Effective Strategies for Communicating with Seniors with Dementia – part I

Dementia  |  October 19, 2023

People with dementia not only have difficulty expressing thoughts and emotions but also have trouble understanding others.

Dementia, a complex ailment, defies classification as a standalone disease. Rather, it represents a collection of distressing symptoms that profoundly impact memory, cognition, and social skills, ultimately disrupting one’s everyday life. By definition, dementia signifies a breakdown in two or more brain functions, spanning from memory loss to compromised decision-making, extending to an inability to execute routine tasks like managing finances or preparing meals. In addition, Alzheimer’s disease and other types of dementia gradually erode an individual’s capacity to communicate effectively.

Difficulty with Senior Communication: Look for Clues

Changes in the ability to communicate are unique to each person with dementia. The family and/or caregiver may recognize changes such as:

• Using familiar words repeatedly
• Inventing new words to describe familiar objects
• Easily losing his or her train of thought
• Reverting to a native language
• Having difficulty organizing words logically
• Speaking less often

A Guide to Effective Communication During the Different Stages of Dementia

Stage 1: Mild Cognitive Impairment (MCI) During the early stage of Alzheimer’s or other dementias, seniors may experience mild memory loss and occasional difficulty finding the right words. Communication may still be relatively unaffected, but you should be prepared for subtle changes. Here are a few tips for effective communication during this stage:

1. Use simple and straightforward language: Keep your sentences concise and avoid complex vocabulary. Use familiar terms and try to speak in a calm and reassuring tone.
2. Be patient and offer support: Allow the person time to gather their thoughts and avoid rushing them. Offer gentle reminders if they struggle to find the right words. Express empathy and lend a listening ear.
3. Use visual aids and gestures: Incorporate visual cues or gestures to reinforce your message. This can be helpful for individuals experiencing mild memory loss.

Stage 2: Moderate Cognitive Decline During the moderate stage of Alzheimer’s or other dementias, communication becomes more challenging. Memory loss intensifies, and individuals may struggle to communicate their needs and thoughts effectively. Here are some strategies to enhance communication during this stage:

1. Maintain eye contact and be mindful of non-verbal cues: Pay attention to facial expressions and body language to better understand their emotions and needs. Maintain eye contact, as it can help establish a connection and build trust.
2. Simplify choices: Avoid overwhelming the person with too many options. Instead, present choices one at a time, using visual aids if necessary. For example, when asking what they would like to eat, show them pictures of available options.
3. Use reminiscence as a communication tool: Tap into the person’s long-term memory by encouraging conversations about their past. This can evoke positive emotions and stimulate dialogue.

Stage 3: Severe Cognitive Decline In the advanced stage of Alzheimer’s or other dementias, communication abilities deteriorate significantly. Individuals may struggle to understand or respond to verbal cues. However, it’s important to continue engaging with them and making efforts to communicate effectively:

1. Non-verbal communication becomes crucial: Utilize touch, facial expressions, and gentle gestures to convey your emotions and intentions. Physical contact, such as holding their hand, can provide comfort and a sense of security.
2. Engage through sensory stimulation: Explore activities that engage the person’s senses, such as listening to familiar music or touching textured objects. These activities can help evoke memories and provide a means of connection.
3. Remain present and validate emotions: Despite the decline in communication abilities, emotions still play a significant role. Show empathy and validate their feelings through non-verbal cues, even if they struggle to express themselves verbally.

Communicating with elders during the different stages of Alzheimer’s and other dementias requires flexibility, patience, and understanding. By adjusting your approach to fit their evolving needs, you can create meaningful connections and maintain their dignity throughout their journey. Remember to always be present, compassionate, and receptive to their non-verbal cues.

Always remember to treat a person with dementia with dignity and respect. Don’t talk about them as if they are not there, or talk to them as you would to a young child, and be patient. Offer them ongoing comfort and reassurance, too. If he or she is having trouble communicating, let the person know that it’s okay. Encourage the person to continue to explain his or her thoughts, no matter what.

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