Ways to Encourage Communication

Giving People with Alzheimer's a Voice

Everyone who works in the field of healthcare, knows the importance of including the opinions of patients in the delivery of care and treatment. This feature of healthcare is especially important for people who have long term, chronic and often progressive diseases. In such a situation, the need to have some measure of control over what we want to happen and how we would like to be looked after, gives us a level of control and autonomy.

When someone is suffering from a degenerative neurological disease like Alzheimer's, the ability to communicate their wishes can be adversely affected.  The fact that consultation can be difficult must not stop caregivers and health workers including dementia sufferers in decision making for as long as seem practicable.

Inclusion in decision making has a number of positive effects. It promotes wellbeing, helps maintain skills, allows the expression of emotion, helps enhance and maintain relationships, increases cooperation with others and helps minimize frustration and aggression.

Research shows us that, given the right support, people with dementia can and will express opinions about services. Although communication may be patchy and inconsistent, the spirit of what the person is trying to say is frequently easy to follow. Different approaches at different times and in different circumstances are needed that uses verbal and non verbal forms of communication.

There are a number of important issues that help promote inclusion and give people with Alzheimer's a voice. These are:

• Positive staff relationships.
• The use of other senses to aid communication by using sensory rather than cognitive pathways.  Resources such as carefully chosen pictures, word cards and objects can be helpful for stimulating conversation and interaction for some people.
• Encouraging people to talk about their care in an indirect way sometimes works better than asking people direct questions. So, for example, speculating on what another person's opinions might be, allows them to criticize services they may have felt unable to do in the first person.
• Staff need help to recognize their existing skills and knowledge to enhance their confidence. This can be done by encouraging staff to talk about their experiences, ideas and feelings regarding communication. Including time for reflection and discussion within the daily routine has to be built into health workers day.

A major obstacle is that the very places that provide care for people with chronic illnesses and elder care are often the most difficult environments within which to undertake communication and empower people with dementia. It's easy to plug gaps in the system with more work. The creative act for managers is to find both the time & the motivation to focus on communication with those who find it the hardest to communicate. This takes dedication, commitment, insight and a high level of individual awareness. Over to you!