How to Talk to Residents with Dementia

Dementia in all forms, including Alzheimer’s disease, directly affects our interpersonal communication abilities. Those with dementia struggle to remember basic facts such as the names of loved ones, important dates, and memorable places. Over time, their abilities may be lost altogether as the illness progresses.

Misunderstandings between those who have dementia and those are don’t are common. Confusion and frustration usually result, especially when the parties involved are family members, friends, and colleagues with whom there was frequent and free-flowing communication in the past.

The good news is that effective communication with dementia residents is possible. It just requires a different approach. Refined verbal communication, good listening skills, and close attention to nonverbal cues all come into play.

How Dementia Affects Communication

The manner and extent to which dementia affects communication differs for each person and can vary daily. Changes continue as the illness progresses but commonly include some combination of the following:

• Difficulty thinking of the right word
• Using one word for another
• Using an object’s description rather than its name
• Repeating stories, phrases or words
• Talking less often
• Mixing ideas that aren’t related
• Using offensive language such as cursing
• Reverting to their first language

With certain adjustments and techniques, you can communicate effectively with those who have dementia. It’s important to remember that you are the one who has to adjust because the person with dementia can’t.

Good Listening Skills are Essential

Most of us listen to others in certain ways – we talk quickly, occasionally interrupt, and often multitask during conversations. These common behaviors do not work well when interacting with dementia residents. Make the following adjustments to become a more assertive listener:

• Do Not Interrupt. Those with dementia often take longer to respond, and once they start responding, they may have several starts and stops. Unless they ask for help, do not interrupt them. It’s best to give those with dementia a chance to say things for themselves, even if you think you know what they’re trying to say.
• Listen to Interpret, Not Just to Hear. Because of changes in their brain, dementia residents do not speak as directly as most others. Use context and other clues to interpret what they are trying to tell you.
• Make It Obvious You Are Listening. People with dementia need to be able to tell easily that you are giving them your full attention and listening to what they are trying to say to you. Maintain eye contact and do not engage in any other activity simultaneously. If more than two people are involved in the conversation, invite the person with dementia to speak so they know you want to hear from them.
• Let Them Speak for Themselves. Dementia residents should be allowed to speak for themselves, especially regarding their health and welfare. They may not communicate like they once did, but most still understand their health and wellbeing.
• Repeat Back What You Hear. Once the person with dementia has finished speaking, repeat what you just heard. This helps ensure that no meaning was lost in the translation.

Speaking Skills are Important, Too

When speaking to a person with dementia, talk in ways they can comprehend. The following tips will help dementia residents understand more of what you are telling them.

• Offer Choices. If the resident has options, explain that to them – especially if you think they will resist the activity. For example, instead of telling them to go take a shower, ask if they want to take their shower before or after having their snack.
• Be Respectful. This point should go without saying, but because dementia residents speak less, it can be easier to forget that they are still present and able to hear. Don’t speak as if they aren’t in the room. Try not to correct their mistakes or argue with them. Focus on encouraging. Finally, don’t use condescending words or talk in tones that you would use with a small child or pet.
• Rephrase Questions. If the person with dementia struggles to answer your question, try to reframe it. Keep your sentences short and rephrase questions so they can be answered with a few simple words.
• Keep a Positive Tone. It is essential to pay attention to your tone of voice when communicating with a dementia resident. Keep things friendly and upbeat. It’s entirely normal to begin feeling impatient or frustrated at times. Step outside of the room to regain your composure.

Additional Strategies

It’s also important to carefully observe nonverbal cues and to intentionally use nonverbal cues to help convey your message.

• Maintain physical proximity. Get on their level. If they are lying down, sit next to the bed. If they are sitting, get a chair or kneel. Consider holding their hand or touching their arm to let them know you are listening.
• Use visual cues. In addition to telling them, show them. For example, if suggesting that they wash their hands, mimic the action with your own hands.
• Avoid distractions. Avoid background noise or visuals that can make it harder to hear or focus. Turning off the television briefly can make all the difference at times.
• Educate the resident’s family members. Your team can help the resident and their family members avoid frustration by sharing these strategies and modeling proactive communication behaviors.

Conclusion

Alzheimer’s and other dementias impact the ability of residents to communicate. You can overcome many common issues by having a good understanding of how dementia affects their communication abilities. Use good listening skills, clear speaking habits, and nonverbal cues to help you and the resident better understand each other.

If you need assistance, contact us. PCALIC, through partners like PCH Mutual, offers insurance and risk management for assisted living facilities. Learn more.