Dementia is not a specific disease but instead describes a group of symptoms that affect a person’s brain function – memory, thinking, and social abilities – severely enough to interfere with their everyday functioning.
Alzheimer’s disease and other dementia types also gradually diminish a person’s ability to communicate. As a result, communicating effectively with a senior with Alzheimer’s or related dementia can prove challenging for caregivers.
The damage in their brain changes the way these seniors hear, process, and respond to verbal communication. As a result, they are likely to have difficulties with understanding you and, equally, you may have a hard time understanding what they are trying to express.
In addition to difficulties with how they use words and language, seniors with dementia are also likely to have memory, sight, and/or hearing problems that can add to communication difficulties. This all creates a lot of potential for confusion, upset, misunderstanding, and frustration on both sides.
However, good communication is a vital part of living well after a diagnosis of dementia, and there are many ways to overcome the communication hurdles. As caregivers, it is possible to find ways to adapt the way you communicate – rethinking your speaking and listening strategies – to better match the abilities of your senior patients/clients and make it easier to meet their care needs.
Understanding their needs and emotions will become more complex as their dementia progresses, but there are many ways you can continue to communicate effectively and meaningfully together.
Every person’s experience of dementia is unique, so it is important to find ways to communicate that best meet the individual needs of each senior you work with.
Here are our top twelve tips and techniques.
12 Top Tips for Communicating Effectively with Seniors With Dementia
1. Take the time to compose yourself before you begin
If you feel stressed, distracted, or are rushing between patient/client appointments, your energy is going to create a stressful, distracted interaction with your senior patient/client. Take a moment to breathe deeply, relax and calm yourself before you begin, and ensure you have planned enough time to spend with them so you are not rushing.
By being relaxed and fully present you can maintain a calm and comforting tone, be patient and avoid speaking too sharply or raising your voice. Aim for a lower, slower pitch, which is more calming.
2. Minimize distractions
Hectic, busy environments can make it especially difficult for seniors with dementia to concentrate on a conversation so try to ensure you are in a suitable place to communicate, with minimum distractions.
Ideally, you need a quiet, calm environment with good lighting. Switch off any distractions such as the TV, radio, and mobile phones, and distance yourselves from other people’s conversations.
You may be the only opportunity for communication and human connection that your senior patient/client will have today, so make it count.
3. Be the primary focus
Make sure that you have your senior’s full attention before you begin talking and that they can see and hear you clearly – position yourself in front of them with your face well-lit.
Be as close to them as is comfortable for them, so you can make eye contact when communicating – if your senior is lying down or seated, move down to their level.
4. Keep it simple but don’t be condescending
Try to communicate in a clear and relaxed way, using short, simple sentences. Aim to stick to one idea at a time to avoid confusion or frustration.
It is also helpful to speak at a slightly slower pace, allowing sufficient pauses between sentences to give your senior patient/client time to process the information and form their responses.
This does not mean using baby talk, a singsong voice, or inappropriate terms of endearment. Make sure your attempt to ‘turn up the volume’ and slow down your speech pattern doesn’t come across as condescending. Most seniors will feel insulted if you talk to them like children, even if you don’t mean any offense.
It is about finding a balance, to make sure you are talking in a natural, conversational way while also making allowances for the additional time they may need to process and respond.
5. Avoid asking too many questions
Processing questions and providing answers can quickly become tiring and/or frustrating for seniors with dementia, especially if they cannot find the answer or are being asked to make multiple complicated decisions.
Try to phrase questions in ways that allow for simple ‘yes/no’ answers or give your seniors a clear choice. For example, rather than asking them what they want for lunch, or what they’d like to do this afternoon, provide two or three options, they can select from.
By rephrasing, you can actually provide the solutions rather than constantly asking questions.
6. Use non-verbal signals
It is possible to communicate meaningfully without even using spoken words.
The non-verbal signals we send, through our body language and facial expressions, can often be understood more clearly by seniors with dementia than the words we speak. Therefore, be mindful of using these as much as possible to convey what you are trying to say. This can also include physical contact, where appropriate, to show that you care – for example, holding or patting their hand, placing a hand on their shoulder, or putting your arm around them.
Equally important is being aware of your senior’s body language, as it can tell you a lot about how they are feeling when communicating with you. For example, you might notice that they are becoming tired or frustrated, in which case you can take a short break.
If you sometimes communicate with your senior patient/client via smartphone and tablet, remember it is far better for them to connect with you through video calls – where they can see your facial expressions and body language – than telephone calls, text messages, or email.
7. Active listening
Listening well truly is an art and is thankfully a skill that can be developed. One way to practice this skill is through active listening.
As a caregiver for seniors, active listening skills become essential when interacting. They build trust and rapport, improve your communication, and allow you to relate in a whole new way, avoiding any misunderstandings.
