Communications Strategies

Understand that communication skills is one of the first areas affected by dementia –not only comprehension but language, as well. A person often has trouble locating words or phrases to communicate her thoughts. She has trouble following a conversation, many times because she can’t recall what was said just a few minutes ago.

Every “behavior” is a form of communication!
Strategies for communicating with persons with dementia include: Orientation, Validation, Simple Sentences & Questions, Redirection, and Memory Cueing.

Orientation

• Identify yourself
• Approach the person quietly and slowly from the front and say who you are
• Keep eye contact; if the person is seated or reclined, approach them at eye level
• Call the person by name as this helps to get her attention
• Speak slowly

Validation

• Often a person believes that she is living in a different time or place
• This is HER reality
• “Validate” whenever possible by entering her reality
• This approach conveys safety in her surroundings
• You will never convince her that what she “believes” is not true
• Ask questions about the time and/or place she thinks she is in
• Don’t feel guilty about “lies”

Simple sentences & questions

• Always use easy to understand words and short, simple sentences
• Avoid asking several questions at once
• Avoid questions that require difficult decision-making
• Redirection
• Don’t contradict a person or argue with her – you will never win an argument with a person with dementia!
• Use creative ways to “redirect” the conversation to a topic that she can understand
• Bring up happy memories that you know she will connect with
• Since her short-term memory is impaired, changing the subject gently is often the best course of action to take

Memory Cuing

• Use words, photographs or music to help cue memories
• Use gestures or prompts to help get her point across
• Place reminder notes for help in completing tasks
• Color code
• Number things in the order in which they should be done
• Lay out clothes in the order they should be put on
• Point or touch the item you want her to use
• Begin the task for her and ask for her assistance
   

Non-Verbal Communication

Non-verbal behaviors are a primary source of communication. Looks, head nods, body positioning and posture, gestures, facial expressions and even breathing contribute to the relationship and communication between the caregiver and the person with dementia.
Types of non-verbal communication include eye contact, touch, and body language.

Remember:
The person with dementia can often understand even the slightest of non-verbal cues on your part. If YOU are frustrated, SHE might become frustrated and exhibit negative emotional or behavioral patterns.

Tips to improve communication through non-verbal methods

• Limit distractions
• Face the person and be at their eye level
• Use simple gestures
• “Listen” with your eyes
• If she uses non-verbal cues, show you understand
• If you don’t understand, gently prompt until you do
• Observe breathing to predict emotional responses
• Look for permission to use touch to help soothe her
• Remain calm

Cultural/language differences

• Understand diversity of a person and her family
• Familiarize yourself with a person’s culture and background
• If there is a language barrier, try to learn simple words and phrases in her native language to help communicate with her
• Learn how the person views family and healthcare from the perspective of her ethnicity and culture
• Don’t assume all people from one country, religion or background have the same cultural principles
• Get to know the person through her family, if possible
• Diversity also applies to sexual orientation
• Above all else, be respectful of the person and her diversity

Summary

• Be patient with the person with dementia, with her family, and with yourself
• Be supportive
• Offer reassurance
• Be kind and never argue
• Speak in a slow, soft manner
• Use unspoken communication; touch an item, look her in the eye respectfully, gesture to describe
• Help her focus by providing a quiet environment that doesn’t create distractions
• If she becomes frustrated trying to understand you or communicate with you, show her that you care about her and what she is trying to say; try not to interrupt
• Focus on the fact that sometimes the emotions behind the words are more important that what is being said; try to understand the feelings behind the words
• Remember that a person with Alzheimer’s often has difficulty expressing her thoughts and emotions; she also has more trouble understanding others