Communication Tips

  • Do not try to argue or reason with the person. Their ability to reason is no longer there, and the person will not be able to remember your reasoning or rationally weigh your points. Do not argue with the person over what they see, hear or feel. If the person is seeing things you don’t see, reassure him and respond to his or her feelings about it. Remember that these ideas or hallucinations are very real to the person who is experiencing them. Rather, offer reassurance and validation (e.g., “I know this is troubling for you, let me see if I can help”).
  • Avoid quizzing, testing or trying to teach the person to remember. These techniques won’t work and will only serve to embarrass and humiliate. Imagine the feelings associated with not being able to recall a child’s name during such a test. Instead of saying, “Do you know who this is?”, try “Here is your granddaughter Susan who has come to visit.”
  • Try to understand. Rather than correcting mispronunciations or inaccurate statements, recognize that your loved one may no longer be able to consistently come up with the right words, or may have trouble comprehending what you’re saying. Be patient and use phrases such as “I’m sorry, could you repeat that?” or keep the flow of conversation going by providing the elusive word.
  • Reassure and comfort. Do not reality orient. The person may be worried about the children, parents, going “home” even if living at home or going to work even if long retired. Trying to convince them of the truth is generally fruitless and can be frustrating or even frightening. Jump into their world and help to make it less frightening by providing lots of reassurance. For example, if your loved one is worried because some relatives haven’t arrived, provide an explanation that might be acceptable and reassuring such as, “they decided to spend the night elsewhere tonight, they’re fine”. If your loved one does not recognize you, go along with it or try stepping out of the room and announce your identity upon your return.
  • Always focus your full attention on them. Turn off the radio or television. Do not talk on the phone in front of them. Avoid any distractions. Keep eye contact, remain patient, and, most importantly, try to listen to their wants and needs.
  • Speak slowly, calmly and quietly. This will allow the person time to process what you are saying. People with dementia often watch our non-verbal cues (facial expression, body language, tone of voice) to interpret what we are saying and may mirror our mood.
  • Be aware of your nonverbal communication. Speak slowly, calmly and in a normal volume. Use a gentle, relaxed tone.  People with dementia can be sensitive to changes in mood, voice, posture or facial expression. You can do wonders to ease tension by smiling at a frustrating moment. If you have difficulty understanding what your loved one is saying, listen for the feelings behind what he or she is trying to communicate and validate those feelings. For example, say, “I know that you’re frustrated right now” or “I’m glad you’re so happy today.”
  • People who have dementia will be repetitive. It’s like taking a road trip to Disney World with a three-year-old who keeps saying over and over and over again, “Are we there yet?”  The reality is that a person who has dementia will be repetitive because they are anxious. As annoying as the repetition is, be happy that the person is still involved. As the dementia progresses, they will lose interest in being an active participant or will lose their vocabulary and no longer ask. You may later wish to have back those moments of “Are we there yet?” Try to reassure the person with dementia, and use a calming voice to respond to whatever they ask.
  • Forgive yourself when you don’t always respond appropriately. You may find it difficult to communicate with as much understanding and patience as you’d like to. Keep in mind that because of the memory loss, your loved one is unlikely to remember everything you say.
  • Simplify your communication. Stand directly in front of your loved one and make eye contact. Communicate one idea at a time and use simple instructions. Try breaking even simple tasks into one-step commands. If you’re helping with a task, let your loved one know what you’re going to do next. If possible, demonstrate what you want your loved one to do — such as brushing teeth or putting on a jacket. If you must repeat things, try to use the same words. If your loved one doesn’t understand a second time, then try rewording. Avoid abstract concepts, which your loved one may find difficult to grasp. For example, phrases such as “jump into bed” can be confusing. Instead, use direct statements such as “it’s time to get into bed.”
  • Validate the feeling behind the words. Even if you are unable to understand what is being communicated, look at the non-verbal signs of emotion. Is she upset? Joyful? Afraid? Respond accordingly providing lots of affection and comfort.
  • Reminiscence can be very useful and validating. Persons with dementia usually retain their memories from long ago. Discussing these memories and prior accomplishments often provide a sense of security.
  • Reduce clutter, extraneous noises or confusing aspects in the environment. Check out any real basis to the person’s fear. For example, the person may “hear people” in the next room because the TV is on.
  • If the person misplaced something and thinks you or someone else “stole it,” offer to help look for the item. Keep track of frequent hiding places, and if possible keep duplicates of the item.
  • Accept changes. Keep in mind that the changes you see and hear in your loved one are a result of the disease, not of your loved one trying to be difficult or hurtful. When your loved one says inappropriate things, remember it’s the disease talking. Try not to take it personally.
  • Use a familiar name. As the person with dementia “time travels,” depending on when and where in time they think they are, they may not recognize their last name or even a title like “mom” or “aunt”.  A familiar name – a childhood name – may help orient them.
  • Turn questions into answers. Do not ask a person with dementia if they have to go to the bathroom. Instead say, “Let’s go to the bathroom.” The same goes for bathing or eating. Do not ask if they would like to take a bath or eat. The person with dementia will usually say no. Direct them to what needs to be done.
  • Use touch. Our sense of touch helps to validate who we are and keeps us focused. Touch is a nonverbal form of communication that conveys warmth and caring to some. Know who you are touching. Some people enjoy being touched, but some people hate to be touched. Learn to respect and accept another person’s personal boundaries.
  • Keep your sense of humor. If you are caring for a person who enjoys humor, keep the jokes coming. When a person does something that is funny, laugh about what happened instead of criticizing them. Humor can defuse a challenging behavior.
  • Always treat people with dignity and respect.  “Treat others how you would like to be treated.”
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