Editor’s Note: Almost all of us have either been (or will be) touched by dementia/Alzheimer’s at some point, or know someone who has. It’s a difficult, frustrating condition for the person experiencing it, their family, and caregivers. We’re grateful to our author for sharing her personal experiences and first-hand information in the interest of helping others on this path.
My great-grandmother suffered from Alzheimer’s before she passed away at 99 years old. My mother was diagnosed with the early stages of dementia a few years back, and it has progressed in what seemed like such a brief amount of time. Helping loved ones or anyone with dementia comes with numerous challenges. Not only does the person with dementia struggle, but family, friends, and caregivers do too.
What Is Dementia
I used to think dementia was a disease, but I was wrong. Many long nights and hours of research have taught me a lot. As has my personal experience.
According to Mayo Clinic, dementia is not a specific disease but a group of conditions characterized by the impairment of at least two brain functions. For instance, judgment and memory loss. Forgetfulness, limited social skills, and thinking abilities become so impaired that it interferes with normal daily functioning.
Medication and therapies are available to help manage the symptoms, with some reversible causes. Unfortunately, when the damage or reason is irreversible, time slips away, so get as much time in with your loved ones.
People dealing with dementia from conditions like Alzheimer’s and related diseases have a progressible biological brain disorder, making it more and more challenging to think clearly, remember things, communicate with others, and take care of themselves. Dementia can cause intense mood swings and even change someone’s behaviors and personality.
10 Tips For Better Communication With Someone That Has Dementia
Communication is such a massive part of life. Unfortunately, we aren’t born with the knowledge of how to best communicate with someone with dementia, but there’s no better time to learn. People with dementia struggle with communication because they lose thoughts and words that were just at the tip of their tongue. Let’s talk about how improving our communication skills can enhance our ability to handle problematic behaviors and, more importantly, continue forward with a healthy, happy environment for all.
1: Set A Positive Vibe or Mood For Interactions
Our attitude and body language communicate our feelings and thoughts more powerfully than words spoken. Speaking to our loved ones in a pleasant and respectful tone helps set the mood. It’s essential that we use proper facial expressions, uplifting tones of voice, and physical touch to convey our message and show them our feelings of affection.
2: Getting Their Attention
Limit noise and distractions when communicating. Turn off the television or radio, close the door, shut the curtains, or move to quieter surroundings. Before speaking, we should ensure we have our loved ones’ attention. We can address them by name, identify ourselves using our name or relation, and use nonverbal cues and touch to help them remain focused. If they’re sitting down, we must get down to their level to maintain eye contact.
3: Keep Communication Clear
We have to keep our words and sentences simple and straightforward. We should speak slowly and distinctly, using a reassuring tone. It’s best to refrain from raising our voice louder or higher; instead, we should lower the pitch of our voice. When my mom doesn’t understand what I said the first time, I make sure to use the exact wording over again to repeat the question or message. If she still doesn’t understand, I’ll give it a minute or so and rephrase the question more straightforwardly. We should use the names of people and places rather than pronouns because they can become confusing.
4: Ask Simple & Answerable Questions
Just because our brain can keep up doesn’t mean theirs will. We must stick to asking one question at a time rather than a few at once. Avoid asking open-ended questions or providing too many choices. Also, if asking a question with options, it’s best to have visual prompts or cues that help clarify our question and guide a response.
5: Listen With Ears, Eyes, and Heart
We HAVE to be patient with people dealing with dementia. When waiting for a reply or response, we have to be as patient as possible. If they struggle with an answer, it’s good to suggest words. Keep a mindful eye on nonverbal cues and body language. It’s crucial that we respond correctly. ALWAYS try to listen for their words’ meaning and underlying feelings. Always consider how it might feel if the shoe was on the other foot.
6: Break Activities Down Into A Series of Steps
Many tasks are more manageable when we break down the steps into simple processes. We should encourage our loved ones to do whatever they can and gently remind them of the steps we know they tend to forget. When we notice there are steps someone can no longer accomplish on their own, we should step in and assist. Use cues like showing them with your hands where to place the clean dishes or how to operate something.
7: Distract & Redirect
When little ones become flustered, we’re often taught as parents to distract and redirect them. The same goes for people with dementia. It is easy for them to get worked up and flustered. So when we notice that happening, we should try to change the subject or environment to help keep them from becoming agitated or upset. If I notice my mom getting irritated and struggling with communication, I always connect with her on an emotional level by explaining that I see she’s feeling some kind of way. Then I will try to redirect things in a more positive direction, whether changing the subject, offering to play a game, or listening to some oldies.
8: Respond With Reassurance & Affection
Confusion, anxiety, and feeling unsure about themselves are common for people with dementia. They can often confuse reality, sometimes remembering things that never really happened. It’s best to avoid convincing them they’re wrong about it. We need to remain focused and respond with verbal and physical expressions full of support, comfort, and reassurance. Sometimes, the little things, like holding their hands, hugging, touching, and praising them, get our loved ones to respond when nothing else seems to work.
9: Take Trips Down Memory Lane
Just because people with dementia struggle with memory issues doesn’t mean we should stop remembering the good old days of the past. While my mom can’t always remember what she was saying mid-sentence or something that happened 45 minutes ago, she can clearly recall events that took place years ago. That being said, we should avoid asking questions that depend on short-term memory so often.
10: Keeping A Sense of Humor
We should use humor whenever we can, but not at our loved one’s expense. After all, they say laughter is the best medicine. Those dealing with dementia tend to retain social skills and are generally delighted to laugh with us.
