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Losing the ability to communicate can be one of the most frustrating and difficult problems for people with dementia, their families and carers. As the illness progresses, the person with dementia gradually loses their ability to communicate. They find it more and more difficult to express themselves clearly and to understand what others say.
Some changes in communication
Each person with dementia is unique and the difficulties experienced in communicating thoughts and feelings are different for each individual. There are many causes of dementia, each affecting the brain in different ways.
Some changes you might notice in the person with dementia include:
- They may have difficulty in finding a word. A related word might be given instead of one they cannot remember.
- They may talk fluently, but not make sense.
- They may not be able to understand what you are saying or may only be able to grasp part of it.
- Writing and reading skills may deteriorate.
- They may lose the normal social conventions of conversation and interrupt or ignore a speaker or fail to respond when spoken to.
- They may have difficulty in expressing emotions appropriately.
Where to begin
It is important to check that communication problems are not due to impaired vision or hearing. Glasses or a hearing aid may help some people. Check that hearing aids are functioning correctly and glasses are cleaned regularly.
There are many aspects to communication
Carers need to pay attention to how they present themselves to the person with dementia. Communication is made up of three parts:
- 55 per cent is body language, which is the message we give out by our facial expression, posture and gestures.
- 38 per cent is the tone and pitch of our voice.
- 7 per cent is the words we use.
These statistics highlight the importance of how families and carers present themselves to a person with dementia. Negative body language, such as sighs and raised eyebrows, can be easily picked up. There are a number of approaches you can use to communicate positively with a person with dementia, to make yourself understood and to show you care for them.
Caring attitude
People retain their feelings and emotions even though they may not understand what is being said, so it is important to always maintain their dignity and self- esteem. Be flexible and always allow plenty of time for a response. Where appropriate, use touch to keep the person’s attention and to communicate feelings of warmth and affection.
Ways of talking
When you talk to a person with dementia:
- Remain calm and talk in a gentle, matter-of-fact way.
- Keep sentences short and simple, focusing on one idea at a time.
- Always allow plenty of time for what you have said to be understood.
- It can be helpful to use orienting names or labels whenever you can, such as ‘your son Jack’.
Body language
You may need to use some hand gestures and facial expressions to make yourself understood. Pointing or demonstrating can help. Touching and holding the person’s hand may help keep their attention and show them that you care.
The right environment
When communicating with a person with dementia, try to:
- Avoid competing noises, such as TV or radio.
- Stay still while you are talking. This makes it easier for the person with dementia to follow what you are saying.
- Maintain regular routines – this helps to minimise confusion and can assist communication.
- Keep a consistent approach. It is much less confusing for the person with dementia if everyone uses the same style of communication. Repeating the message in exactly the same way is important for all the family and all the carers.
What NOT to do
Try not to do any of these things:
- Don’t argue with the person. It will only make the situation worse.
- Don’t order the person around.
- Don’t tell the person what they can and can’t do. Instead, state what they can do.
- Don’t be condescending. A condescending tone of voice may be picked up, even if the words are not understood.
- Don’t ask a lot of direct questions that rely on a good memory.
- Don’t talk about people in front of them as if they are not there.
Adapted from Understanding difficult behaviours, by Anne Robinson, Beth Spencer and Laurie White.
Tips from a person with dementia
Christine Boden was diagnosed with Alzheimer’s disease at age 46. She now lives with a re-diagnosis of frontotemporal dementia, made when she was 49. She has shared a number of her insights about ways family and carers can help a person with dementia. Christine is also the author of Who will I be when I die?, which was the first book written by an Australian with dementia.
Here are some of Christine’s suggestions for communicating with a person with dementia:
- Give us time to speak. Wait for us to search around that untidy heap on the floor of the brain for the word we want to use. Try not to finish our sentences. Just listen, and don’t let us feel embarrassed if we lose the thread of what we say.
- Don’t rush us into something because we can’t think or speak fast enough to let you know whether we agree. Try to give us time to respond and to let you know whether we really want to do it.
- When you want to talk to us, think of some way to do this without questions, which can alarm us or make us feel uncomfortable. If we have forgotten something special that happened recently, don’t assume it wasn’t special for us too. Just give us a gentle prompt – we may just be momentarily blank.
- Don’t try too hard to help us remember something that just happened. If it never registered, we are never going to be able to recall it.
- Avoid background noise if you can. If the TV is on, mute it first.
- If children are underfoot, remember we will get tired very easily and find it very hard to concentrate on talking and listening as well. Maybe one child at a time and without background noise would be best.
- Earplugs may be useful if visiting shopping centres or other noisy places.
Where to get help
- Your doctor
- Your local community health service
- Your local council
- National Dementia Helpline Tel. 1800 100 500
- Carer Respite Centres Tel. 1800 059 059
- Carer Resource Centres Tel. 1800 242 636
- Aged Care Assessment Services – contact your regional Department of Human Services office
- The Aged Care Information Line Tel. 1800 500 853
Things to remember
- Losing the ability to communicate can be frustrating and difficult for people with dementia, their families and carers.
- Positive communication can help a person with dementia maintain their dignity and self-esteem.
- A caring attitude, use of appropriate body language and the right environment are all important aspects of communication.
- Be flexible and allow plenty of time for a response.
You might also be interested in:
Dementia - carers and activities.
Dementia - caring for someone who lives alone.
Dementia - different types.
Dementia - early planning will help.
Dementia - how carers can help with dressing.
Want to know more?
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