Dementia is a progressive neurological condition that can affect a person’s cognition, memory and language. When the brain is injured, through a stroke or disease, it’s called dementia. The most common form is Alzheimer’s. As it affects language, dementia can cause problems with communication.
How does dementia affect communication?
Dementia can affect communication in several ways – compromising memory, thinking, concentration and perception. This creates barriers in the ways a person living with dementia can express themselves and understand others. When carers don’t compensate for this, it can lead to frustration and anxiety.
Communication is made up of verbal and non-verbal expression. When we talk, we combine words with gesture, tone and facial expression. Dementia impairs the brain, making it difficult for a person to decode what they hear, as well as what they see. Sometimes the signal is crossed, or misinterpreted as it takes the brain longer to process the information.
How dementia affects communication:
Forgetting names of objects or people
Struggling to find the right vocabulary
Omitting or substituting words
Misinterpreting body language or tone of voice
This decline in communication can affect a person’s quality of life. Some people living with dementia may be unable to initiate conversation - so the responsibility to encourage this, is with carers. Fortunately, knowing how to communicate effectively with a person living with dementia, can vastly improve their quality of life.
How to communicate with someone living with dementia.
It is important to be empathetic, patient and respectful when talking to someone who is living with dementia. Holding a conversation can be difficult, as dementia affects a person’s ability to recall and process what is being said. These tips will help you communicate in a more meaningful way:
• Slow down
Being patient will help you communicate better with anyone who is living with dementia. Those with cognitive impairments need time to process their thoughts. By slowing down, you’ll create an environment where you both feel less stressed, more relaxed and able to express yourselves.
Often what a person living with dementia says and what they may understand are at a different ability level to what you might expect. This is where it's useful to understand the difference between receptive and expressive language. Receptive communication is how someone interprets what you're saying to them and expressive language is the words they use to communicate with you. Someone living with dementia may struggle with understanding what you're saying or expressing themselves. Receptive communication is the harder of the two to identify so it's important to remember that someone living with dementa may have difficulty processing what you're saying of doing.
• Non verbal communication
Dementia will often impair a person with demetia's verbal communication more than their visual communication so they may rely on other ways to communicate. This is where body language comes into play via facial expressions and gestures. Observing a person's body language can really aid understanding what they're trying to say.
Introduce yourself, keep your tone of voice calm and light. Be mindful of your physical presence. Standing over someone can feel intimidating, so drop down to their level. If it’s appropriate, offer a gesture of comfort and reassurance - like holding a hand - while you speak.
Try to understand the frustrations of communicating, which can be symptomatic of dementia. Adjust the way you speak to foster better relationships. Smile, nod, offer encouragement and remain calm and neutral when the conversation falters. Simplify your space by removing distractions from the room - this will make it easier for your companion to focus and express themselves.
For a person living with dementia, our usual communication style may be tricky to follow. Bouncy conversation, littered with idioms and metaphor can cause confusion. Keep the warmth, but simplify your words and ask simple questions. Stop frequently to allow them time to process and think. This will help limit feelings of frustration and reduce any associated poor behaviours. It's also important to avoid the common trap of falling into 'Elder speak' where you slow down the pacing of words, and increase your volume. Evidence shows that is more likely to be perceived negatively, come across as patronising, increase agitation and reduce understanding.
• Listen closely
One way we can all learn how to communicate better is to actively listen. People living with dementia sometimes struggle to express themselves. On occasion, it may not make sense. Pause for a moment, reflect on the meaning behind the words and paraphrase it back without judgement. Show you’re following what is being said by maintaining eye contact and nod encouragingly.
There are days your loved one will exhibit behaviours which are uncharacteristically aggressive. One way to keep calm is to ‘reframe’ negative situations. Acknowledge your own feelings first and take a moment to let them pass. Then consider what message is behind that behaviour. Are they tired? Have you asked too many questions? Take the emotion out of the situation by viewing conversation objectively, rather than critically.
• Use prompts
If you’re looking for ways to start a conversation with someone living with dementia, then consider objects and photos from happy events in their life. Sensory stimulation through touching objects, seeing photos or hearing familiar songs can be a great way to encourage talk.
• Avoid arguments
Memory deterioration and cognitive lapses mean communication can be difficult for people living with dementia. Testing memory, asking complex questions, or offering too much choice can trigger feelings of frustration. The consequence is your loved one may say something nonsensical or hurtful if they feel overwhelmed. Try to let negative comments pass without acknowledgment and take a moment for the heat of emotions to fade.
Many dementia charities in the UK offer advice and support. Knowledge can help you understand how the disease affects an individual, helping you to communicate in a better way. Find out more:
• The Carers Trust for support for carers
Curam carers understand the joy of communicating well with people who are living with dementia. Specialist dementia carers can improve the quality of life for you and your loved one, by providing hourly, respite or even live-in care. Read more about hiring a dementia carer or download the Curam App today.