In her first article for us, Beth Britton gives tips and advice to enable meaningful engagement with a person who has dementia.
Communicating with a person who has dementia, especially as their dementia becomes more advanced, is probably one of the areas of care and support that families and professionals struggle with the most. We certainly did as a family during my father’s nineteen years with vascular dementia. My dad went through periods of repetition and forgetfulness before eventually having limited and then no verbal communication at all.
Communication difficulties can exist in many forms – from the person who can now only talk in the first language they learned as a child, to the person who uses words that don’t correlate to what they want to say, or the person whose words have been replaced with sounds (something that happened to my dad in the latter years of his dementia). One thing all of these difficulties have in common, however, is the need for those of us without dementia to modify our approach to support the person more effectively.
Tips and advice to improve your communication with a person who has dementia
- Observe the person and their environment. Does the person appear to be calm and settled, or do they appear to be uncomfortable or in pain? Is it a calm and quiet space for the person to try and communicate without distractions, or do you need to either remove distractions or support the person to go to another room?
- Connect. Remember to make eye contact and to interact with the person on their level (don’t stand over them)
- Don’t bombard the person. You may have a question you want to ask or a piece of information to share. Do it at a speed and volume that is suitable for the person (only raise your voice if you know the person has a hearing problem and needs you to do this), and don’t share multiple pieces of information at the same time or ask more than one question at once.
- Be patient. Give the person the time they need to absorb what you’ve said and formulate their answer or response. Don’t rush in to fill the silence or finish their sentences unless they actively look to you for some help with words they are struggling to recall or pronounce.
- Listen. Really listen! Many of us think we are listening when we are actually only partly listening while trying to formulate our answer or response. Being distracted in this way means you can miss vital information or clues about what the person is trying to communicate to you.
- Get to know the person’s own language. The person may use specific words or sounds to express certain thoughts, feelings or needs. Family members or regular professional care staff – like a live-in carer – often pick up on these patterns, and sharing that learning with others can help everyone communicate better with the person.
- Be sensory aware. Helping a person to feel or smell an item if they can’t see it very well, or using visuals to help a person who is hard of hearing to make choices, are important ways to support a person to express themselves if they have eyesight or hearing problems.
- Think beyond words. Communication is about so much more than just words. Think about the person’s body language and gestures – what do these tell you about what they are trying to communicate? And what about your own body language and gestures – do they help or hinder in getting your message across? Could you use a gentle touch of the person’s hand or arm to reassure them that you are focused on them and there to help?
- Be creative. Remember that you may need to back up words with pictures (think picture cards or pictorial menus etc) or show the person items or objects to help them to understand you. Get even more creative by using art or music to assist your communication with the person – When my dad could no longer hold a conversation he could still sing a song, so getting creative really does have its benefits.
- Use technology. If the person is struggling to orientate themselves with time and place and asking repetitive questions, consider purchasing a dementia clock or creating a day board (with words and pictures for the day and what will be happening) to help them.
- Validate. Avoid arguing with the person and instead aim to validate their feelings and emotions.
- Learn from people living with dementia. Listen to some of the Dementia Diarists expressing how they feel about the communication challenges they are facing.
- Last, but by no means least, be empathetic, kind and compassionate. The person with dementia may be feeling frustrated or annoyed at being unable to say or express what they want you to understand, despondent or isolated because they aren’t getting their message across as they want to, or worried and anxious because of what might happen or is happening as a result of misunderstood communication. Put yourself in their shoes and aim to make communicating with you as positive an experience as possible for them.
About the author:
Beth Britton is an award-winning content creator, consultant, trainer, mentor, campaigner and speaker who is an expert in ageing, health and social care