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Language and communication can become more difficult for a person living with dementia over time. The type of difficulties a person will face as dementia progresses will differ for each individual. Good communication can be key to improving the quality of life for the person with dementia.
Here are some phrases and words that should be avoided and some advice on best approach to communicating with someone living with dementia.
Things to avoid saying:
“Remember when………….” It may be tempting to try and jog someone’s memory, but this type of question may remind the person that they have memory problems. This can be a painful and frustrating experience for the person living with dementia and make them feel they are being tested. It can be pleasant and comforting to talk about the past, however, it’s usually more helpful to lead the conversation and allow the person to join in. Try using “remember when…….” this allows them to search their memory and join in if and when they feel comfortable.
“I’ve just told you that” We know it can be tough to keep answering the same question while keeping the frustration or upset from your voice. Reminding the person that you have just answered the question will not help them to retain the information for next time and just remind them of their condition. Try to remember that the person cannot help repeating themself and it is really important that they feel heard and understood. Answer repeated questions calmly and patiently, with an even tone of voice. If you feel the need, take a break, and remove yourself from the conversation for a while.
“Your sister died years ago” a person living with dementia may forget a bereavement and often ask after someone who has died. Reminding them of a loved one’s death may be painful and they can react as if they are hearing the news for the first time. How to respond to these types of difficult questions will vary for different people in different circumstances, however, it’s always important to show sensitivity and minimise any distress. For some people, encouraging them to talk about the person they are asking about can be comforting. Distraction techniques can be useful, although try not to avoid the question if they keep asking, as this can cause the person to feel more anxious.
“What did you do yesterday?” try to avoid asking too many open-ended questions about the past. This can be very frustrating for a dementia sufferer if they cannot answer the question. Although it is polite to enquire about someone’s day it is better to stick to questions about the present time. Instead of asking them about their day, speak briefly about your day and give them time to ask you questions about it. They might then offer information about what they have done. Talk to them about the present and use items in the environment such as photos or ornaments to stimulate conversation.
“Do you recognise me?” It can be distressing when somebody with dementia doesn’t recognise you, especially if you have a close relationship with them. Remember that it is likely to be upsetting for them to not recognise people around them too. Asking the person if they know who you are can make them feel guilty or anxious if they don’t remember or offended if they do. The way you greet somebody with dementia might change depending on the stage of their condition – judge for yourself but keep it friendly. A warm hello could suffice, or it may help to say your name and your relationship to them each time.
“Let’s have a cup of coffee now, then we can go for a walk and after that we can get some lunch in the cafe in town.” Long, complex sentences can be difficult to grasp for somebody with dementia. It’s difficult to process several ideas at once as cognitive abilities slow down, so it’s better to give directions or instructions one step at a time. Wherever possible use short, simple sentences. Avoid speaking in loud or busy environments and wait until you have the person’s full attention before speaking. During a conversation always give the person the time to process what you are saying.
Here are some things to avoid when interacting with someone with dementia:
Arguing: Don’t argue with or say no to someone with dementia. Instead, you can try diversion and distraction.
Confrontation: Accept the blame when something is wrong (even if it is a fantasy). Leave the conversation or room if necessary to avoid confrontation.
Elderspeak: Avoid using “elderspeak”, which can include talking in a high-pitched voice, using words like “love” or “deary”, or speaking to the person like they are a child. Instead, try to keep your tone of voice the same as with anyone else.