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Dementia - communication issues

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Losingtheabilitytocommunicatecanbeoneofthemostfrustratinganddifficultproblemsfor
peoplewithdementia,theirfamiliesandcarers.Astheillnessprogresses,thepersonwith
dementiagraduallylosestheirabilitytocommunicate.Theyfinditmoreandmoredifficultto
expressthemselvesclearlyandtounderstandwhatotherssay.
Some changes in communication
Eachpersonwithdementiaisuniqueandthedifficultiesexperiencedincommunicatingthoughts
andfeelingsaredifferentforeachindividual.Therearemanycausesofdementia,eachaffecting
thebrainindifferentways.
Somechangesyoumightnoticeinthepersonwithdementiainclude:
Theymayhavedifficultyinfindingaword.Arelatedwordmightbegiveninsteadofonethey
cannotremember.
Theymaytalkfluently,butnotmakesense.
Theymaynotbeabletounderstandwhatyouaresayingormayonlybeabletograsppartofit.
Writingandreadingskillsmaydeteriorate.
Theymaylosethenormalsocialconventionsofconversationandinterruptorignoreaspeakeror
failtorespondwhenspokento.
Theymayhavedifficultyinexpressingemotionsappropriately.
Where to begin
Itisimportanttocheckthatcommunicationproblemsarenotduetoimpairedvisionorhearing.
Glassesorahearingaidmayhelpsomepeople.Checkthathearingaidsarefunctioningcorrectly
andglassesarecleanedregularly.
There are many aspects to communication
Carersneedtopayattentiontohowtheypresentthemselvestothepersonwithdementia.
Communicationismadeupofthreeparts:

55percentisbodylanguage,whichisthemessagewegiveoutbyourfacialexpression,
postureandgestures.
38percentisthetoneandpitchofourvoice.
7percentisthewordsweuse.

Thesestatisticshighlighttheimportanceofhowfamiliesandcarerspresentthemselvestoaperson
withdementia.Negativebodylanguage,suchassighsandraisedeyebrows,canbeeasilypicked
up.Thereareanumberofapproachesyoucanusetocommunicatepositivelywithapersonwith
dementia,tomakeyourselfunderstoodandtoshowyoucareforthem.
Caring attitude
Peopleretaintheirfeelingsandemotionseventhoughtheymaynotunderstandwhatisbeingsaid,
soitisimportanttoalwaysmaintaintheirdignityandself-esteem.Beflexibleandalwaysallow
plentyoftimeforaresponse.Whereappropriate,usetouchtokeepthepersonsattentionandto
communicatefeelingsofwarmthandaffection.
Ways of talking
Whenyoutalktoapersonwithdementia:

Remaincalmandtalkinagentle,matter-of-factway.
Keepsentencesshortandsimple,focusingononeideaatatime.
Alwaysallowplentyoftimeforwhatyouhavesaidtobeunderstood.
Itcanbehelpfultouseorientingnamesorlabelswheneveryoucan,suchasyourson
Jack.

Body language

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Youmayneedtousesomehandgesturesandfacialexpressionstomakeyourselfunderstood.
Pointingordemonstratingcanhelp.Touchingandholdingthepersonshandmayhelpkeeptheir
attentionandshowthemthatyoucare.
The right environment
Whencommunicatingwithapersonwithdementia,tryto:

Avoidcompetingnoises,suchasTVorradio.
Staystillwhileyouaretalking.Thismakesiteasierforthepersonwithdementiatofollow
whatyouaresaying.
Maintainregularroutinesthishelpstominimiseconfusionandcanassistcommunication.
Keepaconsistentapproach.Itismuchlessconfusingforthepersonwithdementiaif
everyoneusesthesamestyleofcommunication.Repeatingthemessageinexactlythe
samewayisimportantforallthefamilyandallthecarers.

