“When communicating with someone with dementia, we always want to focus on the person and meet him or her where they are,” says Ruth Drew, MS, LPC, director of information and support services at the Alzheimer’s Association. “If they’re struggling, we don’t try to pull them into our reality. We try to communicate in a way that is going to make sense to them.”
That means understanding a person’s memory and communication struggles. “They may have trouble decoding what we’re saying,” Drew points out. A damaged brain may have trouble processing language; responding becomes difficult.
“People usually just struggle with little things in the early stages,” she notes. “But over time, finding the right words, and being able to express a complete thought, gets harder. They may fill in with a word that doesn’t make sense or they may not be able to finish their sentence.”
These changes may make it feel as if we can no longer relate to someone we love, but “we can still connect and communicate throughout the course of the disease if we are willing to change our approach,” Drew says. Connection remains possible when we adapt our communication in small ways.
Connect at eye level. If your loved one is sitting down, show your love and respect by sitting and meeting his or her gaze on the same level.
Keep it simple. Speaking slowly and deliberately gives the person more time to process what you’re saying.
Set a calm, kind tone. Your own state of mind plays a bigger role in your communication now, so take a deep breath and put frustrations aside before you visit your loved one.
“The person will read your mood,” she says. “If you’re upset and anxious and agitated, it’ll come through in your body language, your tone of voice, your face, everything. Your anxiety can shut them down.”
Don’t argue. It can be tempting to correct the person’s errors of perception or memory, and you may even get angry with him or her. This won’t help.
“It makes no sense to argue with people with dementia, because they are playing by a different set of rules,” Drew explains. “Focus on their safety, comfort, and happiness.” There’s no real danger if they believe it’s 1955 and they’re in college. Let that be the reality for the moment.
Tolerate ambiguity. It can be especially hard when your loved ones try to tell you something urgent and the words don’t make sense. Yet asking them questions such as “Are you in pain?” or “Why are you upset?” demands that they evaluate their own condition, and they might not be able to answer.
But you can connect without words.
“You may have no idea what they’re trying to say to you, but you can respond to the emotion they are expressing and help them feel understood,” she says. “For example, you can hold out your hand. If they take your hand, you can put your hand on top of it and say, ‘This is a bad day, isn’t it?’ And just sit there with them.”
This originally appeared as “How do I talk with someone who has dementia without confusing him — or getting frustrated myself?” in the July/August 2018 print issue of Experience Life.