How To Talk To People With Dementia: 15 Tips For Communicating
The set of diseases and disorders known as dementia are one of the biggest challenges that medicine is facing today With an increasingly aging population, the prevalence of this type of disorders is increasing over time, with more and more cases coming to consultation.
Psychologists and neuropsychologists, as well as any other type of professional within the field of health or even at a social-care level, must therefore be correctly prepared to deal with this type of patient, taking into account the possible difficulties that they may present. .
Among them we can find a basic aspect that can make interaction very difficult, both to evaluate their abilities and to carry out different therapies that help maintain and enhance their abilities as much as possible: communication. That is why in this article we are going to mention a series of small Things to keep in mind when talking to patients with advanced dementia
We understand dementia as a type of disorder characterized by the presence of the loss or deterioration of one or more mental faculties whose alteration generates difficulties in daily life or a decrease in the quality of life of the subject (causing a previously non-existent limitation). Generally it is a deterioration that progresses progressively and irreversibly although there are some that are treatable or in some cases even have a complete recovery (such as those generated by infections).
This deterioration is generally due to organic causes, although in some cases the exact reason for its appearance is unknown (although neurochemical and structural alterations are known that generate or participate in the symptoms, not because they occur). The evolution can be very variable in each case, although the trend is towards a progressive or gradual deterioration in most cases.
There are a large number of different dementias, which can affect different abilities. In many cases there ends up being a deterioration in the ability to attend, remember, retain or even understand and processing what they are told can make it difficult to treat and even evaluate them. That is why below we offer a series of indications that may be useful when treating a patient with these characteristics.
1. Speak clearly and vocally
A main aspect when communicating with a patient with dementia is the fact that be willing to adjust to the person’s needs Our tone must adjust to what the person needs and what we are expressing must be understood. Vocalizing is essential.
2. Short sentences, slow pace
Using excessively complex structures will make it difficult for the patient to understand. It is necessary to use vocabulary adjusted to the patient’s capacity (and his knowledge and level of education) and the shorter and clearer the better. Avoid ambiguities and use a slower pace
3. Repeat things
Whether there are problems encoding new information, retaining it, or simply paying attention, it can be difficult for a person with more or less advanced dementia to grasp what is asked of them from the first moment. Repeating the instructions may be more than necessary depending on the case.
4. Make sure he understands what you say
Linked to the above, it is essential to ensure that the patient has understood what is being requested. This must be done in such a way that the patient does not feel ridiculed or bad for requiring new explanations
And it must be taken into account that many people, even if they maintain sufficient abilities, pretend to have understood what is being said to them out of embarrassment or social desirability, and this is something that is actually hindering efficient communication.
5. Tolerate frustration and don’t get upset
The fact that a person does not understand what we want to say, does not achieve improvement, or that an efficient communication channel between patient and therapist is not found can be frustrating. Dealing with this type of patient may require a certain amount of patience, in addition to taking into account that the patient is not doing it on purpose.
6. No reproaches
It may seem obvious, but often the environment or even some professionals (especially those not specialized in this sector) tend to blame in one way or another for forgetfulness or loss of faculties. The person does not forget things because they do or because they do not value what they are told: they are being affected by a disorder that you cannot control and that causes you to be unable to store information
Likewise, especially in the initial periods of dementia, patients are usually aware of the presence of deficits. Blaming them will only increase their discomfort and anguish at the deterioration they have already perceived.
7. Avoid distractions
It can be difficult for a person with dementia to stay focused. This is why it is recommended that communication attempts be carried out in a context in which there are as few possible distractions as possible. A crowded office or a radio on for example can easily make you lose the thread
8. Find ways to communicate
It is not uncommon for serious problems to appear when communicating orally. Likewise, in advanced stages, people with dementia can become mute, unable to follow a conversation due to losing concentration, or even remain in a state of absence. It is important to try to find a way to communicate, as socialization is important and can be calming for them.
If oral language does not work, perhaps gestures and mime can be used, or photos or drawings that represent various concepts You can also use songs that are relevant to you. If they lose concentration, a caress or a little squeeze on the hand can help them follow the thread of the situation a little more.
9. Start the interaction
Although it may be interesting to let the patient take the first step to communicate, the truth is that it can be complicated for them. Many dementias end up affecting the ability to motivate action and interaction, which generally makes it more efficient. let the professional be the one who tries to establish the interaction and direct it
10. Better specific indications or choices than general proposals
This is a small mistake that some people make and that can alter the person’s performance and performance in the task that is asked of them or the question that is asked. Making general proposals requires you to first imagine and generate responses, as well as process the idea of ​​whether you should do it or not. This implies a much greater effort, as well as increased likelihood of confusion
If we want it to carry out an action, it is important to tell it what it is expected to do, in a concrete way. Telling someone to raise a hand is not the same as asking them if they could raise it. In the first case it can do so, while in the second it can be interpreted as a mere question to answer. Likewise, perhaps decision making is one of the damaged skills. It can be useful to evaluate it, but you have to take into account what you are seeing at each moment. A hand. The capabilities of telling it to do something.
11. Try to use positive phrases
It’s good use instructions and phrases that express what the patient does or should do positively, avoiding the use of negations that are more complex to understand.
12. Give it time
Sometimes, something that is interpreted as a lack of memory or reasoning ability can actually be a processing speed problem. By this we mean that we do not have to rush and jump from one thing to another, but that we have to give the patient a reasonable amount of time. in order to process the information and/or express itself
13. Position, an important element
Another aspect to take into account when talking to a patient with dementia is the place or space we occupy. We must stand in front of the person, facing them and relatively close so that our person captures their attention and has an easier time observing our gestural language and listening to our voice.
14. Don’t rush to identify everything as a symptom of dementia
We must keep in mind that it is not uncommon for people with dementia or simply elderly people to have hearing problems, something that in turn must be assessed when examining a patient. in order not to confuse a sensory problem with symptoms of dementia Likewise, it is necessary to previously assess whether or not they have been enrolled in school, which is also relevant in terms of adjusting the tests and treatments to their needs.
15. Always take them into account and treat them as an adult and dignified person
A person with dementia is still an adult. Her treatment of her Their dignity must always be respected and they must be treated with respect
Even if the person is not aware of where they are or with whom, they should be treated as adults and not infantilized. Likewise, they should not be talked about as if they were not present, even if they do not present any reaction to stimulation or language.
