Communication Challenges When Dementia is Present

When decision making is clouded:

My father was just “ripped off” again: “Dad, I have told you that buying items online is not a good idea if you don’t know the reputation of the company.”  Bill’s father had been scammed by buying items from companies with poor reputations.  He has been swindled out of money and had his identity stolen by making bad choices and giving out information that should be protected. 

Older man looking at laptop and speaking on cell phone with a slightly confused expression

Bill’s dad is progressing in his dementia and living alone on a large piece of property.  They have always had an honest relationship and Bill wants Dad to understand he needs help making financial decisions so that he isn’t taken advantage of again.  The problem with this story is that Dad has lost the capacity to make sound decisions because of his dementia and Bill is having a hard time communicating this fact with Dad.

When two way communication is breaking down:

Susan’s husband is in the mid-stages of Alzheimer’s dementia.  He is a retired engineer and had his own business for over 40 years. They have been married for 55 years and have always shared everything.  Early in his diagnosis he wanted to be told if he made a mistake; he wanted to do whatever he could to help slow down the progression.  But now every time Susan tells her husband what he has done, he becomes either angry or wanders out of the house, especially when she is talking about him or his behaviors to another person. The problem with this story is that Susan is at that point where she can’t share information with her husband because he can’t process all the details or understand what she is saying.  Like Bill, she is the one that will have to change in order to change the behavioral responses.

Communicating without words:

Marty has fairly advanced dementia including trouble with language, both expressive and receptive. Her family does not know how to act when they visit her and she does not participate in most activities in her assisted living/memory living environment.  But she lights up when she spends time with a therapist who has experience in communicating with people like her. 

Older woman walks with middle-aged woman arm and arm.

They sit together, admiring the environment with the therapist pointing out items beauty.  They are simply in the moment together with no expectations for information sharing or communicating.  When the weather is nice, they always walk outdoors which sometimes is known as “forest bathing”.  They connect in a more spiritual manner: just spirit to spirit.  It takes a special therapist to not want to be “more in the brain”, for we are trained to talk to the intellect and not to just be with another person.  Being in this less demanding space can be very healing for a person and it is my belief that it can bring about a sense of peace that increases one’s sense of self. 

Three of My Ten “Do’s and Don’ts” in Communicating with Someone with a Dementia:

  1. Do not reason with the person who has dementia. Work with an expert or get support from a support group on how to deal with a problem that protects self-esteem and reduces stress, keeping the individual safe from potential abuse while maintaining their dignity.
  2. Keep information shared simple. This means don’t tell someone about a serious illness of a family member because they can’t process what that truly means and can become very anxious and not remember why. You need to remember too many details about anything can overwhelm someone with a dementia.
  3. Learn Active Listening. This is responding to the feelings and letting the person know you understand what they are saying or communicating.  Marty cannot articulate in language, but she can in the relationship with the therapist who does not challenge her in any way.  For others who have language abilities, it might be responding with something like “It seems that going to those activities makes you anxious.”  And in this situation you would use distraction to bring about calm.  You stated the feeling and where the feeling is coming from – you didn’t solve it.

These are just 3 of my list of 10 communications tips.

Remember your family member is on a journey that will have many potholes along the way.  Our job is to find the “joys” in life as they happen and to make the best of being in the moment for everyone.