12 Expert Strategies to Manage Dementia Communications

There is a difference between talking at someone and talking with someone. Communicating with people who have dementia can be especially challenging because the back and forth of conversation may be interrupted, stalled or take an unexpected turn due to the effects of the disease.

People with dementia often have difficulty with memory, focus, language, and problem solving, which then causes frustration. They can become frustrated and act out verbally and physical towards you, ask you to endlessly repeat information, or not even recognize who you are, but it’s important that you do not take this personally.

To be an effective communicator with a senior living with dementia, you must understand these special challenges, accept them, have patience, and use strategies to reach your senior loved one.

Let’s look at some strategies to improve communication.

Communication Tips

1. Talk about one thing at time. Do not require someone with dementia to handle a multitude of topics. Keep it simple. If you switch to another line of thought, you may confuse your loved one. Avoid multiple choice questions: “Dad, do you want tea, soda, or coffee?”
2. Limit distractions. A blaring TV, radio, or other people talking in the room can be a great distraction for a person with dementia. Furthermore, if he or she is hard of hearing, then your voice may blend into the sound in the room. Family holiday gatherings can be especially disorienting. Find a quiet place out of the main pathways of running children and loud conversations. Engage your loved one without overwhelming him or her.
3. Finish your sentences. Do not assume that a person with dementia can finish your thoughts. Keep your sentences simple to give them an opportunity to process.
4. Speak clearly. Use a calm, clear and friendly voice. Remain respectful and positive. Avoid sounding disappointed when they do not understand.
5. Use non-verbal communication. It may also help to use gestures to augment what you are trying to communicate. People with dementia understand non-verbal communication. Maintain eye contact, smile, nod your head, and hold their hand. These gestures can speak volumes.
6. Be patient. Don’t jump in to keep the conversation going. Silence is fine. People with dementia need additional time to process information. If you attempt to re-ask a question, you may force your loved one to start the reasoning out process all over again before they can respond.
7. There will be good days and bad days. The effects of dementia, long-term or short-term, are unpredictable and unique to each person. Observe your loved one. What time of day is he or she most open to talk, and when times are they less receptive?
8. When the conversation is going badly, redirect it to another topic. Change the subject or the environment. Example: “Why don’t we go outside and talk about your garden?”
9. Recall good memories. People with dementia may not remember what happened five minutes ago, but they can be crystal clear on what happened 50 years ago. Instead of asking questions that rely on short-term memory, ask questions about the person’s past, what they enjoyed doing, who their friends were.

As dementia progresses you will need to make some adjustments to communicate with your loved one. What use to work well may no longer work at all.

Communication Tips as Dementia Progresses

The behavior of a person with dementia has a purpose and a source, though it may be difficult to identify what the motivation for the behavior is. Most behaviors noted in seniors with dementia are responses to feelings or experiences that they cannot understand and/or express verbally. For example, hunger, pain, side effects of medications, frustration and inability to sleep. Addressing these key things can help minimize harmful behaviors.

People with dementia may misinterpret what they have heard or become convinced that others are stealing from them when they have actually misplaced an item.

10. In the middle stage of dementia, it may be tempting to correct your loved one when they make mistake (misidentify a photo, use an incorrect date, call someone a son or daughter when they are actually a sibling). In the milder stages of dementia, an occasional correction may be appreciated. As the disease progresses, correction can become an irritant to the person with dementia and quickly shut down the conversation. Ask yourself how important it really is to point out the errors.
11. Written notes may become increasingly useful in providing information to your loved one. Also, if your senior can’t find the words to express themselves, you could ask them to point or gesture. The use of simple pictures can also be helpful.
12. In the later stage of dementia, you should approach your loved one from the front and identify yourself. It is OK if you don’t know what to say. Being present still communicates that you care to your loved one.

Memory Support Options at Bethesda

Bethesda’s Care Management department can provide resources, assistance, and information to assist family caregivers, including those who are caring for a senior with dementia in the person’s home. The program, which offers a comprehensive array of services through its unique Senior Support Solutions service, assists residents living in Bethesda’s independent living retirement communities.

When the senior’s dementia becomes more extensive, Bethesda has established memory support neighborhoods in most of its skilled nursing communities. The neighborhoods are secure with staff that specializes in caring for people in the advanced stages of dementia. Residents are encouraged to remain engaged with the focus on their capabilities, and maintaining those capabilities.

Proper communication is key to dealing with loved ones struggling with memory care. Learn how else you can support your senior loved ones through the Alzheimer’s & Dementia section of our blog.