A person with Alzheimer’s disease may no longer have the ability to express his/her wants or needs. It can be frustrating for a caregiver to communicate with and understand the person in order to give appropriate assistance. These tips for communication may help:
Don’t: Use baby talk.
- Do: Use simple words and short sentences; talk in a gentle, calm tone. Be respectful!
Don’t: Talk about the person as though they weren’t there.
- Do: Include the person in conversation by using his/her name and making eye contact. Redirect the conversation to a topic the person knows and enjoys.
Don’t: Be impatient or make fun of inabilities and/or disconnected comments.
- Do: Allow time (at least 90+ seconds) for a response. Frame instructions simply and in a positive way. Avoid asking questions that will embarrass, such as “How many children do you have and what are their names?” or “what is your address and phone number?’ Show interest and be open to concerns the person may be trying to express.
Don’t: Ignore or trivialize memories (even if they may be confused).
- Do: Engage the person in reminiscence activities, such as remembering childhood, school days, favorite job, or popular music; In other words, talk of happier times in the past which are less stressful than the present. Validate feelings of frustration and sadness with comments, such as “I understand you feel frustrated and I’m sorry” rather than “I know what you are feeling, but it can’t be helped.”
Don’t: Interrupt or monopolize the conversation.
- Do: Offer a word if the person is stuck, but allow them to continue their train of thought when they are interested in talking. Give prompt words or ideas then allow the person to elaborate as much as they are able.
Don’t: Allow noise and other distractions to interfere.
- Do: Turn off TV, radio, and give full attention to the person.
Don’t: ARGUE!
- Do: Remember the person has a disease that affects thinking processes, memory, and articulation. Positive communication can help to reduce feelings of frustration, fear, anger, anxiety, isolation, and agitation that the individual may be experiencing. Validate the person. Reassure them that you care. Listen to responses for cues and ways to improve concerns. Arguing serves NO good purpose; it only increases negative feelings and behaviors. Arguing does NOT change the fact that your loved one has dementia.
I am an experienced caregiver, both informally (to my Dad and grandma) and formally (35+ years in private, home health, assisted living, nursing home, and psychiatric ward settings). The most important word of advice I can give for positive communication, and I stress this: Enter the world of the person with Alzheimer’s disease (any form of dementia). If the person doesn’t remember eating breakfast 10 minutes ago, it’s okay to feel frustrated, but don’t argue that you just cooked eggs, bacon, and pancakes, made a mess in the kitchen, served them seconds, and they should feel full; if the person says you haven’t helped them all day, it’s okay to feel frustrated, but don’t argue that you just finished bathing, shaving, and dressing them; if the person is worried about finding his daddy, it’s okay to feel frustrated, but don’t argue that his dad died an old man 25 years ago and that he spoke at the funeral; and if the person says “You aren’t MY daughter” in an angry tone, it’s okay to feel sad and to grieve over the loss you feel, but don’t argue that because you are preventing him from leaving the house to walk in the snow in his underwear and bare feet after midnight means you are no longer his daughter. And when the person with Alzheimer’s disease tells you he loves you and is proud of you and smiles when you help him put on his shoes and reaches for your hand on a walk, don’t take it for granted or forget it.
~Tamara Nixon, BS, CHES
Related articles:
Alzheimer’s Association (n.d.). Communication and Alzheimer’s. Retrieved June 1, 2014, from http://www.alz.org/care/dementia-communication-tips.asp#helping
De Vries, K. (2013). Communicating with older people with dementia. Nursing Older People, 25(4), 30-38. Retrieved from http://web.b.ebscohost.com.library.capella.edu/ehost/detail?vid=4&sid=ef984bf3-f8fd-4113-8661-b4ff76da7490%40sessionmgr198&hid=118&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=ccm&AN=2012101430
Green, D. (2012). Communication and cognitive impairment. Nursing & Residential Care, 14(9), 446-449. Retrieved from http://web.b.ebscohost.com.library.capella.edu/ehost/detail?vid=4&sid=ef984bf3-f8fd-4113-8661-b4ff76da7490%40sessionmgr198&hid=118&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=ccm&AN=2011696205
Haak, N.J. (2002). Maintaining connections: understanding communication from the perspective of persons with dementia. Alzheimer’s Care Quarterly, 3(2), 116-128. Retrieved from http://web.b.ebscohost.com.library.capella.edu/ehost/detail?vid=4&sid=ef984bf3-f8fd-4113-8661-b4ff76da7490%40sessionmgr198&hid=118&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=ccm&AN=2002078178
Wilson, R., Rochon, E., Leonard, C., & Mihailidis, A. (2012). Formal caregivers’ perceptions of effective communication strategies while assisting residents with Alzheimer’s disease during activities of daily living. Canadian Journal of Speech-Language Pathology & Audiology, 36(4), 314-331. Retrieved from http://web.b.ebscohost.com.library.capella.edu/ehost/pdfviewer/pdfviewer?sid=ef984bf3-f8fd-4113-8661-b4ff76da7490%40sessionmgr198&vid=5&hid=118