On this episode of All Home Care Matters, we are going to be discussing how to talk with your loved one with Dementia. If you are new to the show we have multiple episodes and resources on Dementia and Alzheimer’s. If there is a specific topic or situation that you are looking for you can find them on our website, wherever you get your podcasts, or on our YouTube channel, where we have an entire playlist dedicated to Dementia.
If this is your first time joining us, first we want to thank you for listening, but we will also be briefly going over what dementia is to begin the episode. Then we will dive right into some communication strategies that may help you talk to your loved one. Now let’s move on to the rest of the show.
First, what is Dementia? According to the Alzheimer’s Association, Dementia is an umbrella term for loss of memory, language, problem-solving, and other thinking abilities that are severe enough to interfere with daily life. The most common cause of dementia is Alzheimer’s. Traumatic brain injuries, diseases like Parkinson’s or Huntington’s, and protein build-up in the brain are a few other causes of dementia.
These types of dementia are not reversible, but there are a few types that are. Brain tumors, thyroid issues, infections, and immune disorders, and even some medications, can cause dementia or dementia-like symptoms. Treating the initial cause of these health issues can reverse dementia and dementia-like symptoms.
Dementia usually starts slow and progressively worsens. Some signs to look for in your loved one are problems with short-term memory, issues keeping track of their purse or wallet, having trouble paying bills on time, struggling with planning and preparing meals, not being able to remember appointments, issues with traveling, or wandering through their neighborhood.
The Mayo Clinic states that there is no sure way to prevent dementia, but there are steps you can take that might help. More research is needed, but it might be beneficial to do the following: keep your mind active, be physically and socially active, quit smoking, get enough vitamins, particularly vitamin D, manage cardiovascular risk factors, treat health conditions, maintain a healthy diet, and get quality sleep.
Brenda Gurung, an Alzheimer’s Association certified dementia practitioner says that “Alzheimer’s and other dementias are difficult disease journeys, but there is so much opportunity for connection and success together. When you understand even a bit of what’s happening in the brain — and when you embrace some simple techniques — you’ll have more delightful visits with your loved one, deeper connections, and a smoother journey.”
Once we know how dementia can affect communication, we can then figure out the best ways to create a communication strategy that is tailored to our loved ones. Dementia affects a person’s communication and cognition, memory and focus, language skills, visual perception, and problem-solving skills, which are all needed in social situations.
In a blog post for A Place for Mom, the largest senior living referral service in the U.S. and Canada, Merritt Whitley offers some tools that you may find helpful when having a conversation with your loved one with dementia. You should limit potential distractions and be as present with them as you can. Turn off the TV and any other distracting electronics. The quieter and calmer you can make the space, the better.
If you are not home and not able to find a quiet space, try to find a more secluded area and a space to sit down. For example, if you are at a café, find a seat away from the counter and the door to limit the number of people that walk by. If simple distractions, like the television or someone walking by you, take your attention away from a conversation, imagine what your loved one must feel like. Simple distractions can make any social situation too overwhelming for your loved one with dementia, so try to limit them as much as possible.
When talking to your loved one, try your best to speak naturally and use gestures. Don’t raise your voice when talking to them. Raising your voice raises the pitch of your voice, as well, and makes it harder for your loved one to hear and understand. Talk in clear, calm, and simple sentences. You can try using gestures or small body movements while you talk, but don’t use overly exaggerated movements. You don’t want to embarrass your loved one or make them feel like they are incompetent in your eyes and using exaggerated gestures will likely make them think that.
Your loved one may need more time to respond than you might think. If they don’t respond right away, don’t try to answer for them, or repeat the question, unless they ask you to. Your loved one just needs more time to process what you said and then to process what they want to say. Wait for them to respond. If they are having trouble thinking of the correct word, don’t jump in and tell them. Let them come to it on their own. It may take time, but if you answer for them or tell them what to say, they may become defensive and no longer want to participate in the conversation.
You will also want to stick to one topic while talking to your loved one. They may be unable to follow a conversation if you are jumping from topic to topic quickly. Your loved one will take longer to processes information, and if you change topics, they will likely become confused. Ask them open-ended and observational questions. Don’t ask them if they remember a certain item or day, as it can be confusing for them and make them upset.
While conversing with your loved one, don’t refer to yourself or others by their relationship. For example, don’t mention your brother, use his name, instead. Using names in place of relationships can be especially helpful if your loved one believes they are in an earlier time in their life. Trying to bring them back to reality with titles and relationships may end up confusing them more and make them lash out.
Figures of speech and slang words can be difficult for your loved one to understand, so try not to use them. Esther Heerema, a social worker for Very Well Health, says that using phrases like, “it’s no use crying over spilled milk” are confusing for your loved one and they may try to find where the milk has been spilled. Using the proverb interpretation test, where the test taker is asked to interpret abstract ideas such as “it’s no use crying over spilled milk” is one way that doctors screen for symptoms of dementia.