Dealing With Troubling Behavior
Some of the most difficult challenges of caring for a loved one with dementia are frequent behavioral and personality changes. Creativity, patience, compassion, and flexibility are the best ways to face said challenges. It’s also helpful that we don’t take things personally and maintain that sense of humor we talked about.
It’s extremely helpful to remember that we can’t change people. Our loved ones or the people we care for have a brain disorder that ultimately shapes who they are and have become. If we try to control or change their behavior, we will most likely be unsuccessful or met with intense resistance.
Try To Accommodate Behaviors Rather Than Control Them Suppose someone insists on sleeping on their floor rather than in their bed. We can put a mattress on the floor to help make them more comfortable rather than trying to stress or fight them to sleep elsewhere.
We Can Change OUR Behavior & Physical Environment Changing our behaviors can often cause a change in our loved one’s behavior. It’s like leading by example.
Talk To Their PCP Primary Care Physician Before we try to address behavior issues, it’s best to check with your loved one’s doctor first. Behavioral problems sometimes have an underlying medical reason. It could be that they’re in pain or struggling with the adverse effects of medications. In situations like incontinence or hallucinations, there are some medications or treatments to help manage the problem.
Behaviors Have A Purpose or Reason People with dementia can’t always tell or explain what they want or need. Maybe you find them taking all of their clothes out of their closet on a daily basis, leaving us to wonder why. Most likely, the person is trying to fulfill the need to be busy and feel productive. It’s vital that we always consider what needs our loved ones might be trying to meet through their behaviors. When it’s possible, we should accommodate them accordingly.
Behaviors Are Triggered We have to understand that all behaviors are triggered, occurring for some reason or another. It could be something we did or said that triggers the behavior, or maybe a change in their physical environment. The root of these changing behaviors is to disrupt our created patterns. We have to take a different approach or try other methods of explaining the potential consequences of actions.
What Works Today, Doesn’t Always Work Tomorrow Because multiple factors influence dementia patients’ troubling behaviors and the natural progression of the disease process, what solutions we find to be effective today might need to be modified tomorrow. And sometimes, the techniques may no longer work at all. The key to managing challenging behaviors lies in being flexible and creative with our strategies for addressing issues.
There are various dementia-associated behaviors. Below you’ll find the behaviors and suggestions that can be useful for handling them.
Wandering There have been many “Silver Alerts” issued throughout the years. This is because people with dementia tend to walk aimlessly for various reasons, including medication side effects, boredom, or because they’re looking for something or someone. In some cases, they’re trying to fulfill a physical need like hunger, thirst, or exercise. Finding out the triggers of dementia patients wandering isn’t always easy. However, the triggers can provide insights into dealing with the wandering behavior.
- Set time aside for regular exercise to minimize any restlessness.
- Install locks with a key to keep loved ones from wandering unknown; keep fire safety in mind.
- Install security or monitoring systems to help keep an eye on those when you’re in another room.
- Have your loved one or patient wear an ID bracelet so they can be identified if they are lost.
- Mask doors with a curtain or streamer to keep them from leaving.
- Keep the person’s essential items up. Things they wouldn’t leave the house without.
These techniques are designed to keep dementia patients from leaving to wander the area.
Incontinence As dementia progresses, the loss of bowel or bladder control often occurs. Accidents can result from environmental factors, like someone forgetting where the bathroom is, or they can’t get to it on time. When accidents happen, our understanding and reassurance help our loved ones maintain their dignity and minimize embarrassment.
- Get a routine established for toilet time. We can try to remind loved ones or help them to the bathroom every couple of hours.
- Scheduled fluid intake can help ensure dementia patients don’t become dehydrated. Also, limit fluid intake during the evening before bedtime.
- Put signs on the door to help your loved one know which door is the bathroom in case they become confused.
- Easy-to-use clothing with velcro, strings, or straps can help dementia patients struggle with getting onto the toilet in time.
- Incontinence pads and underwear keep laundry clean, and it’s easier to clean up.
Agitation Agitation deals with a range of behaviors associated with dementia, including sleeplessness, irritability, and physical or verbal aggression. Usually, these behavior problems progress with the stages of dementia, from mild to severe. A dementia patient’s agitation can be triggered by various things, like fear, fatigue, stress, and environmental factors. More often than not, agitation is triggered when they feel their control is being taken away.
- Reduce clutter, noise, and the number of people in a space.
- Keep the same routines to maintain structure. Avoid moving furniture and household objects. Familiarity provides a pleasant and comfortable environment.
- Limit or reduce sugar, caffeine intake, and foods that lead to spikes in energy levels.
- Use gentle touches, soothing music, quiet reading, and walks to ease agitation. Speak in reassuring tones, and don’t restrain someone while dealing with a period of agitation; it only makes it worse.
- Keep any dangerous objects out of reach.
- Allow your loved ones to do as much as possible, and support their independence and ability to care for themselves.
- Always acknowledge confused people’s anger over the loss of control in their life. Relate as much as possible, and let them know you understand the frustration they’re experiencing.
The list goes on with problematic behavior, and those behaviors can change at the drop of a dime. One of the things I have personally found helpful is to remain patient and remind myself how it might feel if I were the one dealing with it. After all, it can be genetic. I would hope that if a day came when I am dealing with dementia, someone close to me would take the time to understand what’s happening to me and love me patiently, regardless.
My best suggestion to you all is to do your research, find support groups, and do the best you can for your loved ones while they’re here with us. You never know which day might be the last.