Communicating with Loved Ones Suffering from Dementia

11 Jul

Written By Louise

Dealing with loved ones who suffer from dementia can be a heart-wrenching experience that is both emotionally challenging and mentally exhausting. There are many misconceptions about dementia sufferers, which frequently develop due to a lack of understanding of the disease and not knowing how to interact with those affected by it. By employing appropriate strategies and adopting a compassionate approach, you can maintain meaningful interactions and provide emotional support to your loved ones, thereby enriching their quality of life.

In this blog, we will explore effective strategies to help you navigate conversations with loved ones affected by dementia.

Introduction

You might have noticed that your ageing loved ones are making risky decisions. This is commonplace, and often the underlying reason is the fear associated with ageing. Elderly loved ones consider various factors when making decisions, including the fear of losing independence and potential long-term side effects of medical conditions, including dementia.

They might be resistant to seeking or accepting help and sometimes secretive about any cognitive changes they experience. Therefore, the way you approach them when expressing your opinion can make a huge difference to the outcome and can be the difference between conflict and agreement.

Patience and persistence go a long way towards making conversations productive when dealing with elderly loved ones. Challenging conversations, especially when you or your loved one is depressed, stressed, or exhausted, will never be productive. Instead, aim to bring up your concerns in multiple conversations and choose days when you both are feeling relaxed. Perhaps a morning is better than late afternoon? They might feel overwhelmed if you give them too much information all at once, be concerned about the loss of control, or fear that you plan to put them into a care home.

Your loved one might already be aware that they are facing some new challenges, even if they choose to avoid discussions about their future. Be gentle in your discussions, don't push, give ultimatums, or otherwise antagonise them. Instead, speak calmly, with love and tenderness. Focus on addressing your loved one’s concerns rather than telling them what to do. If you are caring for an ageing parent, remember that they are still your parent. It can be very difficult for both of you when the care-giving dynamic changes, and it's easy to treat them as a child in your relationship. However, remember that your parent is an adult and deserves to be treated as adults.

During conversations, empower your loved one by making them part of the decision-making process and give them plenty of choices and input into every decision. For example, instead of telling them they need to eat more, you could say “I’m very concerned because you look like you are losing weight and I’m worried you’re not eating enough. What can we do to improve this? Can I prepare some meals for you or organise a hot meal delivery each day?”

As your loved one’s cognitive abilities decline, communication becomes a significant barrier to connecting with them effectively. Communication underpins all interaction and it is inappropriate to assume that those with dementia are unable to communicate or make decisions. Sufferers of dementia are often spoken to as if they have no understanding at all. When they become upset or frustrated, they are often soothed in the same way a baby would be placated. People also converse with others about the dementia sufferer as if they were not present.

Identifying how your loved one can communicate is the first step in establishing your new relationship. Those in the early stages of dementia may be able to communicate verbally, whilst others may rely upon gestures or pointing. The ability to communicate may also fluctuate, requiring you to modify your communication methods. Fluctuations may occur as a result of tiredness, medication, dehydration or disease progression.

Due to the deterioration of the brain, sufferers of dementia often become confused and misunderstand what is being said. Words may become jumbled or elusive. They may have problems with expressing what they want to say. They may be convinced that a specific thing which they have either ‘imagined’ or have misunderstood was being said. This is frustrating for your loved one and for you. Your loved one will be desperate to be understood and when this isn’t achieved, they may become angry or despondent.

In time, you might see the disease before you see the person. However, seeing and respecting your loved one before you see the condition will ensure that you maintain a meaningful connection with your loved one. This is essential for their well-being and your own mental and emotional health.

With compassion and effective communication techniques, you can continue to engage, connect, and provide support to your loved one on their unique journey. Helping your loved one to make choices about their care empowers them and reduces situations of abusive behaviour.

Finding the Best Method of Communication

When it comes to communicating with your loved one, perseverance in finding the most appropriate means of communication is crucial. This not only reduces frustration between both parties but also prevents your loved one from feeling like they have failed. Understanding their feelings and behaviour enables you to see the underlying messages being communicated, rather than perceiving the person as aggressive or difficult. As a caregiver, it becomes your responsibility to find a solution to communication problems.

However, it's important to consider other factors when relying on non-verbal communication. For instance, asking someone who is blind or has had a stroke to draw or write would be inappropriate. Therefore, it's necessary to explore alternative methods that cater to their specific needs and abilities.

