Communicating with someone who has dementia Te whakawhiti kōrero ki te tangata mate wairua tuakoi
Dementia can make communication difficult and frustrating — for the person with dementia and also for family members and those caring for them. But there are things you can do to improve communication and reduce frustration.
Tips for positive communication
Make time for conversation
Set aside a time to talk. Give your full attention to the conversation and try to make sure you are not interrupted.
Allow time for the person to communicate and process any information you give them, and for them to respond.
Be focused
Listen to the person carefully. Try to make sure the environment is calm and quiet to avoid distractions or the person becoming overly stimulated with what is happening around them.
- Try not to interrupt, talk over them, or talk for them
- Use clear, direct language
- Ask one question at a time to avoid confusion.
If they cannot find the right words, ask questions to find out what they mean. For example, "Are you talking about the café we went to today?"
Be flexible
It may help for you to change the way you talk. You may need to talk more slowly, emphasise key words and use short sentences. You may need to repeat key words or phrases.
It can also be helpful to be specific, and give options within a question. For example, “Would you like to wear your blue trousers or black trousers today?”, instead of “What would you like to wear?”
If the person likes to walk and talk, walk with them while you talk.
If you are struggling to understand what they are talking about, give them time to try and find the right words. Be open to things they are trying to tell you. Use what you know about them to try and understand their reality. Consider that when the person says "X" they may mean "Y".
Use non-verbal communication
As well as speaking, you can also communicate using:
- pictures
- objects
- writing
- natural gestures, facial expressions, posture
- drawings.
Watch the other person's body language and other non-verbal cues that suggest they are responding. This might include:
- looking at you
- smiling and nodding
- looking at the thing they cannot name
- looking at someone who was with them at the place they are trying to tell you about.
Be respectful
Encourage communication and accept it how it is offered — verbally or non-verbally. Confirm what they have said to show you are listening. Validate their emotions by saying things such as "I can see you are happy today".
Do not correct their mistakes and avoid arguing, as it may make the situation worse. People with dementia are unable to reason and problem solve as they once did, and arguing might increase the frustration for both people.
Common communication problems and solutions
You are likely to come across some of these issues when communicating with someone who has dementia. These solutions may help.
Dementia can cause people to lose their words, ideas or train of thought. Their conversations may lack content and be very repetitive, and sometimes it may not be easy to understand or make sense of. This can interfere with their daily life and lead to social isolation.
- Make sure memory aids such as memory books include things they often talk about.
- Prompt them: "Tell me about your family" or "Tell me about your day".
- Help them preserve their ability to read by making sure reading material uses short, to-the-point sentences.
- Talking about things from the past may be more successful than trying to discuss recent events. Short term memory is often more affected than long term memory in people who have dementia.
- Conversations that talk about feelings and opinions may be better than trying to talk about “the facts”.
Someone with dementia may say unexpected things such as:
- "Where's my wife?"
- "Where are we going?"
- "You aren't my husband."
- "There are people watching in my window."
There are some solutions you can try.
- Use written cues to support a person's understanding of their world. For example, make a card with a picture of their door in the rest home that says this is their home and how long they have lived there. Make cards describing what time lunch will be and who will bring it to them.
- Use a memo board. Place it somewhere the person can see with information about where they are, what day it is and what is happening today. For example, "Today at 2:30 Kay will take you to the doctor." This also helps visitors know what is happening.
- Talk about the memory cues they can use and read them out loud together.
- Rehearse what they can do to remember. For example:
"What do you do to remember where you are?" — "I read the memo board"
"What do you do to walk safely?" — "I walk with my walking stick".
Changing behaviour
A person with dementia may behave in ways that are out of character. This might include what may appear to be over-reacting to a situation, resisting their carers, or going into other people's rooms if they live in a facility. There are a few ways you can help staff handle this.
Consider what the behaviour might indicate
Consider examples of when the person's behaviour has changed in the past, and why this was. This will help you understand what the person is now trying to communicate by their change in behaviour. Think about whether the person’s behaviour may indicate they:
- are unwell
- have an infection
- are experiencing pain
- might need the toilet or be constipated
- may be hungry, too hot, too cold.
Supporting communication with others
If the person lives in a facility, tell staff about their usual routine at home. This will help them structure a familiar routine while the person is in care. Let the facility know things like what time of day they showered, when they liked to go for a walk, what their routine was after dinner and in the evening.
Create prompts
Create written and visual cues to prompt the person — for example when to eat and when to shower.
Place a clear sign on their door to help them recognise this is their home. Including a photo of them when they were young may be helpful, as they may recognise themselves when they were younger but not recognise a photo of themselves now.
How to make a memory book
A memory book can be very helpful for someone with memory loss and for their whānau.
It provides a record of their personal history and can describe:
- likes, dislikes, interests and hobbies
- work history
- information about family and friends.
If someone is diagnosed with dementia, it is best to start creating a memory book early. This way, the person can be involved in choosing the pictures and can use their own language to describe them.
Even if someone has memory loss without a diagnosis of dementia, a memory book is a good idea in case their memory loss gets worse.
Not only will this book help someone remember their life story, but it can also be a storybook for future generations.
Getting started on your memory book
To build your memory book you will need:
- something to keep all the information together such as a ring binder and clear plastic sleeves, a clearfile folder or display book
- tape or glue, scissors, pens and markers
- family pictures, tokens from past events and anything else that is meaningful to the person.
Topics to include
Include reminders of the important people, places and things in their life. These can include:
- family members
- key life events — give dates and describe the events
- places I have lived — describe the place and use photos and a map
- personality — things that make me happy
- religious or spiritual beliefs
- favourite foods or recipes
- holidays or favourite times of the year
- clubs or groups I have belonged to
- work history
- recreational activities and hobbies
- animals and pets
- travel — places I have visited, using maps and photos.
Some pages to include
- My name is...
- My children are...
- My grandchildren are...
- I was born at...
- I live at...
- I love ... (hobbies and passions)
- My favourite ... is... You can include things like colour, TV programmes, food, holidays.
Tips for your memory book
- Use personalised statements such as "My wife…", "This is my daughter…", "I enjoy….".
- Use short statements and sentences. Longer, complex sentences may be confusing.
- Use one page for each picture.
When talking about the pictures, prompt the person to read the sentences you have written and elaborate on what is happening. Do not correct them if they make mistakes.