Speaking Dementia

20 Communication Techniques that Help Improve the Caregiving and Carereceiving Relationship

Based on the teachings of Dr. Verna Benner Carson, author of Becoming an Alzheimer’s Whisperer: A Resource Guide for Family Caregivers as well as Alzheimer’s Association best practices and our caregivers’ experiences, Open Arms Solutions is pleased to share the following tips to help family caregivers improve their communication techniques and ultimately enhance the caregiving and care-receiving relationships.

1. Be welcoming

Say the individual’s name and identify yourself to him or her. Establish and maintain eye contact. State your message using simple words.

2. Keep it positive

Instead of “Don’t put your hand in the gravy” try “Please put your hands in your lap” (use gestures). “Could you please
come here?” rather than,“No, don’t go out that door.”

3. Avoid unnecessary questions

“We are having macaroni for lunch today” vs. “What would you like for lunch today?” Or, if you need to ask a question, offer simple choices, for example, “Would you like chicken or macaroni today?”

4. Keep it simple

Simplify your statements and avoid being lengthy.

5. One step at a time

Break tasks into simple steps:
“Pick up the comb.”
“Comb your hair.”
“Pick up your toothbrush.”
“Put the toothbrush on your teeth.”
“Move the toothbrush,” etc.

6. Speak to your loved one as an adult

Remember to preserve your loved one’s dignity at all times. It is common to use the word “we” as in “Don’t we look pretty today?” Instead, say “You look very nice today,” which is more respectful.

7. Nonverbal Communication

Tone of voice, facial expressions, touch and gestures are effective and important parts of communicating with your loved one.

Tone of voice – Listen to your own tone of voice; it speaks volumes. The person with memory loss maintains the ability to understand tone of voice, even after the ability to understand words has been lost. Listen to your loved one’s tone of voice; it will reveal their message more so than their words.

Facial expression – Know that your loved one is able to read your facial expressions even though you may not even be aware of them. Be aware when speaking with your loved one, as well as with others, that your facial expressions speak a thousand words.

Touch – It is important to offer your loved one reassurance. Hugs work wonders. Touching someone’s arm or shoulder, holding their hand and patting provide comfort and pleasure to most people. Provide a gentle touch and you will bring a smile to your loved one’s heart.

Gestures – We use gestures daily to communicate our needs, for example hand gestures to describe how large something is, pointing in the correct direction to guide someone or waving “hello.” Using simple gestures is helpful as a complementary addition to your words and your tone of voice. Remember to avoid gestures that could be misinterpreted as being threatening to your loved one.

8. Speak softly/reduce background noise peak softly/reduce background noise

It takes longer for a person with memory loss to process what we have said. By speaking calmly and slowly, you have a much greater chance of being understood. Also try reducing background noise. You may be able to hear over the radio, but the person with dementia probably can’t.

9.  Be aware of hearing or vision problems e aware of hearing or vision problems

Older people suffer with these losses, and it is important to remember they do not hear or see as well through cloudy lenses or compromised hearing.

10.  Smile and the world smiles with you Smile and the world smiles with you

Laughter is often the best medicine, so use your sense of humor. Be sensitive not to laugh at your loved one, but at the situation.

11. Put logic and reason aside at times logic and reason aside at times

Confrontation with your loved one will only increase their agitation and anxiety. “You know you’re not supposed to wear that bra outside of your dress.” Instead try, “Let me help you with this.”   Instead try “Let me help you with this.”

12. Forget the phrase “Don’t you remember?”get the phrase “Don’t you remember?”

Instead, use non-controlling, non-confronting statements. This approach helps the person maintain dignity in what can be an awkward situation. Try “This is your daughter, Susan.” vs. “Don’t you remember your daughter, Susan?” Or help the person put words to their thoughts, for example, “You’re trying to ask if your wife is coming, aren’t you?”

13. Validate feelings Validate feelings

Even if the content of what your loved one is saying is “not real,” the feelings are always real. An example of validating is “I understand how upset you must feel to think I’d steal your purse.”

14. Live in their reality

Continuously confronting that person with a sad reality, such as a reminder of the long-ago death of a loved one, may force them to re-live that grief again and again. A “therapeutic fib” is a much kinder response to “Where is John?” Try “John has gone out” and then redirect attention to another activity.

15. Put it in writing

A simple written note can help to calm a person who is trying to remember a specific piece of information. Create signage and reminder notes to offer cues.

16. Keep talking

Even when you are not sure you are getting through, explain what you are doing and update the person even on a familiar event. Talking keeps you connected.

17. Music matters

Try incorporating music (not as background noise, but as a focused activity). Musical memories linger long after other memories have faded. Many people with memory loss find renewed meaning and connection in their lives through music.

18. Avoid confrontation

Try not to argue, instead change the subject, compliment the person, leave the room or ask for help to derail arguments. Avoid insistence, rather, try again later. Practice 100% forgiveness.

19. Take your time and be consistent

Allow plenty of time for comprehension…then triple it. Repeat instructions exactly the same way.

20. Try not to take it personally

Remember, Alzheimer’s causes your loved one to forget, but your support and understanding will continue to be appreciated.