Communicating with someone who has dementia due to Alzheimer’s or another cause requires incredible patience and flexibility. Someone with dementia can shift unpredictably between clarity and confusion, and from a desperate pleading for help to a hostile rejection of it.
Here are 8 ways to enhance communication with those suffering from dementia, so you can help preserve their dignity, maintain their emotional stability, and give them some sense of autonomy. (Please note that this is not a complete list of what can be done. Also, these tips aren’t applicable to situations of advanced dementia, when communication may no longer be feasible.)
1. Keep It Simple
Limit what you say to one piece of information at a time, and speak very slowly and clearly. Don’t ask too many questions, and also be prudent with joking and sarcasm—they can cause frustration if your loved one thinks she should “get it” but doesn’t.
2. “Translate” Language to Make It Easier to Understand
Rather than explaining what objects are, try referring to them by their appearance. For example, refer to a medication that needs to be taken as “the blue one,” or cheese in the refrigerator as the one in the red wrapper. Characteristics that can be perceived with the senses may be more comprehensible than words.
3. Maintain a Consistent Routine
Keeping to the same schedule when calling to check in, preparing meals, or engaging in fun activities can be reassuring and prevent agitation.
4. Help Them Answer Their Own Questions
My friend Mike guides conversation with his mother so she can figure things out for herself. This helps her feel in more control. “When she asks me a question, I don’t answer it,” he says. “I ask her questions to help her find her own answer.” Here’s an example of one such conversation:
Mom: What day is today?
Mike: I’m not in front of my computer watching changes in the stock market, so what day might that be?
Mom: Saturday or Sunday?
Mike: Right. Now, where are you going at 11:30 today?
Mom: My hair appointment.
Mike: Right. So what day is today?
5. Divert Them From Impossible Tasks
If your loved one becomes fixated on doing something impractical or impossible (such as wanting to go back to work), don’t reject his request outright. Instead, say “Maybe you can do that tomorrow.” The notion will often be forgotten by the next day. And if he stays fixated on an uncomfortable topic, try diverting him with a neutral activity you know he would enjoy—such as working on a puzzle or looking through a photo album.
6. Neutralize Negative Moments
One morning, your loved one may greet you with a smile and a kiss. The next, with detachment or even a sneer. You can’t take these things personally. To defuse a volatile situation, discuss neutral topics (the weather, a movie you just saw.) Meanwhile, you can gently reassure your loved one that everything is okay if she becomes combative.
7. Avoid Awakening Bad Memories
Your loved one may not remember a tragic loss in her life that happened in the past. Being reminded may trigger a fit of sobbing, as if it just happened. If she mentions wanting to visit someone who’s passed on, you can acknowledge that it would be nice but then change the subject.
8. Tap the Power of Music
Music can sometimes open up a connection that is blocked. Patty, a friend of my sister’s, shared an experience of inviting a cellist friend to come play for her mother at an assisted living facility. Hearing the music brought her mother out of a detached state, and she became quite alert. As Patty told me, “Music can travel to the nooks and crannies of your soul, where your words can’t go.” Even years after her mother no longer spoke, Patty could see her mother’s foot moving to the beat when music was playing.
There’s another very important person you need to take care of during your ordeal: yourself. As you assume more responsibilities for the life of someone who needs a lot of help—especially if both of you are living in the same home—you may tend to forget about your own needs. It’s important to give yourself time to do things just for yourself, as well as a space that you can call your own.
Meanwhile, stay on the lookout for those fleeting but treasured moments of clarity and affection. Appreciate them as special gifts during this trying time. Even if loved ones are unresponsive to your conversation, don’t give up on them; they might still be hearing you and cherishing the contact.