While you may not be able to verbally communicate with a loved one due to their dementia, your simple presence may be all that is needed to calm them and let them know they are safe.
From the time memory issues are first recognized through the late stages of Alzheimer’s or another form of dementia, the ability to communicate gradually diminishes. It may plateau for while rapidly deteriorate and then plateau again. Don’t make assumptions about their ability to communicate. It may change.
According to the Alzheimer’s Association, challenges you might expect to encounter include:
- Difficulty finding the right words
- Using familiar words repeatedly
- Describing familiar objects rather than calling them by name
- Easily losing a train of thought
- Difficulty organizing words logically
- Reverting to speaking a native language
- Speaking less often
- Relying on gestures more than speaking
Although communication may be challenging, it is possible. We recognize that what’s most important is that you meet them where they are in the progression of the dementia—and not attempt to bring them into your world. Remember, Alzheimer’s, as well as other forms of dementia, are a disease.
As such, you can’t argue with a disease. And, if the true answer to a repeated question (such as an inquiry into when a spouse who passed away a dozen years ago is coming to visit) would only bring repeated pain, it may be best to try to redirect the conversation and change the topic.
Here are some tips on how to keep your conversations with someone suffering from dementia positive and valuable for everyone involved.
Approach from the front
There’s nothing to be gained by surprising someone who may have trouble understanding their surroundings to begin with. Approach from the front so they become aware of you as you enter their field of vision.
Establish eye contact
Once you approach them, get down on their level and look them in the eye. Then, before beginning conversation, make sure that they see you, too. Realize that they may not recognize you at first (or at all) or may need some time to do so.
Call them by their name
To initiate conversation, call them by their name. Depending upon where they are in their journey, understand that this may change. While you may have called your mother “Mom” for years, you may find you get a better response by using their actual name. And while that loss may make you sad, know that you are communicating with them in their world.
Let them initiate touch
If a loved one doesn’t remember you, your touch may startle or even be unwelcome. Again, don’t force them to join you in your world. Extend a hand, make yourself available and let them welcome you into theirs.
Any background noise from a television or other people talking can make your loved one lose track of the conversation. If you wish to spend quality time with them, it’s best to find a quiet place where you can talk without distractions.
Much the same as diminishing distractions, it is best to keep any conversations one-on-one. Even small family gatherings could leave your loved one anxious or confused. If they’re having challenges just identifying you, even a small group of people talking all at once could be all the more confusing or even frightening.
Keep it simple
Keep questions, comments, observations or requests short, simple and to the point. Refer to nouns by their actual name (a “car,” not “it”). And avoid open-ended “yes” or “no” questions. Resist asking, “Where would you like to go?” Instead, ask, “Would you like to go for a ride?” And don’t describe everything you’ll see along the way. They won’t remember it and may only become confused. Instead, just let them experience and enjoy the journey.
As we stated above, you can’t argue with a disease. Learn to give in and walk away from a conversation that is turning into an argument. Who’s right and who’s wrong won’t make any real difference. But the anxiety and hurt feelings you leave behind may be the one thing that is recalled on your next visit.
Pay attention to visual clues
While a loved one may no longer be able to communicate what they want or what they’re feeling with their voice, their bodies may be shouting out loud and clear. Pay attention to folded arms, a grimace on their face, something (or someone) they react to or the way they hold their body.
Accept that the thinking process of someone with dementia will be slower than yours—if they ever complete the thought at all. Resist the temptation to complete their sentences. It won’t help and it’s likely to just frustrate them (and you) all the more.
Even if your loved one doesn’t remember your face or your relationship, learn to rely on your memory. Remember that it’s your presence and your friendship that are the most important thing to them. Remember that a smile can mean the world. And remember that laughter can reduce the anxiety that comes with meeting a stranger—even if they have already “met” you several times that day as they journeyed along the gray mile.