One of the most challenging aspects of caregiving is learning to cope with and understand the behaviors associated with dementia. Communicating with a person with dementia can be uncomfortable at times and it’s perfectly normal for caregivers to feel reluctant to admit their feelings.
It’s important to understand that there are some dementia behaviors that are not within your power to change, but changing the way you communicate can make a positive difference in your daily routine and increase your self-confidence. The Family Caregiver Alliance recommends these communication tips for caregivers:
Ten Tips for Communicating with a Person with Dementia
- Get the person’s attention. Reduce noise and distractions by turning off the TV, music, closing the door or moving to a quieter area. Before you speak, make sure you have the person’s attention, addressing them by name and identifying yourself by name and relation. If the person is seated, get down to their level and be sure to maintain eye contact.
- Interact in a positive mood. Your body language and your attitude communicate your feelings and thoughts stronger than your words. Set a positive mood by speaking to your loved one in a respectful and pleasant manner. Show your affection and convey your message with facial expressions, tone of voice and physical touch.
- Express your message clearly. Use simple words and sentences and speak in a reassuring tone, slowly and distinctly. Try not to raise your voice higher and louder. If the person is not understanding you the first time, use the same wording to repeat your message or question. If he or she still doesn’t understand, wait a few minutes and phrase the question a different way. Use specific names for people and places, instead of pronouns (he, she, they) or abbreviations.
- Ask simple, easy to answer questions. Questions with a yes or no answer work best, as well as asking one question at a time. Refrain from giving too many choices or asking open-ended questions. For example, ask, “Would you like to wear your pink shirt or your white shirt?” Even better, show the choices. A visual display can help clarify your question and often guide a response.
- Listen with your ears, eyes and heart. It may take a while for your loved one to answer you. Patience is important. If he/she is struggling with an answer, it’s okay to suggest words. Watch for body language and non-verbal cues and respond appropriately. Always try to listen for the meaning and feelings behind the words.
- Arrange activities into a series of steps. This can make tasks involving many steps much more manageable. Encourage your loved one to do what he/she can and gently remind about any steps that tend to be forgotten. Provide assistance with steps that can no longer be done alone. Visual cues are helpful such as showing with your hands where to place the dinner plate.
- When the going gets tough, distract and redirect. Try changing the subject or the environment when your loved one becomes upset or agitated. Connecting with feelings is important before you redirect. You might say, “I see your feeling sad- I’m sorry you’re upset right now. Let’s go get a snack.”
- Keep affection and reassurance in your response. People with dementia often feel unsure of themselves, confused or anxious. They often mix up reality and may recall things that never really happened. Avoid trying to convince them they are wrong. Remain focused on the feelings they are showing (which are real) and respond with verbal and physical expressions of comfort, reassurance and support. Sometimes holding hands, hugging or praise will get the person to respond when all else fails.
- Remember the good old days. Retelling the past can be a soothing and positive activity. Many people with dementia many not remember what happened 40 minutes ago, but they can clearly remember their lives 40 years earlier. With this in mind, avoid asking questions that rely on short-term memory, such as asking the person what they had for breakfast. Instead, try asking general questions about the distant past, as this information is more likely to be retained.
- Maintain your sense of humor. Use humor whenever possible, but never at the person’s expense. People with dementia are likely to retain their social skills and are usually delighted to laugh along with you.
If you are faced with certain dementia-associated behaviors such as agitation, wandering, verbal outbursts, repetitive speech, paranoia and/or sleeplessness, here are some things to remember:
- Communicate with the doctor about new behaviors.
- Behavior has a purpose and is often triggered.
- Changing our own behavior will often result in a change in our loved one’s behavior.
- Try to accommodate the behavior, not control it.
- Get support from others.
Also remember that even though it may be difficult to find time to focus on yourself and your own needs, it’s very important that you do in order to prevent burnout and frustration.
For more information about caring for a loved one with dementia, we invite you to watch our webinar video presented by Capital Nursing Education.