One of the simplest and most effective methods of communicating with someone who has dementia, regardless of the stage, is the 3 Step Approach:

Begin by saying the person's name to grab their attention, and then identify yourself. This helps them understand who is speaking and establishes a connection.
Seek and maintain eye contact throughout the conversation. Eye contact can enhance engagement and facilitate a better understanding of the message being conveyed.
Share your message in its simplest form, using a voice tone and gestures that align with your words. Demonstrate through actions or gestures what you want the person to do, as this visual cue can assist them in understanding and responding appropriately.

By following these three steps, you can enhance communication with your loved one and create a more meaningful and effective interaction. Remember, finding the best method of communication requires patience, adaptability and empathy.

Creating a Calm and Familiar Environment

People with dementia often find comfort in familiar surroundings. Therefore, it's important to create a calm and familiar environment that promotes comfort and enhances communication. To achieve this, it's essential to minimise distractions such as loud noises or excessive clutter. Choose a quiet space that is well-lit and free from potential triggers of confusion, where you can engage in conversation without interruptions. Incorporating familiar objects or photographs can provide a sense of comfort, making it easier for your loved one to engage in meaningful communication.

Maintaining a Calm and Positive Demeanour

People with dementia can pick up on emotions, even if they struggle to comprehend specific details. Approaching interactions with a calm and positive attitude, using a warm and reassuring tone, can greatly impact the quality of communication. Your demeanour sets the tone for the conversation and helps create a safe space for your loved one to express themselves. It's important to maintain a gentle and friendly demeanour, even when you need to repeat information or answer questions multiple times.

Using Simple and Clear Language

Dementia affects language processing, making it challenging for individuals to understand complex sentences or questions. Therefore, using clear and concise language is essential when communicating with people with dementia.

To achieve effective communication:

Simplify your sentences: Keep your language simple by using short and familiar words, and utilise short sentences when conveying your message. Focus on one idea at a time, avoiding complex explanations or concepts that may confuse your loved one.
Break down instructions or requests: To facilitate understanding and follow-through, break down instructions or requests into manageable steps to help your loved one understand and follow along. Avoid using slang or jargon that may be unfamiliar to your loved one.
Allow ample time for processing: Give your loved one plenty of time to process the information. Speak slowly and clearly, emphasising key words and ideas. Although it may feel uncomfortable, provide more time than you would in a typical conversation. This allows your loved one to gather their thoughts and respond. Maintaining a calm and reassuring tone is crucial for effective communication.

Observing your loved one's reactions to key points in the conversation and focusing on their strengths can further enhance communication. It's important not to assume that a lack of verbal communication indicates a lack of understanding.

Maintaining Eye Contact and Utilising Non-Verbal Cues

Non-verbal cues, such as facial expressions and gestures, play a significant role in communication when words fail. Maintaining eye contact helps establish a connection, while facial expressions convey emotions and intent. Utilising gestures, nodding, gentle touches, or warm smiles can enhance understanding and create a sense of reassurance. Additionally, paying attention to your own body language is essential, as it can influence your loved one's comfort level and level of engagement.

Being Patient and Empathetic

Patience is crucial when communicating with someone affected by dementia. It's important to remember that they may struggle to articulate their thoughts or understand your words. Respond to their emotions and feelings, rather than the accuracy of their words. Be patient and resist the urge to finish their sentences, even though it may be tempting to do so. Allow your loved one ample time to process information and respond.

Put yourself in their shoes, recognising the frustration and confusion they may be experiencing.

Demonstrating patience and empathy creates a supportive environment that fosters effective communication.

Using Visual Aids and Memory Prompts

Visual aids, such as photographs, written cues, or memory books, can be powerful tools in facilitating communication. These aids act as prompts, providing a visual reference for your loved one. Incorporate photographs, picture books, drawings, or objects to promote engagement, reduce frustration, and assist in conveying messages.

Memory aids, such as calendars or whiteboards, can help with orientation and memory recall. Write down important information, schedules, or reminders in a prominent location within their living environment to provide visual cues and promote independence.

While technology can be a valuable tool for communication, it's important to carefully consider its suitability for your loved one. Some technology solutions may exacerbate confusion for individuals with dementia.

You could consider using Alexa, plus there are various apps designed specifically for individuals with dementia, such as memory aids, communication apps, and virtual reality experiences. Websites like Dementia UK provide information on technology resources suitable for individuals with dementia.

Utilising Reminiscence Therapy

Reminiscence therapy involves encouraging individuals to recall and share past memories. This technique can stimulate cognitive function and improve communication. Engage your loved one in discussions about their childhood, hobbies, or significant life events.

