COMMUNICATION STRATEGIES

Anna Ortegara, RN, MS, Director, Residential Care Services, Rush Alzheimers Disease Center, Chicago

I had the opportunity to hear her speak on the care of Alzheimers patients. Knowledgeable, articulate- EXCELLENT. This is her article on Communication

Challenges on Communications

• Since persons with dementia may have limited attention spans, they may find it difficult to follow long conversations
• Persons with dementia may attempt to describe an object that they cannot name or create a word to describe the object
• Since person with dementia are only able to focus on one thought at a time, multiple step instructions may lead to confusion
• Short term memory problems often lead persons with dementia to lose their train of thought or to repeat thoughts again and again. They may quickly forget what the did understand a the beginning of the conversation
• Background distractions such as television, noise or nearby conversations can compete for attention and impair conversations and communication
• Persons with dementia usually need much more time that the average person to respond to a question. Staff and family caregivers must be patients, allowing these people enough time to process questions and formulate responses
• Communication challenges and the resulting frustrations may cause many of the difficult behaviors that commonly occur in persons with dementia
• Persons with dementia may have additional hearing or visions difficulty that impair their communication ability.

Communication: Focusing on Abilities

• People who suffer with dementia are individuals, with individual needs and wants. Furthermore, the disease progression associated with dementia occurs at different rates for different people. The staff, and family caregivers must be flexible with their communication techniques, adapting their strategies to reflect each persons changing cognitive levels and needs.
• In order to improve communication with persons who have dementia, staff and family caregivers must become creative listeners, studying both verbal and nonverbal communications
• Staff and family caregivers must be creative, and adapt communication strategies to meet each persons unique needs
• Persons with dementia will often communicate to family and staff through their behaviors and expressions of emotion.

Communication Strategies: Helping the Person with Dementia Communicate

• Self expression is vital to a person well being. Make every effort to show interest in what the person with dementia is communicating or attempting to communicate
• Never interrupt a person who has dementia when he or she is trying to communicate an idea because this distraction may cause them to lose their train of thought. It may be helpful to supply a word that the person with dementia is struggling to find
• Eye contact and touch are excellent methods to let person know their thoughts are being heard.
• Never contradict or argue with a person with dementia because this may lead to a catastrophic reaction such as yelling, crying or striking out. Staff must be sensitive to the limited understand and comprehension of the person
• Look a the emotional meanings and subtexts behind statements made by person with dementia. As an example, persons waiting for their mothers are most likely feeling lonely, insecure and fearful

Communication Strategies: Helping the Person with Dementia Understand You

• Because it is critical to get a person with dementia attention before saying anything to them, staff and family caregivers should begin a conversation by making eye contact. Next it is important to identify yourself and call the resident by name.
• Staff and family caregivers need to speak slowly and clearly, and in a low pitched voice, while maintaining an open, calm and friendly communication manner
• It is important to remember to break down tasks into clear and simple tasks.
• Staff and family caregivers must also be aware of what words are familiar to the person and remember to use them often. Using words from a persons native language can be extremely helpful in communication efforts
• When communication with a person who has dementia, avoid open ended questions. Offer a yes or no question or a choice between no more than two items
• If a person with dementia does not understand the question, repeat it or rephrase it.
• Persons with dementia need more time than the average person to process a question and may require extra time and patience to respond
• Most importantly, simple expressions of caring communicate to any person that they are loved and appreciated. A smile or a hug speaks volumes to a person with dementia.