Communicating with someone with dementia

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Why communication changes

The way a person’s communication changes because of dementia depends on various factors, not least the progress and type of the condition. Among the reasons for communication changes are:

  • changes or damage to the area of the brain dealing with speech and memory
  • confusion, fear and anxiety
  • deterioration in hearing and sight
  • difficulty adapting to unfamiliar environment
  • difficulty processing information
  • difficulty understanding
  • fatigue
  • fear of making mistakes or not meeting expectations.
  • problems with teeth and dentures.

How communication changes

Whatever the reasons for change, some changes are more common than others. These include:

  • inability to understand what is being said
  • difficulty finding the right word: this can manifest itself either be not providing a word or providing one that has a completely different meaning
  • increased tendency to interrupt
  • ignoring other participants in conversations
  • not responding to questions
  • communicating words and sounds that do not make sense
  • difficulty in expressing emotions
  • deteriorating ability to write
  • deteriorating ability to read
  • reduced vocabulary
  • reverting to a first language, even if it has not been used for many years, sometimes since childhood.

How you can help manage communication changes

There are many things that a carer can do to assist the communication needs of people with dementia. Among the most important are:

  • Take the person with dementia to have their hearing and eyesight checked. This will provide leads on what you can expect when communicating with them. It may also help them receive attention that could aid communication.
  • Be patient. Never hurry the person to express their thoughts or emotions. Long pauses may not indicate the end of their sentence, it could indicate they are thinking about what to say next. It’s okay if it takes time for them to re-capture the thread of a conversation.
  • Do not finish their sentences. Think about how you feel when people do that to you. It may well be that what you are going to say for them is not what they were going to say at all.
  • Speak slowly and not too loud.
  • Face the person when you are speaking to them.
  • Allow the person plenty of time to respond. If they have not responded after a reasonable gap, repeat your question exactly as you asked it the first time.
  • Use short, familiar words and short, simple sentences.
  • Try not to use words that have more than one meaning.
  • Ask only one question at a time and try to avoid questions that require a lot of thought or rely on memory.
  • If you are giving instructions for a task, give one instruction at a time, and make the instructions as simple as possible.
  • Try not to argue with the person. Their reason and logic process may be affected by their dementia.
  • Try not to correct the person unless it is absolutely necessary.
  • If other people are present, try to avoid having too many people involved in a conversation at the same time.
  • Use touch to communicate feelings of affection. Touch is also a way to attract or keep the person’s attention.
  • When using people’s names in conversation, provide some context e.g. ‘Your neighbour, Sam.’
  • Use facial expressions and hand gestures to help communicate with them.
  • Try to ensure conversations are held in a quiet environment. This may not be easy if you are out, but in their home make sure television, radio and other aural distractions are turned off.
  • Do not communicate when you are outside their line of vision e.g. shouting from another room.
  • Try not to express things in terms of what they cannot do. Instead, point out what they can do. For example, instead of telling them they cannot go to the shop, tell them they can undertake some task while you go to the shop.
  • Never talk about the person in front of them as if they are not there.
  • Try not to communicate important information at the end of the day or when they appear tired.

Support and care

If you are searching for care and support for your loved one, do not rush into the first available option. Visit CareAbout to check various options and facilities, particularly focusing on those who provide specialist dementia care.

An individual diagnosis of dementia has an impact on a network of people: friends, families and colleagues. Support and further information is available from the National Dementia Helpline 1800 100 500 or at www.dementia.org.au

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