What NOT to do
Trynottodoanyofthesethings:

Dontarguewiththeperson.Itwillonlymakethesituationworse.
Dontorderthepersonaround.
Donttellthepersonwhattheycanandcantdo.Instead,statewhattheycando.
Dontbecondescending.Acondescendingtoneofvoicemaybepickedup,evenifthe
wordsarenotunderstood.
Dontaskalotofdirectquestionsthatrelyonagoodmemory.
Donttalkaboutpeopleinfrontofthemasiftheyarenotthere.

AdaptedfromUnderstanding difficult behaviours, byAnneRobinson,BethSpencerandLaurie

White.
Tips from a person with dementia
ChristineBodenwasdiagnosedwithAlzheimersdiseaseatage46.Shenowliveswitharediagnosisoffrontotemporaldementia,madewhenshewas49.Shehassharedanumberofher
insightsaboutwaysfamilyandcarerscanhelpapersonwithdementia.Christineisalsotheauthor
ofWho will I be when I die?,whichwasthefirstbookwrittenbyanAustralianwithdementia.
HerearesomeofChristinessuggestionsforcommunicatingwithapersonwithdementia:

Giveustimetospeak.Waitforustosearcharoundthatuntidyheaponthefloorofthe
brainforthewordwewanttouse.Trynottofinishoursentences.Justlisten,anddontlet
usfeelembarrassedifwelosethethreadofwhatwesay.
Dontrushusintosomethingbecausewecantthinkorspeakfastenoughtoletyouknow
whetherweagree.Trytogiveustimetorespondandtoletyouknowwhetherwereally
wanttodoit.
Whenyouwanttotalktous,thinkofsomewaytodothiswithoutquestions,whichcan
alarmusormakeusfeeluncomfortable.Ifwehaveforgottensomethingspecialthat
happenedrecently,dontassumeitwasntspecialforustoo.Justgiveusagentleprompt
wemayjustbemomentarilyblank.
Donttrytoohardtohelpusremembersomethingthatjusthappened.Ifitnever
registered,wearenevergoingtobeabletorecallit.
Avoidbackgroundnoiseifyoucan.IftheTVison,muteitfirst.
Ifchildrenareunderfoot,rememberwewillgettiredveryeasilyandfinditveryhardto
concentrateontalkingandlisteningaswell.Maybeonechildatatimeandwithout
backgroundnoisewouldbebest.
Earplugsmaybeusefulifvisitingshoppingcentresorothernoisyplaces.

Where to get help

Yourdoctor
Yourlocalcommunityhealthservice
Yourlocalcouncil
NationalDementiaHelplineTel.1800100500
DementiaBehaviourManagementAdvisoryService(DBMAS)Tel.1800699799for24hourtelephoneadviceforcarersandcareworkers
CarerRespiteCentresTel.1800059059

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CarerResourceCentresTel.1800242636
AgedCareAssessmentServicescontactyourregionalDepartmentofHealthoffice
TheAgedCareInformationLineTel.1800500853

Things to remember

Losingtheabilitytocommunicatecanbefrustratinganddifficultforpeoplewithdementia,
theirfamiliesandcarers.
Positivecommunicationcanhelpapersonwithdementiamaintaintheirdignityandselfesteem.
Acaringattitude,useofappropriatebodylanguageandtherightenvironmentareall
importantaspectsofcommunication.
Beflexibleandallowplentyoftimeforaresponse.

This page has been produced in consultation with, and approved by:

Alzheimer'sAustraliaVictoria
ThisBetterHealthChannelfactsheethaspassedthrougharigorousapprovalprocess.The
informationprovidedwasaccurateatthetimeofpublicationandisnotintendedtotaketheplace
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Forthelatestupdatesandmoreinformation,visitwww.betterhealth.vic.gov.au
Copyight 1999/2010StateofVictoria.ReproducedfromtheBetterHealthChannel
(www.betterhealth.vic.gov.au)atnocostwithpermissionoftheVictorianMinisterforHealth.
Unauthorisedreproductionandotherusescomprisedinthecopyrightareprohibitedwithout
permission.

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