To me, communication is the most important aspect of caring for people with dementia. Effective communication can help them to maintain their identity and sense of personhood. If the person feels that they are valued by the person communicating with them, it can help them feel loved and allow for good relationships to form. Positive communication can help individuals with dementia to form social bonds with others and encourages social interactions and inclusion, promoting well-being.
Ineffective communication on the other hand, could lead to social withdrawal and cause the person to feel a lack of empowerment. It can cause the person with dementia to feel worthless and unimportant and contribute to ill-being. An example of this that I have observed in my time working in a care home, was an activity co-ordinator who only involved certain residents in activities based on their ability to participate. The residents who were not included in the activity but had to be present due to immobility soon became restless and interacted little with others, having not had the encouragement they needed from staff.
Effective communication may allow the person with dementia to maintain their strengths and abilities for longer, it can slow the progression of their dementia and encourage cognitive functions to remain in tact for longer. If an individual is not given the chance to communicate independently due to carers or family members having lowered expectations that enforce dependency, it could deskill the person.
An example of positive communication I have seen involved a carer allowing time for a resident they were caring for to find words and answers to questions they were asked. For example, simply asking someone what clothes they would like to wear can have a really positive impact through involving the person in their own care, and helping them to feel in control by respecting their choices and preferences. The opposite practice of this, and one that should not be encouraged, is when a carer presumes that an individual is unable to choose for themselves and therefore does not give them the chance to choose for themselves.
So, here are some simple tips for communicating with individuals with dementia:
- Show respect by addressing the person by how they wish to be referred. For example, some people may prefer a formal greeting, such as ‘Mrs Green’ whilst some may prefer a first name basis or a nickname.
- Get on the same physical level as the person. For example, if they are sitting down, don’t stand other them as you interact with them, get a chair and sit along side them or kneel down so they can see your facial expressions (often important for conveying meaning)
- Use visual aids to help make things clearer if necessary. For example, pointing to a particular place or showing the item you are talking about. If you are asking someone whether they would like a cup of tea, show them the teapot or an actual cup of tea.
- Always offer choices, even if you don’t feel an individual will be able to verbalise their choice. If the person cannot make the choice you are offering after visually showing them, it’s a good idea to make a choice on that person’s behalf based on their previous choices. Knowing the person well and finding out as much as you can about them from family members is very important in this case, particularly if they are unable to communicate verbally.
- Speak calmly and clearly, trying to avoid complex sentences with multiple topics. Try and ask questions that require a yes or no response if the person has difficultly constructing sentences. These are called closed questions and are much easier to answer than open ones with multiple options for answers.
- The most important tip I can give for communicating is to give the person your time. Don’t be in a rush to get answers. The more stressed the person feels, the more difficult it will be for them to concentrate on what you are saying and to formulate an answer. Give the person as much time as they need and offer lots of encouragement.
Human interaction is one of the most important things to any of us. We all need to engage in conversations to feel like part of the world. Whether those conversations are verbal, using words, or physical, using body language such as a simple smile or hug. Everyone deserves to be spoken to and treated with respect.
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