If your loved one has Alzheimer’s or another form of dementia, it may be challenging for them to hold conversations or communicate important information. And, as a caregiver or loved one who might be dealing with dementia for the first time, you may not know best practices for communication. To effectively communicate with someone with dementia, it’s important to understand their challenges, be empathetic, use simple language, and seek help if necessary. At Sunrise Senior Living, we aim to support families as they navigate a dementia diagnosis and explore care options. With our practical dementia communication tips, we hope to help you have successful conversations.
1. Understand Communication Challenges in Alzheimer's and Dementia
Before you implement any communication tips, it’s important to understand how dementia affects communication. Dementia and Alzheimer's don't just affect memory—they also affect the ability to communicate due to cognitive and linguistic decline, according to a study on enhancing communication for people with dementia. Dementia may cause difficulty with the following communication skills:
- Word-finding and comprehension: Due to changes in cognitive functioning, people with dementia often have difficulty finding the right words. This could cause them to hesitate or to substitute different words. It can also be difficult for someone with dementia to comprehend properly, often making it harder for them to hold a conversation. They may also struggle with expression.
- Repetition: People with dementia may repeat words, phrases, or questions frequently because they can’t remember what they already said or did. They may also repeat themselves when they feel anxious or uncertain about something.
- Emotional and behavior responses: Not being able to communicate effectively could affect your loved one’s ability to express themselves. This can often lead to frustration, which may cause increased irritability, resulting in emotional or physical outbursts. At Sunrise, we refer to these responses as behavioral expressions.
2. Practice Effective Communication
The following tips will help you communicate effectively with a loved one who has dementia.
Be Patient and Provide Reassurance
Your demeanor sets the tone for the conversation, so keep it positive by practicing patience and staying calm. It might be easier said than done if you grow frustrated due to repetition or any outbursts on their part. However, it’s important to remember they may not be able to control themselves, but you can. You should strive to create a safe, supportive environment for your loved one with reassurance to help them feel confident enough to speak openly.
To guide a conversation with a loved one with dementia, it’s important to incorporate gentle reminders for reassurance. Here are some ways to do that:
- Speak clearly and a bit slower.
- Don’t raise your voice or shout, use a moderate tone of voice.
- Repeat sentences word for word and slowly if they seem confused.
- If repeating a sentence doesn't help, wait a few minutes and try wording it differently.
- Encourage your loved one to describe what they're talking about with simple sentences that begin with who, what, when, or where, but not why.
- Acknowledge and validate their frustration of not being able to communicate well.
- Praise your loved one for their attempts rather than criticizing them for getting things wrong.
At Sunrise, we teach our caregivers to center first. Centering involves taking a few deep breaths, helping us to be calm and more open and responsive as we converse.
Simplify Your Message
Dementia can affect focus, which could make it make it harder for your loved one to understand conversations. To help reduce confusion, try using plain and clear language. Instead of long sentences with complex words, use shorter sentences with simple words. It can also help to share information in smaller chunks. For example, if you're giving your loved one instructions on something, explain one small step at a time instead of all the steps at once.
Ask Easy-to-Answer or Open-Ended Questions
When asking general questions, keep them simple and easy to answer. Instead of asking what your loved one wants to do, try giving them choices. It’s often easier than expecting them to come up with an answer. For instance, ask if they'd rather look at photo albums or go for a walk.
You can also spark conversations with questions about topics familiar to your loved one, such as their hobbies, favorite activities, or family memories. Reminiscent questions can help improve your loved one’s mood, bring back good memories, and make it easier for them to engage in conversation.
You might try saying, “Tell me about the time you… won a trophy for winning the golf tournament.” or “Tell me about the first time you met Dad.” Try to tap into the memories that are most important to them and remember that their long-term memories are often better than their most recent ones.
3. Emphasize Nonverbal and Visual Cues
The following techniques can help you have meaningful conversations with your loved one with dementia.
Be Mindful of Their Body Language
Sometimes a loved one with dementia can’t use words to communicate their feelings, so pay close attention to their body language and emotions. Some signs of frustration or discomfort in your loved one may include the following:
- Restlessness or fidgeting
- Changes in posture or walking
- Unusual gestures
- Furrowed eyebrows or lack of smile
- Sighing, humming, or grunting
- Wandering or pacing
Use Nonverbal Cues
While it’s crucial to keep an eye on your loved one’s body language, it’s just as important to pay attention to your own. When someone with dementia has a hard time with comprehension, they may look at your body language or gestures to help them.
Some effective nonverbal cues can have a positive impact on conversations. Try these nonverbal communication tips to help your loved one:
- Position yourself in front of them so they can easily read your body language
- Maintain eye contact to show you're listening
- Avoid sudden movements to prevent frustration and never approach them from the back as that can be startling
- Use kind, caring facial expressions and soft touch to reassure them
- Avoid standing or hovering over them and instead sit at eye level
Use Visual Aids or Prompts
Dementia may make it harder for your loved one to comprehend words, but visual aids can serve as a tool to improve communication, reduce frustration, and promote independence. There are several types of visual aids that can help a loved one with dementia, including:
- Objects: If you’re talking about a certain topic, it might help to add a corresponding visual element. For instance, if you’re talking about a pancake recipe, it might help to provide a pan or pancake mix to help them connect with the topic.
- Calendars, planners, or timers: To help someone in the early to moderate stages of dementia stay aware of the date, time, their routine, and upcoming events, physical clocks and calendars can be useful.
