Communication in the Alzheimer's World
01/14/2014
Alzheimer's Communication: Ways to understand and be understood
Communication can be heartbreaking and frustrating when you know a senior who suffers from Alzheimer’s disease. As a caregiver for someone with Alzheimer’s, we want to help them as much as possible but often, due to conditions of the disease, it’s difficult to understand what the person needs, and it’s difficult for them to understand what we’re trying to communicate. Alzheimer’s, also called Senile Dementia of the Alzheimer Type (SDAT), is a disease that produces physical change in the brain. It triggers shrinking in some areas of the brain and widening in others which causes connections inside to break and disrupt the brain’s electrical signals. This disruption affects communication skills. According to alz.org, communication with a person with Alzheimer's requires patience, understanding, and good listening skills. The organization offers a number of suggestions about how to effectively communicate with a person suffering from Alzheimer’s disease, including understanding changes in communication, helping the person with Alzheimer’s communicate, and finding better ways to communicate. Understanding Changes in Communication Changes in the ability to communicate are unique to each person with Alzheimer’s. In the early stages of dementia, the person’s communication may not seem very different or he or she might repeat stories or not be able to find a word.As the disease progresses, a caregiver may recognize other changes such as:
- Using familiar words repeatedly
- Inventing new words to describe familiar objects
- Easily losing his or her train of thought
- Reverting back to a native language
- Having difficulty organizing words logically
- Speaking less often
Here are some ways to help the person with Alzheimer’s communicate:
- Be patient and supportive. Let the person know you’re listening and trying to understand. Show the person that you care about what he or she is saying and be careful not to interrupt.
- Offer Comfort and Reassurance. If he or she is having trouble communicating, let the person know that it’s okay. Encourage the person to continue to explain his or her thoughts.
- Avoid Criticizing or Correcting. Don’t tell the person what he or she is saying is incorrect. Instead, listen and try to find the meaning in what is being said. Repeat what was said if it helps to clarify the thought.
- Avoid Arguing. If the person says something you don’t agree with, let it be. Arguing usually only makes things worse; often heightening the level of agitation for the person with dementia.
- Offer a Guess. If the person uses the wrong word or cannot find a word, try guessing the right one. If you understand what the person means, you may not need to give the correct word. Be careful not to cause unnecessary frustration.
- Encourage Unspoken Communication. If you don’t understand what is being said, ask the person to point or gesture.
- Limit Distractions. Find a place that’s quiet. The surroundings should support the person’s ability to focus on his or her thoughts.
- Focus on Feelings, not Facts. Sometimes the emotions being expressed are more important than what is being said. Look for the feelings behind the words. At times, tone of voice and other actions may provide clues.
Tips for Communicating with a Person with Dementia:
- Identify Yourself. Approach the person from the front and say who you are. Keep good eye contact; if the person is seated or reclined, go down to that level.
- Call the Person by Name. It helps orient the person and gets his or her attention.
- Use Short, Simple Words and Sentences. Lengthy requests or stories can be overwhelming. Ask one question at a time.
- Speak Slowly and Distinctively. Be aware of speed and clarity. Use a gentle and relaxed tone; a lower pitch is more calming.
- Patiently wait for a response. The person may need extra time to process what you said.
- Repeat Information or Questions as Needed. If the person doesn’t respond, wait a moment. Then ask again.
- Turn Questions into Answers. Provide the solution rather than the question. For example, say “The bathroom is right here,” instead of asking, “Do you need to use the bathroom?”
- Avoid confusing and vague statements. If you tell the person to “Hop in!” he or she may interpret your instructions literally. Instead, describe the action directly: “Please come here. Your shower is ready.” Instead of using “it” or “that,” name the object or place. For example rather than “Here it is” say “Here’s your hat.”
- Turn Negatives into Positives. Instead of saying, “Don't go there,” say, “Let’s go here.”
- Give Visual Cues. To help demonstrate the task, point or touch the item you want the individual to use or begin the task for the person.
- Avoid Quizzing. Reminiscing may be healthy, but avoid asking, “Do you remember when ... ?”
- Write Things Down. Try using written notes as reminders if the person is able to understand them.
- Treat the Person with Dignity and Respect. Avoid talking down to the person or talking as if he or she isn’t there.
- Convey an Easygoing Manner. Be aware of your feelings and attitude; you may be communicating through your tone of voice. Use positive, friendly facial expressions and nonverbal communication.