It’s estimated that informal care partners like family and friends spend an average of five hours on care every day when they are supporting someone living with dementia. It’s essential that family and friends work to understand the newfound communication challenges that are often presented when dementia is in the picture.
The Changes Associated When Living with Dementia
By Dani Waxman, Founder of RecallCue
The progression of dementia can sneak up on a person living with the disease. As the brain changes and pathways inside the brain deteriorate, things that were once done without thought can become challenging or even impossible. An occasional misplaced word becomes difficulties with understanding words, finding the right words, or even verbalizing thoughts and feelings. People living with dementia face many challenges with the communication methods we all may take for granted.
The National Institute on Aging formally defines dementia as a loss of cognitive functioning that interferes with an individual’s life. Neurons that were once functional deteriorate over time as the dementia progresses. Many people associate dementia with the more well-known signs such as forgetfulness. However, there are many lesser-known symptoms of the early stages of dementia such as issues with problem-solving, language skills, and communication.
As the person’s dementia progresses, their brain is both chemically and physically changing. One of the first areas of the brain affected in many forms of dementia is the prefrontal cortex. This portion of the brain is responsible for impulse control, making logical decisions, sequencing through the steps of a task, allowing us to see another’s point of view, and more. The hippocampus is another part of the brain often affected. This part is responsible for keeping track of time and space.
What does this mean for you? You may notice that the person living with dementia may react to something with more fear or anger than you would have expected. It’s possible that they may say or do something that you wouldn’t think is appropriate for the time or place. They may lose track of the day or whether or not they have already done something that day.These changes may seem surprising because you can’t see anything different physically with the person. It is often hard to remember, but this is the dementia causing these changes, not a choice made by the person. They are still capable, you can support them with the proper tools and skills, but you can’t fix their dementia.
As a person’s dementia progresses, many things will change, which means you’ll need to change, too. Communicating effectively is something you’ll have to think about and practice, as it may be different than what you’ve done throughout your time together.
Greeting and Starting a Conversation
When you begin a conversation with someone living with dementia, start out by being curious. They may or may not recognize you or your relationship to them, so it’s best to use their preferred name.
For example, try Hi Tom, my name is Beth. If Beth is Tom’s daughter, this may seem odd, but if Tom doesn’t recognize her, it may create apprehension or even fear if she were to call him dad.
Be Purposeful with Your Speech
When speaking, be aware of directness and specificity in your words. You don’t want to make assumptions. If you’d like them to try helping you with a task, tell them directly, Please help me set the table. If they don’t do so perfectly, it’s okay. Do not berate them for a misplaced spoon. Thank them for their help.
Consider how you might ask them questions as well. If you are assisting them with their outfit for the day, resist asking, What do you want to wear? Instead, pick out two or three outfits and ask them which one they’d like to wear. Find ways to ask questions that only require a simple yes or no answer as well.
There will be times they don’t remember what you said. Resist any urge to ask, Don’t you remember I told you about the party last week? Calmy repeat yourself and move on from the interaction.
Patient care partners will also have to experiment with different phrasing. You might ask them to get ready to go to the park, but they don’t seem to hear you. Consider that they may have forgotten the meaning of the word park and try again. Tell them it’s time to go outside or time for a walk.
To mitigate this issue, turn off any TVs, radios, or anything else that may be distracting. Allow them to focus only on the conversation at hand. Don’t do anything distracting yourself like multitasking or moving around the room. Stay still in a chair next to them and speak calmly.
Keep Positive Non-Verbal Cues
On the same note, tune into their non-verbal communication. They may not be able to express how they’re feeling at a given time.
Consider New Modes of Communication
You may also want to introduce your person living with dementia to music or art therapy. Music and art therapy engage the brain and provide an outlet for self-expression. By engaging them in music or art they previously loved, you can create an opportunity for positive reminiscent communication between you both. It’s important to introduce the music or art slowly as to not overload their senses.
Finally, explore technological solutions, such as RecallCue, that offer ways to communicate through photo sharing, displaying messages, and reminders on a day clock. Embracing technology can help you communicate and engage with your loved ones even when you can’t be physically present.