Alzheimer's Disease & Dementia Care - Communication Strategy

As Alzheimer's progresses, patients become unable to speak and less able to understand. As a result, it becomes difficult to express feelings and wishes to others and understand what others are saying. It may no longer be realistic for the person you care for to hold a conversation, understand instructions or remember steps to follow.
Lost communication can be frustrating for everyone involved. The following strategies can help improve communication with those you care for:

• Keep it simple. Use simple, short sentences. For example, "Let's take a walk" is much easier to comprehend than "It's a beautiful day, how about going for a walk to enjoy the birds chirping."
• Use neutral tones that are gentle and relaxed.
• Approach the person from the front. Say their name and establish eye contact before beginning to talk.
• Speak slowly, clearly and at a volume that the person with dementia can easily understand.
• Be aware of hearing difficulties and look for clues, such as eye contact or facial expressions, that the person heard you.
• Reduce environmental distractions. Someone with dementia may get confused during conversation when there is background music or other people around.
• Break tasks and instructions into clear, simple steps. (Again, keep it simple.)
• Ask one question at a time and listen. Repeat instructions, as needed, and allow more time for a response. Try not to interrupt.
• Act out messages when possible, such as pointing to an object that you are talking about.
• Be patient with angry outbursts. Remember, it's the disease talking.
• If you become frustrated, take a timeout for yourself.
• Don't talk about someone with dementia as if they are not there. Also avoid "baby talk" or using a "baby voice."

In the late stages of Alzheimer's disease and dementia, an individual may have complete loss of speech and extreme disorientation.
People who no longer understand spoken words may depend on body language for information. Caregivers must be aware of their body language and the message it sends. They should also learn to read the body language of people with dementia to identify their needs, feelings and when they could be in pain.
These nonverbal suggestions often help connect with a person with Alzheimer's disease:

• Make nonverbal messages match your words. Smile when greeting someone, wave when you are saying goodbye.
• Adopt pleasant, positive, nonverbal behaviors to reassure and encourage.
• Look for facial expressions and body language to determine what is pleasurable, uncomfortable or possibly painful.
• Remember that you may be conveying emotions such as sadness or irritation through your actions more than your words.
• A person with dementia can react to your emotions. Be careful not to be in a hurry, frown or speak quickly or angrily.

The key to communicating with someone with Alzheimer's or dementia is to get into their reality. The disease has changed their abilities. Use techniques to continue communication at their level, given their change in condition.
Communicating with someone with dementia requires patience. Ignore angry outbursts - this is the disease talking. Don't, however, ignore your own frustration or stress. Doing so is unhealthy for you and anyone you care for. It can affect the body language you portray and jeopardize your relationship with those you care for. If you're becoming too overwhelmed or frustrated, take a deserved break. Enlist the help of a friend, relative or home care company to give you time to care for yourself and reconnect with others.