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Communicating with someone who has dementia

When someone has dementia, communication can become difficult – for them and for the people they live with or who are caring for them. But by following these tips you can help to improve communication and reduce frustration for both yourself and the person with dementia.

Make time for conversation

Set aside a time to sit down and talk about the day. Give your full attention to the conversation and, if possible, make sure you are not interrupted.

Make sure you allow time for the person to process the information you give. And allow them extra time to respond.

Be focused

Make sure you have the person's attention. Then listen to them – try not to interrupt, talk over, or talk for them. Ask just one question at a time, to avoid confusion.

Be flexible

Be prepared to change the way you talk – for example, you may need to talk more slowly, emphasise key words, and use short sentences. You may need to repeat key words or phrases.

If the person is a pacer, walk with them while you talk.

Be open to different possibilities – be aware that when the person says "X" they may mean "Y". Use what you know about them to try to understand their reality.

Use non-verbal communication

Use pictures, objects and writing to supplement your speech. You can also use natural gestures and drawings. Look for non-verbal cues from the other person that suggests they are responding (for example, looking at you).

When the person with dementia can't find the right words, ask questions to find out what they mean, for example "Are you talking about the cafĂ© we went to today?" Also watch their body language and where they're looking – they might be looking at the thing they can't name, or at someone who was with them at the place they're talking about.

Be respectful

Encourage communication and accept it any way it's offered – verbal or non-verbal. Confirm what they have said to show you are listening, and validate their emotions, for example, "I can see you're happy today".

Don't correct their mistakes, and avoid any confrontation. Nod and smile only if you understand what they are saying.

Common issues and solutions

You are likely to come across some of these issues when communicating with someone who has dementia. Try the possible solutions to see if they help.

Issue

Possible solution

Memory complaints: the person loses words, ideas, their train of thought. This can interfere with their daily life, and lead to social isolation.

Their conversations lack content, and are ambiguous, repetitive, and sometimes unintelligible.

  • Make sure memory aids (such as memory books with familiar photographs and short sentences) include things they often talk about.
  • Prompt them: "Tell me about your family", "Tell me about your day".
  • Help them preserve their ability to read by ensuring all written material uses short, to-the-point sentences and the personal pronoun (you, your).

Repetitive questions, delusions, and hallucinations. For example:

  • "Where is my wife?"
  • "Where are we going?"
  • "You are not my husband."
  • "There are people watching in my window."
  • Use written cues to change challenging behaviour. For example, make a card with a picture of the person's door in the rest home, saying this is their home and how long they have lived there; cards describing what time lunch will be and who will bring it to them.
  • Use a memo board – this is a board placed somewhere the person can see, with information about where they are, what day it is, what's happening today. For example, "Today at 2:30 Kay will take you to the doctor." This also helps visitors know what's been happening.

Behaviours that challenge in a resthome – you may know the person resists their carers or intrudes into other people's rooms, for example. You can help staff handle this by giving as much information as you can about the person.

  • Written descriptions of the person's routine at home (for example how often they showered and what time of day) can help staff structure a familiar routine.
  • Written and visual cues to prompt the person, for example, when to eat, when to shower.
  • A clear sign on their door that helps them recognise this is their home (they may not recognise a photo of them now, but will recognise a photo of themselves when they were young).

Difficulty learning to use memory aids, such as a memory book.

  • 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".

On the next page: How to make a memory book

Written by speech language therapist, Older Person's Mental Health, Canterbury DHB. Adapted by HealthInfo clinical advisers. September 2016.

Sources

Page reference: 287393

Review key: HIMLD-33325