What Is Dementia?
Dementia is described simply as symptoms that affect the communication, intellectual, and social functioning of an individual. It is a condition that affects the brain, which controls all functions of our body. It is not a specific disease; rather there are many causes of dementia. Alzheimer’s disease is the most common form of dementia.
If you’ve spent much time around anyone with dementia then you realize what an obstacle communication can be. I’m going to go over five things you should always remember when communicating with dementia patients.
A Safe Embrace
1. First, Get Their Attention
Your first step should be to get the person’s attention. Do this before trying to communicate with them, before approaching them, or touching them. Begin by saying the person’s name or what they are used to being called. For instance, if you’re speaking with your dad and he’s used to being called dad and responds to it, then make eye contact, smile, and say “Hi Dad, it’s me, Jane.”
Now if you’re speaking to your dad but he no longer answers to dad, say he answers to his first name of Robert, then use that instead. This provides the dementia patient with a certain amount of comfort as well. It let’s them know first you know them and who you are, second you’re friendly, and third you have something you want to say to them. Do this type of greeting before anything else.
So, approach from the front, make eye contact, smile, and greet. These things are key in beginning your communication with a dementia patient. If you startle them or they believe you’re unfriendly they can and often do immediately retreat and refuse to communicate with you.
How to Safely Shake Hands
2. Approach and Touch
After gaining their attention, all is going well, now you can approach, (always from the front where they can plainly see you), and give them a friendly pat or touch of some kind. A pat on the shoulder, a handshake, or a short embrace are all examples that demonstrate friendly behavior.
If you opt for a short embrace, try to remain side-to-side with the person. Even with proper approach and a seemingly receptive behavior, aggression can be displayed without warning. So when you’d like to give a short embrace to someone, remain shoulder to shoulder with them facing the same way, and use one arm to wrap around their shoulder for the embrace. This avoids making them feel smothered and keeps you from placing yourself in such a vulnerable position when embracing them from the front. A better option maybe shaking hands or just holding their hand for a bit.
If opting to shake or hold their hand, go for a thumb-to-thumb grasp instead of the common palm-to-palm. Many people with dementia have a tendency to squeeze very hard. If they have your knuckles in their grasp, this can be very painful, and make it difficult to break the hold. Communicating with a dementia patient can be unpredictable; always keep your safety in mind.
Communicating- Tell Me About It
3. Effective and Simple Communication
You’ve gained their attention. You’ve made sure they are listening to you with a greeting and small touch. It’s time for the actual communication. Remember use short simple directions and sentences.
Keep things short and simple so their minds are able to process. If they can understand what you’re telling them they are more likely to be receptive to it. It depends on the severity of the dementia as to how simple you should keep things.
Try NOT to ask them if they do or don’t want to do something when it’s a matter of importance. Such as grooming and bathing. Many elderly people with dementia hate to shower or bathe and would go completely without forever if they could. When communicating with them about bathing try these techniques.
- Don’t say: “Would you like to take your bath?”
- Don’t say: “You haven’t taken a bath for weeks. You need to go take your bath now.”
- Do say: “Let’s stand up.”
- Do say: “Let’s walk together to the bath.”
- Do say: “Let’s go to the bath.”
Implying that you’ll being doing this activity together helps get compliance from the other person. Doing something together is always more enjoyable than doing it by yourself. So using the term “let’s” instead of “you” is more effective. Go slow and steady and if the person begins to get agitated or violent, then back off and try again later.
So remember these things when communicating with dementia patients:
- Keep it short and simple as you can.
- Use the terms “let’s” and “we,” not “you.”
- Get on their level, don’t make them look up at you.
- Use slow hand motions to help indicate what you want them to do.
- Go slow and steady.
- If the person becomes agitated or violent, back off. Try again later.
Communicating with dementia patients can be very difficult at times, so always keep your own safety in mind.
More Tips For Dementia Behavior
4. Dealing With Confusion and Difficult Questions
People with dementia ask some very difficult questions and knowing how to handle that can be tricky. The way to handle these situations is to show you’re listening and that you do care. Do not try to reorient them to reality. For instance, if they are searching for their parents, telling them that their parents are deceased could cause a lot stress and agitation.
Saying they don’t drive anymore and that their car has been gone a long time may cause a violent outburst. The person generally will not remember any of this and it’s distressing to learn something so drastic may have happened and they don’t remember. Often times, they will just sit there and argue with you.
When communicating with a dementia patient, it’s important to remember not to argue with them. Distracting from the questions can sometimes be helpful but can be difficult to do. Offering them a snack, or performing an activity together may help to distract them from some of these distressing issues. Here are some examples of what to do when some of these questions arise.
Dementia Sufferer: “Where’s my mother? I can’t find my mother!”
You: “You’re looking for your mother?”
Dementia Sufferer: “Yes, I can’t find her!”
Here are some possible answers that could be very reassuring to the patient:
- “We will watch for her together. Why don’t you tell me about her.”
- “You miss your mother very much. Let’s have some ice cream while we wait for her.”
- “I haven’t seen her, but let’s have lunch while we wait.”
Acknowledge the problem, show understanding, and continue to show understanding until they calm down a little. Then attempt some distraction. Dementia is impossible to predict and sometimes none of these methods will work.
Dementia Sufferer: “I want to go home!”
You: “You are missing home?”
Dementia Sufferer: “Yes, I want to go home now!”
You: “Well, tell me about home. Where did you live?”
Dementia Sufferer: “Well, on a farm, yes on a farm.”
Here are some possible responses that could be very reassuring to the patient:
- “Oh, what animals did you have?”
- “Did you help on the farm?”
- “Did you buy a farm when you got older?”
Continue talking about “home” for awhile (even if you’re at home), until the person is calm and then engage them in some other activity.
Remember to acknowledge their problem, show understanding, and don’t argue with them. Allowing them to voice their feelings on the subject may help, gentle persuasion toward another topic or activity can help calm the agitation.
5. When Communicating isn’t Working
When you’ve tried the above methods, and communicating just isn’t working, try looking at other things that may be causing the agitated behavior. Addressing the person’s comfort level may help.
Addressing hunger, pain, temperature, bathroom needs, and illness is all very important. The dementia sufferer may not realize they are uncomfortable, they just become agitated.
Hunger – Often times a dementia patient will not ask for something to eat. Keeping a regular routine of breakfast, lunch, dinner, and a snack in between can help.
Pain – This is a big cause of agitation. Many times you can ask if they are hurting, and they’ll say no. But you may witness them rubbing a shoulder or knee joint and grimacing. Despite their answer, if you can see signs of pain, this should be addressed and may alleviate agitated behavior.
Temperature – A dementia patient will not always recognize the need to put on a jacket, or remove one either. If notice you’re loved one feels cold or hot, you should help make them more comfortable.
Bathroom – Maintaining a routine bathroom schedule is important. Dementia affects many reasoning processes in the brain, and a dementia patient may just feel uncomfortable and not recognize they need to use the bathroom. Gently guiding them to bathroom every few hours can be helpful.
Illness – An infection can cause severe behavior disturbances. Often times, you may notice a sudden persistent change in the person’s behavior, with no real cause. For example, a urinary tract infection is often the cause of major behavior changes.
Remember, when communicating with a dementia patient, comfort is very important to the patient’s positive participation.
Final Thoughts
Keep in mind that these techniques will not always be successful. Starting your communication off on the right foot really helps in maintaining a good relationship and effectively caring for the individual. Always keep your safety and theirs in mind!