Communicating With a Person Who Has Dementia Takes Skill, Heart
Communicating with someone who has dementia can be an ever-changing challenge. But some things never change. One of those constants is that caregivers and friends must fully understand and accept that the person with dementia is not a child any sense of the word.
Dementia may have robbed our friends or loved ones of their ability to understand their own environment, follow a sequence of directions or even understand how to use the toilet. These issues do not in any way make these people less than adults and they should never be treated as such. Treating our elders with respect and dignity means understanding that lost cognitive ability doesn’t take away their adulthood. Elders have lived a lifetime and have left a legacy – some more admirable than others. However, nothing they have done or not done during their lives turns them into overgrown children.
Using respect as the basic foundation of our communication, we then need to learn not to argue with our loved one. People with dementia aren’t being stubborn or forgetful on purpose. Their world as they see it is just as real to them as ours is to us. It’s up to us to join them in their world. Agree with them if possible even when they make what seems to be an outrageous statement. This approach is referred to as the validation method. A geriatric social worker named Naomi Feil is credited with medically pioneering the validation method during the 1980s and it has gained traction because it works.
Another way to communicate with people with dementia is reminiscing. Old movies and music from the person’s youth or young adulthood can bring significant pleasure to any elder, but for someone with short-term memory loss, there is an extra appeal. The movies, music or even photos that they saw or heard during their youth are likely representative of their most intact memories.
Touching through massaging a soothing lotion into a person’s skin or even just holding his or her hand can be a powerful way to communicate caring and love. Look the person in the eye, as well.
A soft voice, slower movements and quiet body language all help. The reverse – jerky or aggressive movements, a strident voice or rough touch – may be upsetting. Caregivers and visitors need to watch their body language around vulnerable people, because our stress levels can easily be communicated to the person we are trying to help. Using positive coping measures to handle our own stress can make these softer movements much more natural.
Challenging questions for caregivers and how to answer
An article in the Washington Post written, by Janice Lynch Schuster, offers some words of wisdom taken from an interview with Naomi Feil about employing the validation method in even very sticky situations.
- People with dementia, particularly Alzheimer’s, can suffer from paranoia. Additionally, they often forget where they left certain possessions. If they gave something away, they may forget that they did so willingly, long ago, and feel now that the object was stolen. How do you cope with that when you can’t “agree” that the item was stolen? Feil suggests “…that in these cases, patients are really saying, ‘I’ve lost my youth, my husband, my money, my power, my control.’ It’s a coping method, blaming others.’ Feil…recommends listening and allowing emotions to be expressed. “Try reminiscing about the object, the time or place or people it represented,” she says.
- Another problem caregivers often face is that the person with dementia continually asks to “go home.” This home is not likely the house where the person last lived. Home represents safely, or perhaps a childhood environment. Feil’s suggests that caregivers respond to the words “I want to go home,” with questions such as “Where would you like to go?” “Who do you want to see the most?” “What would you do first?”
- If the elder is wondering about a long-dead friend or relative, Feil says to ask “When did you last see him?” “What did he say to you?” She suggests that caregivers talk about that person and reminisce.
Try validation if you are new to caregiving or even just visiting with someone who has dementia. Also, use gentle touch, music, DVDs – anything that brings pleasure and helps you connect with your friend or loved one. You can communicate with someone who has dementia. You simply need to learn some new skills and then follow your heart.
Schuster, J.L. (2013, April 8) Dementia makes communication difficult, but some steps can make it easier. Washington Post. Retrieved from http://www.washingtonpost.com/national/health-science/dementia-makes-communication-difficult-but-some-steps-can-make-it-easier/2013/04/08/abd17de8-fd04-11e1-a31e-804fccb658f9_story.html
Abrahms, S. (2011, October 17) Restoring Memory Through Movies. AARP.org. Retrieved from http://www.aarp.org/entertainment/arts-leisure/info-10-2011/movies-help-alzheimers-dementia-sufferers.html?cmp=NLC-RSS-DAILY-BULLETIN
Utah State University. (2013, January 8) Caregiver Coping Strategies Predict Cognitive and Functional Decline in Dementia: The Cache County Dementia Progression Study. Published in the January 2013 issue of The American Journal of Geriatric Psychiatry.