FIVE Communication TIPS for
Interacting with Persons with Dementia

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For many persons with dementia, there are days filled with the agony of confusion, the frustration of not being able to communicate, and the distress of experiencing a life that may no longer make sense like it used to.  For someone who does not understand dementia behavior, it can appear that the individual is no longer very connected to the world or to his or her own life.  Understanding the psychology and reading about real life of people with dementia, autobiographical stories have illustrated that one is not disconnected from his or her life.

It is our task as caregivers and members of the community to better understand their world and respond to their psychological and social needs to empower them through whatever capacities remain and to be present with them according to their reality.
Learning to speak the nonverbal language of the Alzheimer's person will help you to move beyond frustration in efforts to communicate as you once may have with this person.  It’s like learning a new language in a way and will be important for you to leave behind how you might have communicated to this person in the past.   As Alzheimer’s begins to take control, you will need to begin cultivating more qualities such as patience, empathy, intuition, and sensitivity to attend to more organic structures such as feelings, intuition, body language, touch, and eye contact.  

The behavioral symptoms of someone with Alzheimer’s or other types of dementia are very different and unique in every person.  However, a common reaction shared by family and friends is, often, frustration.  I hope that the five communication tips herein will help, to some degree, your experience in communicating more effectively and decrease some of the feelings of frustration and anxiety.

FIVE fundamental communication tips to help guide your approach to communicating with someone with dementia include:

ONE: Know that communication remains possible. Remember that the emotion behind failing words is far more important than the words themselves and needs to be validated. Although many losses occur with this disease, the person still registers feelings and emotions that matter.

Tips:

• Speak clearly and slowly in a low tone of voice.  It’s best if you are eye level and get their attention first before speaking.

• Adjust your tone of voice to correspond to the person’s emotions.

• Use simple sentences.

• Avoid using open-ended questions.  Statements are more effective because they do not call upon the person to make a decision.
• Be patient.

TWO: Focus only on remaining skills. Value what abilities rem ain. Help the person compensate for any lost abilities without bringing them to his or her attention.

Tip:

1. SEEK out opportunity to give the person a sense of control:

Examples:

1. They are no longer able to take a shower or bath alone.  They can STILL wash their face.
2. They can no longer use utensils to eat. They can STILL use their fingers.
3. They can no longer put their pants on by themselves. They can STILL hold on to their belt and hand it to you when ready.

THREE: Live in their world. Never question, chastise, or try to reason with the person. Join him or her in their current "place" or time, wherever that may be, and find joy there.

Tip:

• Dementia does not take away one’s dignity. We do.  Instead of pointing out dropped food on their shirt or that the clothes they picked out don’t match, accept, and help without commenting on what is wrong.

FOUR: Enrich their life. Create moments for success; eliminate possible moments of failure, and praise frequently and with sincerity. Attempt to find humor wherever possible. ALWAYS coach the person to do every activity using whatever skills remain. 
Tip:

• If the person does the job repeatedly, don’t complain, but thank them for helping.

Even if they have done the activity before, demonstrate it again.  And when finished,
be sure to give words of praise for a job well done.

FIVE:  Simplify the environment. Making small physical enhancements, by reducing environmental demands on the person’s already challenged perception, can dramatically increase levels of functioning. More importantly, they lessen the frustration, which often results in behavioral outbursts while promoting feelings of accomplishment, security and belonging. 
Tip:

• Get rid of clutter while at the same time enhancing personal areas with familiar objects and memorabilia such as: familiar magazines next to a favorite chair, a hobby collection in a memory box, a photo album of old pictures.

Improving understanding in these FIVE areas of communication can lead to the biggest successes in caring for someone with dementia and help them nurture their quality of life.

Recommended Resources:    

Learning to speak Alzheimer’s, a groundbreaking approach for everyone dealing with the disease, Koenig-Coste, J.
http://www.amazon.com/Learning-Speak-Alzheimers-Groundbreaking-Approach/dp/0618485171/ref=sr_1_1?ie=UTF8&s=books&qid=1236902508&sr=8-1

Deeper into the Soul, Nader Robert  Shabahangi
http://www.agesong.com/events_and_education/deeper_into_soul.htm

Alzheimer’s Association
http://www.alz.org/index.asp?gclid=CPWGzJzPnpkCFRwpawodLyelUg

Debra Johnson, is creator of the 5-Point Series on Aging - articles that cover a variety of enriching and valuable information that educate and inform the public on common and sometimes uncommon issues having to do with aging, aging parents, and eldercare issues.  She is a Professional Geriatric Care Consultant, public speaker, and writer.  She is principle care manager and founder of Integrative Eldercare…for the Late Life Journey.  Please visit her website for more information about Debra.

Look forward to the next article in the 5-Point Series:
FIVE Types of Dementias and How they Differ

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