Communication

• Basic communication strategies to support carers and family members to interact more effectively

Over time, a person with dementia is likely to experience a gradual reduction in the ability to communicate verbally. This can be one of the most frustrating and difficult problems for them, their families and carers. The person may not only find it more and more difficult to express themselves clearly, but also to understand what others say.

There are many causes of dementia, each affecting the brain in different ways. Each person with dementia is unique, Difficulties in communicating thoughts and feelings are very individualised, but there are some similarities such as:

• Difficulty in finding a word -a related word or phrase might be given instead of a word they cannot remember.

• The ability to speak fairly fluently, yet not make sense to the listener.

• Not being able to understand what you are saying or only being able to understand part of it.

• Writing and reading skills may also deteriorate.

• Losing the normal social conventions of conversations; a person may interrupt or ignore a speaker, or fail to respond when spoken to.

• Difficulty expressing emotions appropriately.

STRATEGIES FOR EFFECTIVE COMMUNICATION

• Check that hearing or eyesight are not impaired, that glasses are clean and hearing aids are functioning correctly.

• Ensure that you have the person’s attention before you start speaking.

• Be sensitive to the feelings of the person, maintain the person’s dignity and self- esteem.

• Actively listen, show patience and interest when they are speaking.

• Allow plenty of time for a response –try not to rush the person with dementia.

• Speak in a gentle, calm, matter of fact manner

• Keep sentences short and simple, focusing on one idea at a time

• If a message needs to be repeated, use exactly the same words again.

• Use orientation names whenever you can e.g. “your son Jack”

• If you are wanting to ascertain their preference for something offer two alternatives e.g. “tea or coffee?”

• Shared laughter and activities can often build a bond and communicate more than words can.

Non-verbal communication

Our body language, tone and pitch of voice communicate as much if not more than the words we use. For this reason we need to be extremely sensitive about the non-verbal communication used with a person with dementia. Sighs, an irritated tone of voice or raised eyebrows may speak louder than the words we use.

• Focus your attention on the person with dementia – face them, make eye contact (unless culturally inappropriate).

• Try to position yourself at the same level.

• At times it may be necessary to use touch to engage the person and maintain their attention e.g. hold their hand, touch their shoulder

• Ensure that you are conveying feelings of warmth – smile, open body language.

• Hand gestures or facial expressions may enhance understanding.

Environment

• Avoid competing sounds such as the TV, a dishwasher or others talking in the background.

• Stand or sit still and remain in the person’s line of vision.

• Ensure that the person is comfortable and therefore able to focus on what you are saying.

Try To Avoid

• Talking about people with dementia as though they are not there

• Arguing

• Ordering the person around – give choices and allow them as much control over the situation as possible.

• Focusing on what they can’t do

• A lot of direct questions that rely on a good memory. It is better to make statements that give the choice to respond, or questions that seek opinions/feelings

• Presuming that you know what they want

• Finishing their sentences for them - be patient and respectful, allowing the person to complete what they had started to say.

Some alternatives: