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A Caregiver’s Guide to Effective Communication Strategies for Dementia

Communication with others is essential to every aspect of our daily life. We’re always communicating, whether it’s with a glance, our voice or sending a text. For most of us, our brains allow us to filter the communication we receive and use it to inform our actions and responses. For someone with dementia, though, the disease causes the brain to change in a variety of ways, making what we consider normal communication challenging. This poses many difficulties and frustrations for both the individual with dementia and their loved ones.

“It’s easy to forget that just because the person with dementia isn’t able to communicate in the way we’re used to, it doesn’t mean that they don’t want to communicate,” says Andrea Campisi, Marketing and Admissions Director of The Reutlinger Community, a Continuing Care Retirement Community in Danville, CA. “The desire to connect and be heard is still present, even as the brain is affected by the disease. Caregivers need to have good listening skills, patience and develop new strategies to help improve communication between themselves and their loved ones.”

Early-Stage Communication in Dementia

In the early stages of dementia, one of the first things a caregiver experiences is that their loved one will forget things or have a hard time speaking. Verbal communication is one of the first abilities that becomes hijacked by the disease, causing individuals to have difficulties including:

  • Not being able to find the right word.
  • Reverting to a native language.
  • Repeating questions, words or stories.
  • Substituting words.
  • Mixing ideas and phrases together.
  • Describing an object instead of calling it by its name.
  • Speaking less often.
  • Losing a train of thought.

Caregivers may at first find communication confusing in this stage because the individual still functions at a high level and acts “normal.” Here are some tips for establishing successful communication in these early stages:

  • Continue to communicate with your loved one and don’t assume that he or she doesn’t understand what you’re saying because of the disease.
  • Ask your loved one what they need help with, and what they’re comfortable doing on their own.
  • Don’t speak over or exclude your loved one from conversations. He or she is still an adult. In the same vein, always speak directly to him or her.
  • Give your loved one plenty of time to respond when you ask questions. Resist the urge to interrupt.
  • Ask simple questions and give limited choices if necessary. Complicated questions and run-on sentences can be confusing.

Mid-Stage Communication in Dementia

The middle stage of dementia is usually the longest and can last for many years. During this phase, your loved one will find it more and more difficult to communicate, and will require more and more personal care. As a caregiver, you will find that you are responsible for quite a lot, such as direct care, coordinating assistance and juggling everything your loved one needs with your needs. Here are some tips for successful communication during this stage:

  • When talking to your loved one, minimize distractions as much as possible. Due to the disease, he or she will have difficulty filtering out background noise, like the TV or a crowd.
  • Speak slowly, clearly and with eye contact. Keep your voice pleasant and calm, since your loved one will understand your tone of voice even if they can’t interpret what you’re saying.
  • Give your loved one plenty of time to respond, and resist the urge to interrupt or suggest words.
  • Be kind and offer reassurance as much as possible. Let your loved one know they are safe and loved.
  • When you become frustrated, avoid the urge to correct or criticize. Listen to the meaning behind what your loved one is saying and try and interpret from there. Is he or she hungry? Thirsty? Need to use the bathroom?
  • When performing tasks, break them down into simple, step-by-step instructions. Once each step is completed, your loved one can continue to the next.
  • Give visual clues while you’re speaking. For example, if you say, “are you hungry?”, point to the refrigerator. Or if your loved one is performing a task, you can demonstrate what needs to happen to give them confidence.
  • Consider writing notes and placing them around the home can help reduce confusion and repetitive questions.

 Late-stage Communication in Dementia

In the final stages of dementia, your loved one’s ability to communicate verbally will decrease or go away entirely. He or she may rely solely on nonverbal communication such as sounds or facial expressions. He or she will require around-the-clock care, and this is usually a point where you as a caregiver will need to hire additional assistance or place your loved one in a Memory Care community where they can receive the assistance they need. Here are some tips for successful communication during this stage:

  • Encourage your loved one to communicate nonverbally. Ask him or her to point to things and ask questions to figure out their intent.
  • Use other senses to communicate with him or her. A caring touch, delicious smells or happy sounds are great ways to bond.
  • Think about how your loved one is communicating to help determine what they’re communicating. Sometimes the emotions they’re expressing are more important than the words coming out of their mouth.
  • It’s okay to not speak if you don’t know what to say. Your love and presence can sometimes be all that’s needed.