Visual cues can be used to help your loved one recall specific events or individuals. Incorporating photographs, drawings, objects, or memory boxes can trigger memories that hold personal significance and evoke shared memories, fostering meaningful conversations.

You can repeat this activity with the same favourite visual cue many times over, possibly even during the same conversation. Each time it will be a fresh trigger for your loved one and will contribute positively to their well-being.

The Alzheimer's Society offers valuable resources on reminiscence therapy.

Tailoring Your Questions

When appropriate, such as when deciding on meal options or choosing what to wear, ask closed questions that can be answered with a "yes" or "no" or with a limited number of choices. Open-ended questions can be overwhelming and may result in confusion. For example, instead of asking, "What would you like to wear?" ask, "Would you like to wear the blue shirt or the red one?" This technique facilitates decision-making and reduces cognitive load.

However, open-ended questions are helpful for encouraging your loved one to share their thoughts and memories. For example, instead of asking, "Did you enjoy your day?" ask, "What was the highlight of your day?" This promotes conversation and allows your loved one to express themselves more fully.

Being a Good Listener

Listening attentively is crucial for effective communication. Allow your loved one to express themselves at their own pace, showing patience and genuine interest. Listen not only to what they are saying, but what they are not saying. Avoid interrupting or finishing their sentences.

Focus on your loved one, refraining from carrying on a separate conversation with another person in their presence. Instead, reframe your conversation to enable your loved one's participation. Additionally, avoid discussing your loved one with another person in front of them.

Effective listening takes time and practice, but it enables you to monitor communication abilities and recognize any changes. Often, your loved one will seek understanding through your gestures, body language, facial expressions, and tone of voice if they are struggling with verbal communication. Observe their reactions and adjust accordingly.

Validating Emotions and Feelings

Individuals with dementia may experience heightened emotions and anxiety due to their cognitive decline. Validating their emotions and feelings can help alleviate distress. Show empathy and understanding, acknowledging their concerns. Assure them that you are there to support and listen, even if you cannot resolve every issue.

Focusing on the Present Moment

Dementia can make it difficult for individuals to remember recent events or maintain a coherent timeline. Instead of dwelling on the past or discussing future plans, focus on the present moment. Engage in activities that bring joy and comfort to your loved one, such as looking at photo albums or participating in their favourite hobbies.

Avoid Correcting or Arguing

Attempting to correct or argue with someone suffering from dementia can lead to frustration and agitation for both parties. Instead, practice acceptance and acknowledge their reality, even if it differs from your own. Redirect the conversation if they become fixated on a particular topic that may cause distress or confusion. Distraction techniques, such as introducing a new subject or engaging in a favourite activity, can help shift their focus to more positive and enjoyable experiences.

Maintaining Familiar Routines and Environment

Consistency and familiarity are crucial for individuals with dementia. It's important to maintain a structured routine and ensure their living environment remains familiar and comfortable. Sudden changes can increase confusion and distress. When communicating, try to avoid noisy or distracting environments that can disrupt focus and comprehension.

Seeking Non-Verbal Cues

Dementia often affects verbal communication, but non-verbal cues can effectively convey emotions and needs. Pay attention to facial expressions, body language, and gestures to understand your loved one's feelings and desires. Respond accordingly, providing comfort, reassurance, or assistance as required.

Seeking Professional Support

Dealing with the challenges of dementia can be overwhelming at times. Seeking professional guidance and support for both yourself and your loved one can offer invaluable assistance.

Numerous UK-based organisations offer resources, helplines, and support groups for caregivers and families. Connect with dementia support groups such as Dementia UK and the Alzheimer's Society, as well as carer support groups like Carers UK and Carers Trust. You can also join educational programs or consult with healthcare professionals specialising in dementia care.

Applying for a Carer's Assessment and arranging a Needs Assessment for your loved one with your local county council are important steps to take.

By implementing these strategies and seeking support, you can improve communication with your loved one and provide them with the care and understanding they need during their journey with dementia.

Making Time for You
Taking care of yourself on this journey is vital too. You might feel frightened, helpless, and frustrated at times. To continue your role as a caregiver, make sure you find ways to restore your energy, such as meditation, seeing a counsellor, or joining a support group.

Care-giving is a significant responsibility, and you shouldn't have to bear it alone. If you have siblings, other relatives, friends, or neighbours, call a family meeting to discuss your concerns and explore how they can support both you and your loved one.

Although you may not have much time for yourself between work, managing your own life, and your care-giving role and it is essential to try and spend a little more time with your loved one, but always make sure that you look after yourself, otherwise you cannot be an effective carer.