communication develop. It can be harder for the person to express what they want to say as well as harder to understand what is being said to them. This can cause frustrations for both the person living with dementia and the person they are communicating with.
Katrina McGarr, a Speech Language Therapist working at the University of Canterbury, shared her knowledge about “how we as communication partners can better facilitate meaningful communication with someone who has dementia”. Katrina advised it is wise to “try and enter into the reality of their world” in order to maintain positive communication. She also shared the following tips around staying FOCUSED in order to enhance communication:
F – face to face (so that they person can observe all your non-verbal cues as well as hearing the words)
O – orient person to the topic
C – continue with the same topic rather than changing topics
U – unstick the conversation when the person with dementia gets stuck
S – structure your questions as a forced choice, for example “Coffee or tea??”
E – exchange ideas in your daily conversation
D – direct, short and simple sentences are best
Other Communication Tips include:
Even if you are certain that what the person is saying is wrong from a factual point of view, arguing will only make the situation worse. People with dementia are often unable to reason and problem solve as they once did, arguing only increases the agitation and frustrations of both parties. Instead, try responding to the emotions behind what the person is saying, and respect that as dementia progresses people may inhabit a more personal (altered) reality that is different to the everyday factual reality as we know it.
This draws attention to the person’s memory problems and can affect a person’s confidence.
Keeping communication alive
Even though a person’s ability to recall recent events and everyday facts may be limited, this does not mean that the person’s emotional world is impaired. People with dementia are often very sensitive to feelings, especially those of failure and inadequacy.
Short term memory is often more affected that long term memory, so conversations that recall important past events may meet with more success. Conversations that are based on opinions and feelings rather than ‘the facts’ may also be more enjoyable for people with dementia.
The past of the brain responsible for understanding language ids different to the part of the brain responsible for producing language. So, just because someone struggles verbally doesn’t necessarily mean that they are not understanding what is being said, or the intention with which it is being communicated.
Communication can be rich with meaning, warmth and humour even without words. Facial expression, tone, pitch, posture, and gesture all convey meaning. Meaningful communication imparts a sense of rapport, respect and belonging that greatly enhances a person’s sense of self-worth. It may be easier and enjoyable to share an activity like going for a walk, where companionship rather than conversation is the focus.
Additional useful websites include:
www.alz.org Caregiving – daily care – communication
www.nhs.uk Communication with someone with dementia
www.alzheimers.org.uk Tips: Communicating with someone with dementia
www.dementia.org.au Managing changes in communication