 Overall Tips for Successful Communication

  • Be patient with your loved one and give them plenty of time to express themselves.
  • Learn how to interpret what they’re really saying by paying attention to nonverbal clues.
  • Pay attention to your body language, because actions can really speak louder than words.
  • Always treat your loved one with respect – don’t speak down to them or use baby talk.
  • Offer choices to provide your loved one autonomy.

If you feel yourself getting frustrated, take a break and do something kind for yourself. A rest can give you just what you need to refocus and provide the best possible care for your loved one.

For more information about our community, our culture and our mission and values, please contact us at 925-272-0261.

Premier Senior Living, Dedicated Care

Offering Assisted Living, Enhanced Assisted Living, Memory Care, Skilled Nursing and Rehabilitation, The Reutlinger Community provides a continuum of care that allows seniors to live a life-enhancing and stimulating environment. Located in Danville, California, The Reutlinger Community’s newly renovated, 110,000 square foot community combines the comfort and familiarity of home with seasoned senior care and skilled nursing specialists to suit any seniors needs, allowing them to live the life they choose with freedom and security.

Because we specialize in a continuum of care, our residents never need to worry about leaving the community they call home or wonder what will happen when they need some more care. Residents and families alike can have peace of mind knowing that there are full-time licensed nurses available, along with activity coordinators, social workers, caregivers, a concierge and Rabbi who focus solely on helping each resident thrive. Even better, our services and amenities are equal to those of a state-of-the-art resort. This is the lifestyle and care that your loved one deserves.

At The Reutlinger Community, seniors have numerous opportunities to engage in award-winning programs that are designed to engage the mind, renew the spirit and provide opportunities to meet new people and learn something new. Whether residents are enjoying our art program and museum, listening to a lecture or educational program or attending spiritual programming and our wide range of activities, there’s something for each resident to love. Participate as much or as little as you like, the choice is all yours.

For more information or to schedule a personal tour, contact us today.

Preserving Their Dignity: Tips for Difficult Conversations (Part 3 of 4)

At The Reutlinger Community, we strive to educate residents, future residents and adult children about all aspects of the dementia process and best practices for ensuring the best quality of life for your loved one – and yourself. In this four-part series, we discuss the importance of providing dignity throughout the dementia journey and how you can connect compassionately and in fulfilling ways.

When your loved one has dementia, it may seem like every conversation ends up being a difficult one. What type of care should Mom or Dad receive? What will happen when he or she requires more help? How should end-of-life treatment be handled?

“Hard conversations will happen throughout all phases of the dementia journey – it’s just a matter of fact considering the course of the disease,” says Andrea Campisi, Marketing and Admissions Director of The Reutlinger Community, a Continuing Care Retirement Community in Danville, CA. Hopefully, you and your loved one (as well as other interested parties) will have important conversations as soon as the disease is diagnosed, but as with any plan, you’ll need to revisit it on a regular basis.

“Eventually, you or your loved one’s designated representative will need to be the decision-maker for care plans and other mid- to late-stage dementia decisions,” says Andrea. “This is easier for everyone involved if your loved one’s wishes are clear and everyone is on the same page regarding next steps. However, even if your loved one is in the more advanced stages of dementia, there are still ways to help preserve their dignity, respect them as a person and take their needs into consideration.”

Having Difficult Conversations Early Stages

There are many tough decisions that have to be made at the beginning of the dementia journey. It’s easy for family members to leap into action and want to make decisions for their loved one. Although this comes from a place of love, remember that your loved one is the person who should ultimately make as many of the hard decisions as possible.

“Too many people hear the word dementia and assume that their loved one can no longer function,” says Andrea. “But most of the time, the person with dementia is still highly functioning and can think clearly, rationally and make their own decisions. If the disease is still in the early stages, you, your loved one and other interested parties should work together to plan for the future.”

