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Communicating in the Dementia World
The creating moments of joy caregiving strategy is practical and successful. Positive thinking is beneficial in all family relationships, and this is never more evident than when dementia enters the picture. Communications with our loved ones should be based on this premise. Our goal is to create joy, to create a better day.
When we adopt a positive attitude, the mood is often contagious. We are more likely to use a friendly tone of voice, provide comfort and security, and show interest and respect. We can help loved ones avoid feelings of anger, sadness, being alone, or being scared. Everyone wants to feel loved and needed. With a positive attitude and the way in which we communicate it, we can help achieve all these things.
Our verbal communications are complemented by physical contact. Touching and hugging reinforce connection and concern. We rekindle warmth by looking into their eyes with a twinkle in our own. When loved ones are sad, don’t ask them what’s wrong. It will only make things worse. Touch them, and say, “I am sorry. That shouldn’t have happened.” Do not try to figure out their story; focus on their feelings and give them comfort.
Communication Tips
Over time, dementia destroys communication skills. Reading, writing, listening, and speaking are all affected. Here are some suggestions for dealing with this reality.
People with dementia are exceptionally sensitive. Be careful about what you say and, even more, about how you say it.
Chat about long-term memories, not short-term memories.
Give people with dementia time to explain themselves, because they need to search for words that are evading them.
During the early stage, it is beneficial to have their friends engaged as visitors, on phone calls, or by sending uplifting cards or notes. These all reinforce your loved one’s feelings of relevance.
Asking your loved one to make long-term commitments will not work, because this will invariably be forgotten. Don’t expect the impossible.
Leaving notes as reminders can sometimes help in the early stage of dementia, but as the disease progresses, this will no longer work.
Expect loved ones to stop initiating conversations. They are waiting for you to do so.
Before dementia appeared, honesty was the best policy. Now, therapeutic lying can solve problems and reduce stress. Remember that what is said will not be remembered tomorrow – or perhaps in five minutes. Your goal is to create joy now.
If your loved one is content or engaged, savor the moment.
Giving options often causes problems: “Would you like a walk in the garden or to watch a movie?” produces frustration and confusion. Just go to the garden and try to enjoy it.
People with dementia often say they want to go home even when they are home. What they really mean is they are uncomfortable and want to be more comfortable and secure. Help them relax and give them a reason to stay wherever they are. Show that you care.
Do not say, “Do you remember?” Usually, they don’t.
When dementia progresses, there are long pauses during which words cannot be summoned. Initially, it may be impolite to interject the missing words, but eventually this will provide welcome relief for everyone.
As dementia advances, it’s our duty to turn our questions around so all they have to say is yes or no.
Over time, short term memory loss progresses to an inability to process and comprehend new information. The old saying that “it goes in one ear and out the other” is replaced by it never went in the first ear. Our skills in non-verbal communication become essential.
Eventually, caregivers must carry the entire burden of conversations. Monologues become common and demanding.
There is nothing wrong with allowing longer periods of silence to take place. This, too, will be forgotten.
Dealing with Conflict
No matter how careful and conscientious you are, there will be differences of opinion. It is unavoidable and never fun. But there are some actions you can take to reduce the discomfort.
If your loved one is confused and afraid, give them comfort and encouragement. Remind them you are there for them.
When there are conflicting opinions, being logical and rational will not work. A person with dementia is driven by emotions, not reality. Acknowledge your loved one’s feelings and let them know you understand (“I can see why you feel that way.”)
It is best if you can nudge the emotions in a more favorable direction. When possible, change the subject and avoid the conflict. Redirect the conversation to something they like to talk about.
Stay calm and be patient. Keep your own emotions in check. Choose your battles wisely. Prioritize.
It is a good idea to always have in mind several topics that are favorite subjects your loved one likes to talk about. Ask them to tell you one of the stories you are bored to death hearing about. They will relish having the opportunity to talk about something they are comfortable with, and you can avoid an argument.
Sometimes it makes sense to just agree with them. There often are differences of opinion in which people with dementia are clearly wrong. But when that is the case, does it really matter who wins an argument? In either case, your loved one will forget the discussion, let alone who won the argument. Why not just agree, drop the issue, and proceed as if it never happened?
Other times, it may make sense to just leave the room. Time for a bathroom break! By the time you return, the issue may have been forgotten.
When necessary, seek help by involving a third party. Your doctor, another professional, or a friend may be able to help resolve major issues.
Remember that you have loved them for years for lots of reasons. They didn’t want dementia either.
Communicating with someone who has dementia isn’t easy, but there are moments of lightheartedness. When you can find these moments and focus on staying positive, it will go a long way in breaking up the tedium and helping you create moments of joy.
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