Communicating with Patients with Dementia

Communicating with patients who have dementia requires patience, empathy, and adaptability. As dementia progresses, individuals may struggle with memory, comprehension, and verbal expression, making effective communication essential for their well-being.

Encouraging dementia patient to communicate

Try to start conversations with the person you’re looking after, especially if you notice that they’re starting fewer conversations themselves. It can help to:

• speak clearly and slowly, using short sentences
• make eye contact with the person when they’re talking or asking questions
• give them time to respond, because they may feel pressured if you try to speed up their answers
• encourage them to join in conversations with others, where possible
• let them speak for themselves during discussions about their welfare or health issues
• try not to patronise them, or ridicule what they say
• acknowledge what they have said, even if they do not answer your question, or what they say seems out of context – show that you’ve heard them and encourage them to say more about their answer
• give them simple choices – avoid creating complicated choices or options for them
• use other ways to communicate – such as rephrasing questions because they cannot answer in the way they used to

Key Strategies for Effective Communication

1.Use Clear and Simple Language

• Speak slowly and clearly, using short sentences.
• Avoid complex questions—opt for yes/no questions instead.
• Repeat or rephrase if necessary, but without frustration.

2.Maintain Eye Contact and Positive Body Language

• Make eye contact to establish connection and trust.
• Use gentle gestures and facial expressions to reinforce meaning.
• Sit at their level to avoid appearing intimidating.

3.Be Patient and Give Time to Respond

• Allow extra time for them to process information and respond.
• Avoid rushing or interrupting, as this can cause distress.

4.Encourage Engagement and Familiar Topics

• Talk about past experiences or familiar subjects to stimulate memory.
• Use visual aids or objects to support conversation.
• Engage in music, art, or storytelling, which can be comforting.

5.Adapt to Non-Verbal Communication

• Watch for facial expressions, gestures, and emotions that indicate understanding.
• If verbal communication is difficult, use touch (if appropriate) to reassure them.

6.Create a Calm Environment

• Reduce background noise (TV, radio) to help focus.
• Choose a quiet, well-lit space for conversations.

Challenges and How to Handle Them

• Repetitive Questions: Answer calmly and redirect attention.
• Confusion or Frustration: Offer reassurance and avoid correcting them harshly.
• Difficulty Finding Words: Help by suggesting words or using visual cues.

Tips for Communicating with Patients with Dementia

• Speak clearly.
• Remain calm; avoid raising your voice.
• Use simple words and short sentences.
• Speak at a slow pace.
• Be conversational; avoid a lot of questions.
• Be respectful.
• Position yourself close, at eye-level, and ensure adequate lighting.
• Remain open and relaxed.
• Use prompts, such as photos or objects, to help the person understand what you are talking about.

Things to Avoid when Communicating with Patients with Dementia

• Don’t complete the person’s sentences.
• Avoid saying, “Remember when…?” or asking, “Do you remember…?” Use a statement, “I remember when…” and the person may or may not join in but won’t feel embarrassed if they don’t remember.
• Avoid being frustrated with repeated questions. Take a break if necessary.
• Don’t remind them of a loved one’s death. You can try encouraging them to talk about the person if they ask.
• Avoid asking questions about them or their past. Instead, focus on the present, tell them about your day to stimulate conversation.
• Don’t ask the person if they recognize you or anyone else. As you greet them, tell them who you are and what your relationship is to them.

The best advice I found is to remember that there is a person “behind” the dementia. Use their name as often as possible and be respectful. Prioritize keeping their dignity intact. It’s not easy to see a loved one struggle with any illness, and dementia is no different.

REFERENCES

1. Banovic S, Zunic LJ, Sinanovic O. Communication Difficulties as a Result of Dementia. Mater Sociomed. 2018 Oct;30(3):221-224. doi: 10.5455/msm.2018.30.221-224. PMID: 30515063; PMCID: PMC6195406.
2. Alzheimer’s Association. (2023). Communication and Alzheimer’s. https://www.alz.org/help-support/caregiving/daily-care/communications
3. Murphy P, Shallice T, Robinson G, et al. Impairments in proverb interpretation following focal frontal lobe lesions. Neuropsychologia. 2013;51(11):2075-2086. doi:10.1016/j.neuropsychologia.2013.06.029
4. Pönkänen L, Hietanen J. Eye contact with neutral and smiling faces: effects on autonomic responses and frontal EEG asymmetry. Front Hum Neurosci. 2012;6. doi:10.3389/fnhum.2012.00122
5. Alzheimer’s Society. (2023, January 11). What not to say to somebody with dementia. https://www.alzheimers.org.uk/blog/language-dementia-what-not-to-say
6. National Institute on Aging. (2017, May 17). Alzheimer’s Caregiving: Changes in Communication Skills. https://www.nia.nih.gov/health/alzheimers-changes-behavior-and-communication/alzheimers-caregiving-changes-communication

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