Communication (for dementia)

By Family Caregiver Alliance

People respond to our body posture, facial expression, and tone of voice more than our actual words. Your upbeat mood can help keep the person you are dealing with remain calmer.
You need to pay attention to the non-verbal clues the person you are caring for is giving you. Understanding his/her feelings may be more important than the content of the conversation. Acknowledge feelings whenever possible.
Keep communication simple. Give one command at a time. Make eye contact before beginning to speak. Keep distractions to a minimum, for example turn off the TV or radio and stop background conversations, when you are interacting with someone with dementia.
A person with dementia may have trouble making a decision. Do not ask “What do you want for dinner?” but rather “Would you like spaghetti or hamburger for dinner?” Giving them a choice between two options can make meal planning easier for you and less frustrating for them.
Long explanations of why someone should do something are lost on a person with dementia. Their ability to follow your argument or to follow through on agreements is limited.
Arguing will increase agitation. Walk away and calm down, if possible, before continuing an interaction that leads to anger for you or your loved one.
Encourage the person by giving positive feedback often, especially for approximations of the desired behavior.
Sharing memories and reminiscing are a way to maintain interaction with someone with memory loss.
Agree with made up stories or explanations from the person with dementia. They do not need to be grounded in reality. Using a therapeutic lie or a “fiblet” can help you to gain cooperation, for example saying you are going out for ice cream but stopping by for a doctor’s appointment before the ice cream. Rewards work.
Use distraction if someone is repeating a question over and over or retelling the same story.
If following your instructions is not working, model for the person what you want them to do. To start someone eating, pick up your fork, put another fork in the person’s hand, and start the eating process for yourself, encouraging him/her to do what you are doing.
Early in the illness, people often lose nouns, the names of objects. You can try and guess what they are saying or substitute the right word if you know it. Have the person point to or show you what he/she is talking about.
Call the person by name and identify yourself: “Hi Mom, it’s me, Mary.”