Navigating successful conversations with dementia patients takes trial and error, respect, and practice. It also helps to understand the do’s and don’ts of asking and answering questions. Oh, and did I say patience? You’ll need a lot of that.
Dementia Caregiver Tips
First, let's discuss some of the behaviors and practices to avoid when communicating with dementia patients—a.k.a. DON'TS!
Don't ask too many questions in a row or offer multiple options. It can confuse and overwhelm them. (e.g., “Do you want me to invite Susan and Karen, and where would you like to go?” or “Would you like to watch TV, go for a walk, play a game, or take a nap?”) Rather, keep it simple: “Would you like to watch TV or go for a walk?”
- Don't ask open-ended questions like, “What would you like to drink?” Instead, give a simple choice: “Would you like coffee or water?”
- Don't yell or raise your voice when speaking. This will show signs of frustration that may cause embarrassment, and then your loved one may “shut down” altogether. Dementia and anger often go together—for both the patient and the caregiver—so it’s best for both of you to remain calm.
- Don't put the dementia patient in the position of guessing. For example, if your loved one is in the company of lesser known people, don’t say, “Mom, who is this? What’s her name?” Rather, set the same scene for success and avoid humiliation of not remembering by saying, “Mom, you remember my dear friend, Sally. She was my best friend since we were eight years old. You used to bake cookies for us after school all the time.”
- Similarly, don’t point to photos and ask your loved one to “guess who this is.” Better yet, reminisce about the person or occasion the photo was taken. It’s helpful to label the photos with people’s names and relationships.
- Don't dismiss feelings. Like most of us, your loved one will have good days and bad days. Get to know the difference in their moods. If they are not having a good day or look sad, acknowledge that you see that.
- Don't complete their thought when they have trouble remembering a word. Give them a chance to recall it.
- Don't argue when the person is not understanding of the reality by saying things like, “I need to go to work now,” or “I have to pick up the kids from school soon.” Rather, try to redirect the conversation to reduce their anxiety. Watch this helpful video by dementia expert Naomi Feil on Validation Therapy.
Now that you know some of the don’ts, let’s take a positive approach to successful communication—a.k.a. DO’S!
- Keep sentences short and simple.
- Keep questions very simple with limited choices.
- Always meet the person and their eye level. If they are in a wheelchair, never talk to them from behind; bend down to meet their eyes.
- Use humor as a tension breaker. Laugh WITH the person, not at them.
- Listen carefully and pay attention to body language. Get to know their non-verbal language.
- Engage in shorter, more frequent conversations rather than longer ones to keep their attention and focus.
- Speak clearly and slowly, particularly if you are talking by phone or video. It helps to prepare a few topics ahead of time as to not let the conversation lag.
- Limit distractions such as a TV or music in the background or children playing in the room. If you are visiting someone in a facility, be aware of other people talking in the common spaces.
- Engage in activities that touch many senses, particularly those that you may have enjoyed together in the past such as, dancing, singing to a fun song, or cooking a family-favorite recipe—focusing on the familiar aromas is a great way to connect the memories.
- Use nonverbal cues such as pointing to coffee or tea when asking which is preferred, if your loved one doesn’t seem to understand the words.
- Always be patient and respectful, even when it’s really hard!
These do’s and don’ts are simple, proven ways of improving communication between caregivers and dementia patients. Even though conversations may get increasingly difficult as the disease progresses, you can adapt and implement different strategies to keep the communication—and the loving connection—strong.