Some open-ended questions can confuse your loved one and make conversation more difficult for them. Asking your loved one what they want to wear for the day or where they want to go can be overwhelming for them, but if you give them a few choices, it can make the decision easier, and still give them a sense of independence. You can try putting out two outfits and asking your loved one which one they would like to choose, and you can do the same with where they would like to go for the day.
When holding a conversation is difficult, there are other things you can do to let your loved one know you are there for them. You can maintain eye contact, smile, hold their hand, or even just sit quietly and be present with them. During the later stages of dementia, it may be difficult for your loved one to communicate verbally, but there are still things you can do together and experience. Utilizing all of their senses is a useful tool when communicating with a loved one with dementia. You can look at old albums, play music you know they enjoy, and cook their favorite foods for them to smell.
Remember that there will be good days and bad and try not to become disheartened with the bad days. While taking care of a loved one, it is important to take care of yourself, as well. If you are interested in learning more about caring for yourself while providing care, check out our quick tips episode on managing caregiver stress, or check out one of the full-length episodes on how to help the caregiver.
If your loved one is being aggressive or volatile, do not interact with that behavior. If they shout at you that they do not want to take a bath, don’t give them a bath. It’s important to respect the communication that they are able to give you at that time. And you don’t just completely abandon the task. Try to come back to it in a few hours if your loved one is in a better headspace.
The Alzheimer’s Society recommends preparing for your conversation with your loved one ahead of time. Imagine yourself in their shoes and think about how you would feel if you were struggling to communicate. While caring for your loved one daily, it is easy to forget how they are feeling is singular to that moment, especially when dealing with cognitive issues.
Before starting a conversation, make sure you have enough time to spend with your loved one. You don’t want to make them feel rushed, as it can give them more stress and make them not want to participate with you. Look back on previous conversations and think about what strategies you have used and how they worked for you. If you know gestures make it easier for your loved one to understand you, try to incorporate them more in your conversations.
It’s important to treat your loved one with respect. Don’t talk to them like a child, even though you may be tempted to. You will want to make sure you are at eye level during your conversation. Try not to be too tall that you are looking down on them. If they are sitting down, sit down with them. If you are in an area where you are unable to sit with them, kneel down next to them, even if it is uncomfortable for you.
You can also plan what you are going to talk about ahead of time. You can use their own environment to come up with a topic. Talking about things they can visually see may make the conversation easier for them to follow. If your loved one experiences Sundowner’s Syndrome, try to plan a time to communicate with them when you know they are more likely to be present. For more information about Sundowner’s Syndrome, you can check out the episode we did on it on our podcast or visit our website for resources.
Sometimes, individuals with dementia that speak more than one language will revert to using their first language. If you notice this happening, see if you can have a family member or friend help translate your conversation. You can also try using a translator app but using technology may end up confusing your loved one more. There may also be organizations in your area that can help you translate a conversation with your loved one.
You should also make sure they are not hungry, in pain, or need to go to the bathroom before you try to have a conversation. All of these things can be distracting to your loved one and they may not be able to communicate that they need something when they are trying to focus on a conversation, too.
When there are other people around, make an effort to include your loved one in conversation. You can ask them simple yes or no questions in group settings so that they can still feel included. If possible, make others aware ahead of time of the proper ways to communicate with your loved one. Mainly, let them know to give your loved one time to respond and keep sentences clear and concise. Your loved one will appreciate being included, even if they are unable to keep up with the conversation for the entire duration.
It is also important to note that talking to too many people at once can be overwhelming and cause too much stress for your loved one, so make sure you are keeping an eye on the situation so you can tell when they have had enough socialization. You want your loved one to enjoy social settings and look forward to them, not become overwhelmed by them.
When talking to your loved one, don’t ask them why. Questioning them will only make them doubt themselves and cause them anxiety. If your loved one seems to be stuck in a loop, asking the same question over and over again, don’t ignore them, but you also don’t want to keep answering the same questions over and over. Instead, try to divert their attention. If they are asking you who you are, you can say your name and then ask them to tell you about a topic you know interests them. This can be a hobby, a favorite author, a favorite food, really anything you know that they are usually able to talk about.
If your loved one is telling you or someone else about a past event and they don’t have the details correct, do not interject and tell them they are wrong or try to correct them. If you interject, you will end up making them anxious or angry and make them believe you think they are stupid. Instead, talk about the memory. Talking about it, even if the details are wrong, can help their cognitive function and make them happier.
The only time you should correct them is when they are talking to their doctor, and they have given them information that you know is incorrect and could be harmful. In this situation, try to tell their doctor in a way that does not seem condescending to them. If this happens frequently, try to inform your doctor of any medical information and changes before the appointment starts and you can always call them before or after the appointment if necessary.
Caring for a loved one with dementia is difficult. Make sure you have a good support system and take the necessary time you need for yourself. As a caregiver, you are not able to provide adequate care if you are not able to have a break and care for yourself too. Reach out to local organizations and remember you can visit our website for resources on caring for yourself while caring for a loved one with dementia.
We want to say thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate long-term care issues. Please visit us at allhomecarematters.com there is a private secure fillable form there where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone is who could benefit from this episode and please make sure to share it with them.
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