Things like treatment and care, living situations and determining powers of attorney should be decided at this time. Ask your loved one to clearly state their wishes for what they want to happen “down the road” – it’s a good idea to create documentation that can be easily shared.

Having Difficult Conversations – Later Stages

As the disease progresses, caregivers will end up having to make more and more decisions on behalf of loved ones with dementia. Some of these may have already been figured out, but plans can change based on the situation. While your loved one won’t be able to make every decision, there are still many opportunities for them to take control and make appropriate decisions.

“Although your loved one may not be able to make decisions about specific courses of treatment, he or she may be able to decide what to wear that day, or what TV show to watch,” says Andrea. “Dementia affects communication and speaking, but it’s still possible for your loved one to express their desires and wishes. You’ll just need to be patient, choose the right moment and understand how they’re trying to communicate.”

Unfortunately, there may come a time when you need to have a tough conversation and your loved one can’t – or won’t – participate. This may require you to work with a third party, like a doctor or therapist, or even make an executive decision. Things like this could be having a conversation about your loved one quitting driving, or deciding that Mom or Dad need to move to a Memory Care community.

It’s important to meet your loved ones “where they are” and understand what types of decisions they can and can’t make. For example, your loved one doesn’t want to move to a Memory Care community, but you know that it’s the right choice. Instead of trying to convince him or her why moving is necessary, you should present the situation and provide opportunities for discussion. Here are some tips for having a hard conversation:

  • Treat your loved one as the adult they are. Don’t talk down to your loved one or treat them like a child. Even if their abilities are being lost, people with dementia can still understand when they’re not being treated like adults, and that’s incredibly frustrating to them. Remember that they’re still a person who deserves respect and dignity, and be sure you always approach conversations that way.
  • Ask open-ended questions and give plenty of time for response. Instead of saying “do you want to move to Memory Care?” say instead, “How do you feel about moving to Memory Care?” Then, give your loved one as much time to respond as needed. It can be difficult to form responses, so be patient.
  • Be flexible. Your loved one may be “sharper” at certain times of the day than others. Avoid having a conversation at a “bad” time, and if you start a conversation and realize your loved one is getting anxious or frustrated, go do something else and come back to the conversation at a better time.
  • Use “I” and “we” phrases. Instead of saying things like “you should…” or “you’re going to… ,” talk about your feelings and emotions. “I feel overwhelmed and can’t give you the quality care you deserve,” is an appropriate thing to say, as is “I’m scared you’re going to seriously hurt yourself going up and down the stairs all the time.”
  • Be understanding. The world can be a confusing and scary place for those with dementia. Be kind and know that your loved one is doing the best they can – as are you. Reassure them and yourself that you want them to have fun, live their best life possible and be happy, and that everything you’re doing is to make that happen.

For more information about our community, our culture and our mission and values, please contact us at 925-272-0261.

Premier Senior Living, Dedicated Care

Offering Assisted LivingEnhanced Assisted LivingMemory CareSkilled Nursing and Rehabilitation, The Reutlinger Community provides a continuum of care that allows seniors to live a life-enhancing and stimulating environment. Located in Danville, California, The Reutlinger Community’s newly renovated, 110,000 square foot community combines the comfort and familiarity of home with seasoned senior care and skilled nursing specialists to suit any seniors needs, allowing them to live the life they choose with freedom and security.

Because we specialize in a continuum of care, our residents never need to worry about leaving the community they call home or wonder what will happen when they need some more care. Residents and families alike can have peace of mind knowing that there are full-time licensed nurses available, along with activity coordinators, social workers, caregivers, a concierge and Rabbi who focus solely on helping each resident thrive. Even better, our services and amenities are equal to those of a state-of-the-art resort. This is the lifestyle and care that your loved one deserves.

At The Reutlinger, seniors have numerous opportunities to engage in award-winning programs that are designed to engage the mind, renew the spirit and provide opportunities to meet new people and learn something new. Whether residents are enjoying our art program and museum, listening to a lecture or educational program or attending spiritual programming and our wide range of activities, there’s something for each resident to love. Participate as much or as little as you like, the choice is all yours.

For more information or to schedule a personal tour, contact us today.