Dementia is one of the biggest public health challenges we face today. With 35 million people living with Dementia worldwide, and the prevalence expected to double every 20 years, it is likely that most of us will be personally touched by Dementia.
Alzheimer’s disease is responsible for almost 50% of dementia. This disease presents unique communication challenges, and often results in social isolation. Depression and further declines in physical health are probable consequences. My main goals, when working with adults who have dementia, are to strengthen their SOCIAL CONNECTIONS.
Here are my top 3 tips for how to best communicate with adults who have dementia.
1. VALIDATE
Adults with dementia often make inaccurate statements. Common reactions include correcting and re-orienting them to the present situation however, repeated correcting may create negative feelings and result in agitation or aggression. Experts say that denying any bad feelings will intensify them so, instead of correcting or arguing, validate their belief, regardless of accuracy. Validation can simply be a mirroring of what they said, commenting on how happy they appear, reassurance, or if they shared something disturbing, acknowledge how difficult it must be.
2. USE CLEAR SPEECH
Speak at a slightly slower rate with a slightly louder volume. Use a full range of intonation, stressing the keywords in your message while adding pauses between phrases and sentences. Avoid using ‘elderspeak’ characterized by an elevated pitch, a noticeably slower rate and repetition. Studies reveal that ‘elderspeak’ does not improve comprehension, and results in withdrawal and lowered self-esteem.
3. WHEN ASKING QUESTIONS…
Avoid any testing questions, and resist the temptation to check if a loved one remembers a name. Instead, offer reassurances and reminders, such as the date, time and place. You can also introduce yourself and any others who enter the room, regardless of your relationship or how long you have known each other.
Try to choose questions that support the individual’s spared abilities and avoid questions that rely on impaired memory, such as the events of their day, or dates of significant events. Even in the later stages of dementia, a person can usually reminisce about past life events and relationships; they may remember song lyrics and how to do routine tasks and they can also often answer questions about their feelings and share their opinions. When asking a question, notice how you are asking. For example, questions with choices are easier to answer than open-ended questions.
Give the person with Dementia extra time to respond to your question. You may not get an immediate response, be patient. They need extra time to process spoken information, and repeating your question will interfere with their processing.
These are Connecting Strategies: you are reaching out, recognizing their strengths, and literally meeting them where they are at. In doing so, you bring ease to the interaction and strengthen the social connection. Considering that the weight of the conversation will fall to you, come prepared with some jokes, local news, interesting articles, family updates, and personal stories. Dementia can make communicating with loved ones difficult, but conversation nourishes relationships and strengthens connections, enhancing both physical and mental health.
For further reading:
Communication skills training in a nursing home: effects of a brief intervention on residents and nursing aides. (2015) Sprangers, Dijkstra and Romijn-Luijten
I Care. A Handbook for Care Partners of People with Dementia. (2014) Brush and Mills