Communication: Engaging with People Experiencing Dementia

Language is a unique human gift and a powerful means of communication. Words can influence our feelings, actions, mood and self-esteem. Words also help us communicate to others our needs and desires. We react physically and emotionally to what is said to us and about us. How language is used can affect us as strongly as physical actions. This is the power of words.

Communicating with individuals who have been diagnosed with dementia or other cognitive impairments can be challenging not only for the caregiver but also for the person with dementia. A person centered approach is the key to communicating with anyone suffering with cognitive decline. All expressions — words, gestures, actions and body language — have meaning. 

“How one approaches or interacts with those experiencing dementia starts with knowing the individual as a person,” states Marlee, a nurse in The Arbor at Wesley at Tehaleh. “What is this person’s cultural background, social history — past and present, communication ability and personal desire? Having these building blocks can help both the caregiver and the individual with dementia find common ground for communication.” 

Dementia is a progressive disease that will eventually affect the person’s ability to understand and remember everyday facts and details. Having tools to help with communication will allow both the caregiver and person with dementia to communicate even in the later stages of the disease.

Try these suggestions to engage a loved one or someone providing care to maintain a cognitive connection.

  1. Make eye contact before speaking to the individual, and stand or sit directly in front of him or her at eye level. 
  2. Take your time, and speak clearly and distinctly.
  3. Speak in a loving manner and always in an adult manner.
  4. Introduce one idea at a time.
  5. Use simple words, and keep the sentences short.
  6. Use hand gestures and facial expressions to help you communicate an idea. Often facial expressions can be more powerful for those with dementia. It is an emotional response that they can physically see and experience.
  7. Ask simple yes or no questions. Asking open ended questions can frustrate those with dementia when they can no longer find their words
  8. Use pictures or picture cards to communicate and start a conversation. 

Requirements for mask wearing have impacted our ability to communicate and may be unsettling for those with dementia because they can’t see our facial expressions. In addition to the tips above, here are some tips from the Alzheimer’s Society for communicating while wearing a mask:

  • Be mindful that a face covering may change visual communication; you may need to adapt how you communicate.
  • Think carefully about your tone. Be clear, calm and friendly. Speak a bit louder from behind the cover.
  • Smile! Your eyes communicate genuine warmth even if your smile is hidden.
  • Think about non-verbal clues. Your body language (calm, open, friendly) should match your words. Gently mirror the person’s gestures if that helps connect you.
  • Above all, be empathetic. Try to understand how the person is feeling – ask them if possible – and support them as patiently as you can.

Communication does not always require verbal exchanges. Music and Art Therapy have been found to be effective tools for communicating well into the later stages of dementia.  Music can be transformative in finding what is deep down in our soul that has not been lost. 

“It gives individuals an opportunity to communicate on a different level when the skills of communication have long faded away,” shares Marysusan Iotte, Campus Administrator at Wesley at Tehaleh. “The joyful experience is not just felt by the person with dementia but can touch the lives of so many that provide care to that individual on a daily basis.” 

It is believed that music predated language as a form of communication and that music affects various areas of the brain, not just one area like linguistics. It sparks basic primal functions found in the brain stem. Many times a person suffering from dementia can sing, keep rhythm and play a musical instrument long after verbal communication has ceased. Even if people are not musically inclined, a song or melody that was important in their past life can evoke memories that come to life in the present. Choosing music from their youth and downloading it can help to provide individuals with the appropriate stimulation when needed or the ability to calm during times of agitation.

Art can also provide a freedom of expression different from music. Tactical stimulation through clay or dough can be used to strengthen hands or provide individuals with sensory stimulation that comes from kneading dough, mixing cookies or hearing the sound and smell of popcorn popping. Art can take on different forms for those with dementia. Art galleries offer sensory stimulation that can be enjoyed by all. Many art galleries are dementia friendly. Check with your local art gallery to find times that are open for individuals with dementia.

Contact us or visit our communities to learn more about The Arbor Memory Care at Wesley.

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