5 Tips for Communicating Better When Dementia Is Involved

5 Tips for Communicating Better When Dementia Is Involved post page

By Valerie FeurichJanuary 12th, 2021

5 Tips for Communicating Better When Dementia Is Involved

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When a person is living with dementia, communication can sometimes become difficult. As a person’s brain is changing, their ability to comprehend and process vocabulary can decrease. Learning how to get started at communicating better can therefore become critically important. We sometimes underestimate how soon issues with communication start and may miss the early signals that someone is probably struggling a bit more than they used to.

Every one of us has been in a situation where you couldn’t think of the right word, and so had to pause. In a healthy brain, the normal reaction to someone offering you a word is: oh good, now we can move on. Whereas when someone is living with dementia, suddenly jumping in with a word can cause confusion, as now they have to look at that word and figure out if that’s the word they were looking for. And when you factor in memory problems, it’s probable they’ll have a hard time remembering what their word was in the first place.

To help you get started with communicating better, we have included five tips that we use here at Positive Approach to Care® that you may want to think about, be aware of, and practice:

  • Matching your pace to theirs: If your person living with dementia is beginning to slow down, Teepa suggests slowing yourself down a bit as well. By practicing being more comfortable with pauses and not rushing in right away to make suggestions, you are giving the person living with dementia an extra moment to possibly recall the word they were looking for.
  • Reflection: If the person living with dementia continues to struggle with word-finding, rather than adding to what he or she said, it can be very helpful to first repeat back to them what you heard. By doing so, the person living with dementia can hear what they’ve said so far, which can help them continue the conversation.
    • For example, if a person says I’m looking for something to…uhhh…, you might give the person a moment, and then assist by saying So you’re looking for something you could*pause*, and see if your person living with dementia can fill in the blank.
    • In addition to verbally reflecting, reflecting back the other person's facial expressions or body language can support your communication effors. See the video below where Teepa Snow and Christine Browdy talk about this in more detail:
  • This or something else: If your person living with dementia is still struggling to find a word, you might ask: Are you looking for something to drink, or something else? By offering one specific word and one overly general word, you’re less likely to distract the person living with dementia from the word they’re trying to think of, but still assist them in communicating with you as you’ve given them two words he or she can say.
    • As Teepa recently explained, the This or Something Else approach is referred to as exclusionary categories, which can be very helpful as they assist but don’t limit the person living with dementia to anything specific.
  • Tell me more about it (Circumlocution): If you’re still unsure what your person living with dementia is trying to communicate, try asking: Can you tell me more about it? With this question, what you’re really asking for is do you have other words you could use aside from the one you’re looking for? And if they use these other words to talk around the word they’re missing (a process called circumlocution), it can help you as a care partner figure out what they’re trying to communicate.
  • Visuals: When word-processing abilities decrease as the brain changes, pointing at a related object when talking to your person living with dementia can help increase mutual understanding. For example, if you’re trying to find out what your person living with dementia would like to drink, you could ask Would you like a coffee [pointing at a coffee mug], or something else? Being able to see the object you’re asking about will likely help your person living with dementia process your question, and make communication a little bit easier.
    • Bilinguals: People who speak multiple languages may have a harder time as their brain begins to change, as they have two vocabulary sets to go look in when trying to find a word and communicate. So if you are a care partner of a person who has English as their second language, you may benefit from getting really good, really fast by integrating objects into your communications, not just words.

As you're trying out these communication tips, don't get discouraged if you forget a tip or rush to answer when the person living with dementia may have just needed a moment more. As with anything worth doing in life, practice is the key to suceess. Or as Jim Rohn famously said: "Success is nothing more than a few simple disciplines, practiced every day."

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28 Comments on “5 Tips for Communicating Better When Dementia Is Involved”

    1. We apologize that you are not able to get it to print. Moving forward we will do our best to adjust and offer a PDF download of the post so that it can be printed. You are welcome to share the link with anyone and post it to social media as well. Thanks for bringing our attention to it.

    1. Hello! I am very sorry you weren’t able to print the file. I created a print-ready pdf, which I hope will work a little better. You can download that by clicking on the blue button near the end of the article.
      Best wishes, Valerie

  1. These are very helpful tips. Thank you Teepa for your insight. My spouse passed in October but I still keep up with your information hoping that perhaps I can help someone else struggling in some small way.

  2. How about referring to the Speech-Language Pathologist (SLP) as this is our field of expertise? It is important to make good referrals to the experts on communication, especially for people living with dementia and their families. It is so very important to access the skills and expertise of the SLP early on to help the individual and family progress through the disease with optimal communication skills. Please make the referral!

  3. This another great article which really helped me out understanding how to better help my clients needs .

  4. What about delusions? How do you communicate when they blame you for everything.. even their imagined death of yourself!

    1. Hi Mildred,

      My name is Alejandro and I work with Positive Approach to Care as a mentor. Thanks for the great question!

      It can be so tricky to communicate with someone when the reality is different from what they are thinking is happening. The tip in the article about reflecting could be a starting point. Using the persons words as a way to let them know that you got their message.

      We do offer free half hour consultations to anyone, if you are interested you can use this link for more information. https://teepasnow.com/services/consulting/phone-consultations/ We would love to support you.

  5. As a caregiver, the simple tips are most helpful. We don’t always have the time or ability to fit one more visit to a specially trained group into our schedule. The tips get us in the right direction.

  6. Very useful, as always, thank you.
    Like Ella Dilling above, my mum passed on in March 2020. I continue to read up on the subject and hope to be able to help other friend’s relatives using the tips.

  7. Thank you Teepa. The easy breakdown in this article is easy to read and understand. These days I sometimes feel very overwhelmed being my husband’s caregiver and just don’t have the energy to watch a long video or read a complicated article even though I know that they do have great information.

    1. This is a great point! Overwhelmed is the word *I’ve* been looking for! There are so many great resources here, but only so much time and/or energy to take advantage of them. This synopsis is much appreciated!

  8. Running into this situation daily, I can now understand where my husband is and why I should slow down. Positive thoughts, greatly appreciated.

  9. All of these tips extremely useful. I have already learned to use 4 of them, but I keep forgetting to say “this or something else.” I usually say “this or that,” giving two specifics, and when neither is correct, my husband gets frustrated and usually gives up or forgets what he was turning to say. Another tip I have learned (and maybe this is a part of the slow down tip), is that when he starts to say anything, I have to stop what I am saying or doing and let him finish his thought immediately. If I finish what I am saying (or doing) at the time, he will have forgotten what he wanted to communicate by the time I switch my attention to him.

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