- Photos and videos: Photos of loved ones and cherished family videos can help bring back memories and encourage conversations that help them stay connected to pleasant events in their past.
- Labels: To help a loved one navigate their surroundings a bit easier, try labeling cabinets, drawers, and doors.
- Cue cards or picture books: If your loved one is having difficulty expressing things verbally, you can create or purchase cue cards or picture books to help your loved one communicate easier. For instance, pictures of their favorite activities or meals can help them choose what they’d like to eat or do, or it can help them recall cherished memories associated with them.
Use Coping Strategies
It's common for people with dementia to become agitated or frustrated if they can't communicate well. This might lead to verbal aggression. If it ever gets to that point, you can help de-escalate difficult situations by staying calm and using gentle persuasion to redirect their attention, according to research published in Dementia. Here are some effective coping strategies you can start using:
- Try to figure out what their behavior is telling you. What is their unmet basic human need? Is it because they are hungry, tired, too hot or too cold, or is the environment too noisy?
- Listen with empathy and rephrase what they are saying to help them to feel heard.
- Ask open questions to encourage them to express their feelings.
After validating their feelings and concerns, you may try one of the following:
- Suggest a new activity like a walk, listening to music, or a craft
- Start a conversation with an engaging question
- Engage in reminiscence through photo albums or videos
If you ever find yourself frustrated or angry, step out of the room temporarily. This can help you take a beat and resume the conversation productively once you’ve calmed down.
If you need to discuss a difficult topic with them, such as how to deal with dementia care, time the conversation when your loved one is less likely to be anxious or upset. Choose a quiet, calm, and familiar environment. Provide them plenty of time and space to express their feelings.
4. Build a Bridge of Understanding
To better communicate with a loved one with dementia, it’s pertinent to understand their side of things and let them know you’re listening. Follow the tips below to help strengthen communication.
Practice Active Listening
Eliminate distractions and look at them when they talk. By giving them your full attention, you're showing them you care and can focus on what they're saying and feeling. Give them time to share their thoughts before moving on or trying to talk for them. Avoid interrupting your loved one, even if they're slow to express their ideas.
Avoid Unnecessary Correction
Because of dementia’s effects on communication skills, your loved one may use the wrong word, swap words, or say factually incorrect things. Instead of correcting them, move on with the conversation if it’s not crucial. If it’s important to correct them, then try to use a gentler approach.
If your loved one says someone hasn't called in weeks but they call every day, you might say, "Do you want to call them right now?" However, if you know calling isn’t an option, try validating them with a response like “You really miss him a lot” or "Talking with them is one of your favorite things, isn't it?" Thoughtful responses that tune into the emotions and unmet needs of your loved one are often more productive.
Validate Their Feelings
Provide plenty of room for your loved one to express their feelings and be sure to validate them, regardless of your opinion. It’s important that you make them feel heard and understood even if they’re frustrated or not making much sense.
The Validation method is proven to be effective and can help reduce agitation, diminish negative behaviors, and increase sense of self in people with dementia, according to comprehensive dementia research. It can also help strengthen your relationship, help them feel supported, and build trust.
At Sunrise, we practice the Validation method and we are an Authorized Validation Organization, which means our memory care communities train our memory care team members using Validation Certification courses. A lot of our training includes learning to validate the resident and look for their unmet need. There’s also an annual mandatory training on behavioral expressions.
5. Seek Help from Memory Care Experts
If caregiving for a loved one with dementia becomes too challenging to handle on your own, you may need to seek support or dementia caregiver tips from memory care experts.
Recognize When Additional Support Is Needed
Dealing with dementia can become difficult over time and as it progresses in your loved one, you may need additional support. This might be especially true if you have to balance work, personal life obligations, and dementia care.
Some signs that your loved one with dementia may need additional support may include the following:
- Increased agitation, withdrawal, or other emotional difficulties
- Inability to maintain a routine
- Safety issues, such as wandering and falls
- Inability to keep up with hygiene and meal preparation
- Falling behind on bills or making bad financial decisions
Trust your instincts about the timing of additional support, especially if you're feeling like you can no longer care for them properly or if caregiver burnout is putting a strain on your relationship. Try asking other family members for help or consider memory care to support your loved one.
Learn How Sunrise Senior Living Supports Families and Caregivers
Sunrise offers a unique Reminiscence neighborhood where specially trained team members learn each resident’s care needs and preferences to provide compassionate, individualized care. Our team members are trained in specialized communication techniques, such as the Validation method mentioned earlier, to better communicate with your loved one with dementia and improve their quality of life. Sunrise communities also account for residents’ abilities and interests to help ensure a lively, engaging environment.
We hope you can use our dementia caregiver tips to have more productive and meaningful conversations with your loved one. Changing your communication style and focusing on patience and empathy can go a long way. And, if you need additional support or care, Sunrise Senior Living is here to help.
Find a Sunrise memory care community near you to see how we strive to improve the lives of seniors living with dementia every single day.
References
[1] Collins, R., Hunt, A., & Clare, L. (2022, February). Methods and approaches for enhancing communication with people with moderate-to-severe dementia that can facilitate their inclusion in research and service evaluation: Findings from the IDEAL programme. Dementia.
[2] Crandall, J., Coatsworth-Pusposky, R., & Martin, L. S. (2022, January 26). Implementing Gentle Persuasive Approaches dementia education for staff on in-patient medicine units: A program evaluation. Dementia.
[3] Norberg, A. (2019, December 20). Alzheimer’s Disease [Internet]. Brisbane (AU): Codon Publications.