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Tips for Communicating with Dementia

On Tuesday morning, I attended a terrific presentation by Dan Kuhn, author of The Art of Dementia Care and Alzheimer’s Early Stages: First Steps for Family, Friends and Caregivers. Dan offered tips to use when communicating with an individual with dementia or Alzheimer’s.

He offered a perspective on what it’s like for a caree with dementia: Imagine, Dan said, you are traveling to a foreign country and don’t speak the language. Or, have moved to the United States from another country and don’t speak English. Or, you arrive at a party that a friend invited you to, but your friend is a no-show and you don’t know anyone.

This perspective helps us understand the feelings of a caree with dementia, the feelings of fear, uncertainty, insecurity. The disease transports a caree into another land where they don’t speak the language. How awful is that.

To help us speak a caree’s language, Dan reminded us that only 7% of communication comes from our words. It’s our our voice and our body language that accounts for the bulk of communication. You can see why it’s so important to do your best to stay calm. When we’re stressed, we communicate that. When we’re calm, we communicate that.

To make communication easier, Dan suggests:

  • Eliminating background noise
  • Making eye contact
  • Using your caree’s preferred name (perhaps your caree no longer answers to “Mon” but to “Phyllis”)
  • Using touch and body language

When communicating, Dan shared these suggestions:

  • Remember the 4 S’s: Smile, short, simple and show
  • Use repetition
  • Narrow down choices
  • Break down steps
  • Allow plenty of time for tasks to be completed; don’t outpace
  • Allow plenty of time for your caree to respond to you
  • Respond to your caree’s emotional tone
  • Connect by whatever means necessary (movement, singing, praying, art, story-telling, dancing)

A few of my tips follow:

  • If your caree is upset or sad, ask: What’s upsetting you? What’s making you sad? (As the disease progresses, these questions may not be appropriate.) We may think we know, but we never really know until we ask.
  • Understand what helps your caree feel safe in his or her environment. Then, use these safety measures to help your caree feel comforted. (You can learn more about this tip in my comment on Bette’s post here.)
  • Let go of the right way (of doing something, of describing something, of saying something) for both yourself and your caree. It’s right if it brings the desired results or if it brings comfort and meaning to your caree.

What tips can you add? What works for you? Please share in our comments section, below.

Resources

Reminders

  • Your Caregiving Journey airs tomorrow at 9 a.m. CT (10 a.m. ET, 7 a.m. PT). Kristin joins me for Table Talk. Listen to the live show (or download the podcast for later listening) here.
  • What’s caregiving like for you? Share in our annual family caregiver survey, which closes tomorrow. Share here.
  • Take a class in our Caregiving Summer School! We’ve got a class to help you start Mondays with a quiet and calm heart; to help you learn the meaning behind your journey; and to help you start your journal. Each class costs $27; Denise leads the class. Register here.
  • Submit your story about “help” (however you define it) for our upcoming book. Deadline is July 1. You’ll find details here.
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About Denise Brown

Avatar of Denise
I began working with family caregivers in 1990 and launched CareGiving.com in 1996 to help and support them. Through my blog, I share words of comfort and offer coping strategies and tips. I also write opinion pieces about recent research, community programs and media coverage of caregiving issues.

7 comments

  1. Along with letting go of the right way, let go of being right. Instead be agreeable. I don’t have to win the argument or get the last word in. More often than not I can just agree with my parents.

  2. Denise,
    This is so helpful – thank you, thank you.

    I am learning that I need to “show” more–instructions in words are often not enough.

    I need to be reminded of the importance of putting myself in another’s shoes; the information shared on perspective is very helpful as well.

    I appreciate the suggestions both from the presentation, and from you – all very much needed.

  3. Even though Robert has not been diagnosed with dementia, his behavior is very similar to someone with it. These are great communication techniques and I think they will help me very much. I found the name tip particularly interesting since it was only about 3 years ago (when his rapid decline started) that he started insisted on everyone calling him “Robert” instead of Rob. It’s a small change but he’s very insistent upon it and we all do it (for the most part) but it was an interesting change in his behavior.

    Trish
    http://www.robertssister.com
    caregiving. family. advocacy.
    Twitter: robertssister1

  4. Denise,
    this is very helpful. My mother has dementia and I have been her caregiver the past 8 years. Only recently, I have placed her in an Assisted Living Home. She is having major behavioral issues which includes outbursts, making the other residents very uneasy. Is there a medication you could recommend that could help her feelings of fear and anxiety? That does not have a zombie affect? She is on an anti-depressant. Any help you could offer would be wonderful.

  5. Avatar of Denise

    Hi Michelle–I just found this article yesterday, which discusses potential reasons for behavior issues. You can read it here: http://www.crisisprevention.com/Resources/Article-Library/Dementia-Care-Specialists-Articles/Treating-Psychotic-Symptoms-in-Persons-with-Dement.

    The article offers suggestions to use before medications. The concern is that medications are over-used and that other solutions can be used.

    Dan Kuhn, who offered these tips above, also suggests that sometimes untreated pain can cause behavior issues. This article can help you understand if she’s in pain: http://www.caregiving.com/2011/05/a-tool-to-measure-pain-in-persons-with-dementia/.

    Just a few thoughts:

    –Was there an activity or routine or belonging that brought her comfort at home that could help her in the facility?

    –If you were to guess what’s causing her outbursts, what would you guess? Then, what do you think could calm your mom?

    –What happens before the outbursts? If you can determine a trigger, then you can make adjustments.

    I also wonder: What suggestions does the staff offer for you?

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