Alzheimer’s disease and other dementias gradually affect every aspect of a person’s life. At first, maybe someone has problems keeping up the house or balancing the checkbook. As the disease progresses, they might increasingly struggle with their day-to-day routine.
“As things progress even further, you’re going to see increased problems with communication,” says Carrie Wilson, director of the Reflections memory care program at the Ivy at Ellington.
“Your loved one isn’t understanding what you’re saying, or what your loved one is saying just doesn’t make sense. In the later stage, that ability to communicate can be lost completely.”
Communicating with a person with dementia requires patience, understanding, and good listening skills. Wilson offers strategies to help both you and your loved one with dementia communicate and connect.
Give Them Time to Respond
In the early stage of dementia disease, your loved one will still be able to participate in conversations. However, they might be easily overwhelmed by excessive stimulation or have difficulty finding the right word.
“We live in a fast-paced world,” Wilson says. “You say something, and I say something right back. One of the hardest things for family members to learn is that they need to allow time for their loved one to process what they’ve said. When you allow someone with dementia to process, you don’t have to overly repeat yourself. But you have to take a deep breath and relax and allow that extra time for your loved one to understand.”
Give the person time to respond. Don’t interrupt unless help is requested.
Avoid Criticizing or Correcting
As the disease progresses, the person with dementia will have greater difficulty communicating and will require more direct care. They may repeat themselves, call things by the wrong name, or forget important dates or events.
“They may think you’re the brother instead of the son,” Wilson says. “Don’t necessarily correct them. The correction brings on embarrassment and frustration. That’s hard for anyone. Who wants to constantly be told you’re wrong?”
“Live in their world if they get confused,” she says. “Living in their world to give them the best moments — instead of correcting every inaccurate statement — can make a huge positive aspect in the person’s life with dementia. And it can make your life more enjoyable, too.”
Wilson acknowledges that this can be a big hurdle to get over, especially if your mom is always referring to you as her sister or if your dad doesn’t remember that you’re his son. “That’s usually a really hard one because a lot of people take it so personally,” Wilson says. “The person with dementia usually knows you’re family — they just can’t place you. But that emotion is still there. Stay with that emotion. Hold onto that instead of what’s right and wrong with names, dates, places, or times.”
Be Patient and Go with the Flow
Don’t let frustration get the better of you, Wilson says.
“I see a lot of families struggling with reminding someone something over and over again: ‘Mom, I already told you,’” she says. “But in the mind of someone with dementia, they haven’t talked to you yet. Every time they ask is the first time. So take a deep breath. They’re not doing this to be annoying. It’s because it’s the first time to them because they can’t remember. You need to be able to deal with that and go with the flow. Answer that question seven times.”
Use Body Language and Visual Cues
As the disease advances, the person with dementia may rely on nonverbal communication, such as facial expressions or vocal sounds. So give visual cues, and demonstrate a task to encourage participation.
“Using body language and visual cues early on and keeping up with them is really important,” Wilson says. “When you’re asking someone to do something, demonstrate visually, too. Lift the glass to your lips. When you say, “Come sit down,” wave them forward and then pat the seat of the chair. You’re still using your verbal communication, but you’re also incorporating visual communication early on so it becomes part of the way you communicate.”
Use Touch as a Form of Communication
When dementia is very advanced, nonverbal communication may be the only option available. Try using touch, sights, sounds, smells, and tastes as a form of communication.
“Go with the emotional connection,” Wilson says. “Sometimes just reassuring someone by sitting next to them, by putting a hand on their shoulder, by simply smiling — those can make a big difference. Being able to establish that calm, emotional connection and to just be content by their side is huge.”
There will be good days and bad days when caring for a loved one with dementia. Along the way, treat the person with dignity and respect. It’s OK if you don’t know what to say. Your presence and friendship are most important.
