When a person is living with dementia (PLwD), 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 when someone offers 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.
- Matching your pace to theirs: If your PLwD 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 PLwD an extra moment to possibly recall the word they were looking for.
- Reflection: If the PLwD 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 PLwD 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 PLwD can fill in the blank
- This or something else: If your PLwD 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 PLwD 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 PLwD to anything specific.
- Tell me more about it (Circumlocution): If you’re still unsure what your PLwD 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 they’re trying to communicate.
- Visuals: When word-processing abilities decrease as the brain changes, pointing at a related object when talking to your PLwD can help increase mutual understanding. For example, if you’re trying to find out what your PLwD 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 PLwD 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.
These Positive Approach to Care communication tips should be a good starting point for you as a care partner. If you want to learn even more of Teepa’s practical tips and insights, join one of our upcoming LIVE Positive Approach to Care (PAC) webinars!