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
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
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
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
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
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.