Using active listening skills, you can make communicating with your senior easier and more productive. For example:
- Pay full attention and look out for non-verbal clues
- Encourage and validate
- Use nonverbal cues (nodding, leaning forward) and brief verbal affirmations (I see, I understand, I know, etc.)
- Request clarification/enquire to avoid misunderstandings
- Summarize/paraphrase to show/check understanding
- Avoid interrupting – it can break their pattern and flow
- Be attuned to and reflect feelings
- Let them express their feelings and take the time they need – show that you are there and care
- Allow the speaker plenty of time and be comfortable with the silences.
It might be tempting to fill in blanks, finish off sentences, or correct inconsistencies, but simply giving your full attention is far more respectful and caring. Be patient if they are unable to speak or think things through at their previous pace.
8. Relieve tensions with humor
It is important to remain positive when communicating with your senior patients/clients and to show this through your voice tone and body language. While there may be miscommunication and misunderstandings between you, humor is a great way to relieve any tension on both sides and can bring you closer together.
Laughter really is the best medicine. Even in the most stressful and challenging caregiving situations, humorous moments will arise, so make the most of them.
Obviously, you must judge this well, so your senior doesn’t think you are laughing at them.
9. Timing is key
There are likely to be times during the day when your senior patient/client is better able to communicate with you, perhaps after an afternoon nap or during a meal together. Work out when they are more relaxed and expressing themselves more clearly, and use this time to ask any critical questions or talk about any key issues.
Make the most of these ‘good’ times and find ways to adapt on more challenging days.
10. Be all-inclusive
If your senior’s family members – or other caregivers/home care providers – are present, be sure to include them in any conversations. Never speak as though your senior patient/client is not there.
When talking in a group, make sure your senior is not stuck at the end of the table or on the outskirts of any seating arrangement. Instead, try to ensure they are in the middle so that the conversation is taking place around them, and do your best to keep them involved in discussions and decisions that they can participate in.
Being included can help seniors to maintain their sense of identity and to know they are valued. It can also help them to feel less isolated or excluded.
11. Avoid criticizing, correcting, arguing
As part of being a caring, compassionate person in your senior’s life, it’s important to respect their opinions and treat them as adults, whether you agree with them or not. If they say something you disagree with, just let it pass. Arguing tends only to make things worse, often heightening the level of agitation or frustration for the senior with dementia.
Rather than arguing or criticizing, try to find the real meaning behind what is being said, and encourage them to express their thoughts and feelings. Do not take anything personally. For example, if they say, ‘You are useless. You never help me!’ try reframing it. ‘What I hear you say is that you’d like more help, and you feel like I’m not helping right now. Is that what you mean?’
If they feel angry, sad, or irritated, let them express their feelings without dismissing them or criticizing them. Instead, allow them to express themselves verbally and non-verbally in whatever way they can.
At the very heart of compassionate communication is a desire to be collaborative – to hold a balance between our needs and the needs of the other. This is particularly relevant for caregivers who are so often looking after the needs of the other.
12. Find creative ways to connect
If your caregiving duties allow for the time, and if suitable for your senior, consider taking something you can do together and communicate about, which may even help trigger positive memories for them. For example:
- Films or music you know they like, from when they were younger
- A favorite book that you can read together and discuss
- Let them teach you dance moves to their favorite tunes
- A craft project or puzzle to work on together
- Ingredients for a snack or meal that you can make and eat together to spark conversations about favorite foods, cooking techniques, or recipes
- A simple gardening project to set up together, such as growing herbs
- Assembling a family album, family tree, or memory box
- If suitable, bring along a pet for some animal therapy or getting out and about for some nature therapy.
Seniors crave social connections as much as anyone else. It’s important to remember that they have lived interesting lives and had rich experiences. You can tap into these and learn from them during your time together. Your caring curiosity about their lives will help trigger memories and provide natural paths for easy conversation.
The bottom line is that all humans need connection. Everyone wants to feel valued, respected, understood, and loved. The effort you make to communicate with your senior patients/clients when you spend time with them may be valued and appreciated far more than you ever realize – and possibly far more than they are able to express.
Keeping lines of communication open and staying connected can have significant physical, mental, and emotional health benefits for seniors after a diagnosis of dementia – helping them to sustain relationships and maintain their quality of life.
Studies have shown that seniors who have regular, positive communication with others (in their family or their community) are also generally healthier and happier, experience less anxiety and depression, have lower rates of chronic illness, have better cognitive health, and increased longevity.
It is impossible to overstate the benefits of communicating well with your senior patient/client, being there for them, and making the most of your time together.
We understand that as caregivers, spending time with your senior patients/clients is never just a job; it’s a passion. Rather than work, this time should be spent in true friendship, which can genuinely make communication more accessible and pleasurable for you both.