There is definitely an art and a science to communicating with people with dementia. Placing their needs at the center of your communications is artful love. Learning and practicing skills that will be effective is wise science.
Let’s first consider why dementia patients have communication challenges. The disease has caused direct damage to parts of the brain that are used to communicate: our hearing, our understanding, and our responding to messages. We can learn about these losses and alter our communications accordingly. It will always be important to remember that each person with dementia suffers different levels of brain function loss, often progressively but not without fluctuations and personal accommodations. Paying close attention to your loved-ones’ challenges at the time will help you know which of these following suggestions are most useful. Remember that our methods of communication are not limited to the spoken or written word. Yes, we learn and use a wide vocabulary to provide an exactness to our messages. Many of the words we speak are used to provide greater descriptions and details. However, this is not even the strongest source of interpersonal communication. Rather, science has informed us that our nonverbal communications can provide up to 80% of our intended or unintended messaging.
Experts have detailed some of the more specific symptoms that reveal challenges in communication for dementia suffers. You may see your loved one expressing:
- A reduced ability to process language, as compared to their previous adult skills
- Visual-perceptual changes, including when participating in direct communications
- A need for more time to process information
- Increased levels of disorientation and confusion
- Less patience and demonstrating irritability
Recall that nonverbal communication refers to all the means that we share emotions and actions with others without the use of words. Our facial expressions are the most used to send these messages, including smiling, frowning, looking directly or away. These physical movements can be more easily interpreted by a person with dementia than spoken words, thus strengthens the importance of your attention. When nonverbal cues are interpreted differently than the spoken words, the individual may become confused, causing greater stress. Our expressions are interpreted by an individual based on their familiarly with us as well as their own thoughts of what those movements mean at the time. When we practice skills that try to match our nonverbal expressions to our spoken words the individual gains comfort and understanding, which often leads to greater cooperation.
Tips for effective nonverbal communication with persons with dementia
- Remain calm and show patience when waiting for their responses
- Work to keep your voice, your face and your whole body looking relaxed
- Strive to make and keep eye contact with the individual
- Remind yourself to observe their responses, trying to learn about their feelings and emotions at the time
Spoken language provides a most important means of communication. There is also many opportunities for mis-understanding, especially when one or more of our personal skills are diminished. Hearing impaired persons must add additional tools, including hearing aids, reading lips and heightened focus onto the speaker. Those of us with visual challenges know that enhanced forward focus on persons expressing nonverbal cues improves their communication experiences. Persons suffering from dementia may not comprehend the words, and creating responses will be confusing.
Video as a tool for effective communication
Dementia gradually impairs a person’s ability to recognize people and communicate. Providing dementia patients with videos loaded with the visuals and sounds of people familiar to them may provide comfort and calm. A unique program was created at the Hebrew Home at Riverdale, New York. Families of residents suffering from dementia were encouraged to create five-minute video messages to be viewed frequently by their loved one. Simple messages of “good morning” and expressions of love through stories recalling happy times were included. Residents often demonstrated joy and pleasure watching the messages. One interesting finding was that the residents were especially benefited when the messages were viewed in the morning, with this happiness carrying over throughout the day.
Consider your loved ones’ limitations at the time
A video message made at the time may include vocabulary and images that you believe he or she can understand. As their dementia condition lingers and their cognitive skills diminish, future video messages can take a different level of complexity.
Consider your loved one’s physical limitations
As noted above, does he or she retain good hearing, or, are you seeing a reduced ability? Does he or she wear a hearing aid ? If so, do you know that it is operating well and worn correctly most of the time. You may want to avoid background music or other sounds when the spoken word is presented. Visual impairments may be partially corrected by eyeglasses but only if they are professionally prescribed, times of viewing and well-fitting, and with clean lenses.
Consider your loved one’s mental capacity
Video presentations can include simple introductions of the messengers. For example, consider asking each person, including the children, to self-introduce themselves. Cute messages as simple as “Hi Grandma, its Lily and I’m 6 years old”. This kind effort will go a long way to provide Grandma with a frame of reference necessary to enjoy the presentation.
The benefits of video messages
- Current technology provides the ease of recording and sharing video messages
- Video books welcome the viewer to watch and re-watch many times
- Communication that includes verbal and nonverbal messages increase comprehension
- Videos present familiar settings, voices, backgrounds and objects for additional recognition
- Viewing times at the elder’s convenience, when he or she has peak alertness, no distractions, limited ambient noise
Tips for caregivers
- Offer the video viewing at appropriate times
- Watch in a well-lit room
- Watch in a space without excessive ambient noise
- View with the senior
- Discuss the show to share the experience and offer further reinforcement
Certainly not every person will find the same benefit from these presentations. Nor, will an individual continue to sustain their benefit as the disease process continues. That said, video messages should be considered as one tool to provide enjoyable communications with your loved one suffering from dementia.