Difficulty communicating can make it hard to maintain relationships and you might find that that the person with dementia starts to withdraw from social situations or avoids interacting with others. It can be hard to know how to help them stay involved. What can be particularly challenging is knowing how to connect with people who are in the advanced stages of dementia.
Dementia can make it difficult for a person to express themselves which can be really frustrating, not only for them but for you too.
There are things that you can do to make communicating easier for you both, and this can lead to more meaningful and enjoyable interactions. Communication is about connecting and there are lots of ways you can do that.
Here are a few ideas:
Try to continue with established routines, as things that hThis can be easier said than done. It’s very natural to correct or contradict someone when you feel they don’t have accurate information. However, confronting a person with dementia with their mistakes will only create a negative atmosphere. Try instead to say something that incorporates the truth and that acknowledges the feeling behind what they are saying.
For example, if a person says they need to go to work but you know they are retired, ask them about what they used to do or make a comment about how much they enjoyed working or how busy they were at work. Also consider what feeling might lie behind their comment, could it be a need to feel useful, to be busy, or to feel valued? Is there a way you can help them to meet this need?
Match your pace with theirs
Become comfortable with pauses when they are trying to think of a word or when they are processing what you’ve said. Try not to overwhelm with information and give one piece of information at a time. It can be difficult for people with dementia to take in lots of verbal information so supplement what you are saying by using gesture, objects, photos and/or writing.
Try using statements not questions
Having to answer questions can make people feel under pressure. A different technique, that can have the same outcome but avoid the stress of having to think of an answer, is to use a statement. For example, instead of saying ‘would you like a drink?’ try ‘I’m thirsty, I think I’ll have a cup of tea’ or instead of ‘when did you last see Karen?’ try ‘I haven’t seen Karen recently’. These statements can also be ways of getting the conversation started.
Help them to finish their own sentences
If someone is struggling to find a word, it can be tempting, if you know the word they are searching for, to say it for them. Some people may not mind this but others could find this irritating. It’s best to check. Ways in which you can help someone find the word are to ask them if they can describe what they are thinking of or see if they able to think of a different but similar word. Or you could reflect back what they have said to see if it triggers the word eg. ‘you checked the fridge and you need to buy……’
You can also use questions to help narrow things down, if this is not too stressful. Instead of bombarding someone with lots of ideas you could try one idea at a time eg. ‘is it a drink or is it something else?’ If it’s something else then keep going with gentle questioning. Sometimes however it is just not possible to get to the word and it’s important for you both to be OK with the fact that this happens now and then.
Try to connect without conversation
When someone has significant communication difficulties it can feel like there is no way to interact with them, but there are things you can try to help you connect ‘in the moment’. It helps to take the focus away from verbal communication but to value other ways of connecting such as eye contact, facial expression, gentle touch. Sometimes people make sounds/vocalisations and it is thought that these might be attempts to engage. Knowing this might help you to respond non-verbally to encourage an ‘interaction’ between you. Sometimes it is about shifting what we think as meaningful communication.
And finally it’s important to remember that not everything will work all of the time and that’s OK.
By Lissy Edwards, DCC practitioner