Education and Care - Communication Techniques

Alzheimer's Foundation of America

It's not what you say, but how you say it. This expression holds doubly true when communicating with individuals with dementia.

Alzheimer's disease or related illnesses impair a person's ability to understand words and to speak. However, they can still benefit from non-verbal communication - body language, voice tone and facial expressions. As the individual's ability to process verbal information declines, the importance of how caregivers communicate with them, verbally and non-verbally, increases.

Here are some tips to enhance interactions:

• Remember that the individual with dementia might be feeling confused, anxious, irritable and depressed, and suffering from low self-esteem.
• Rely on the four S's: Simple, Slow, Show, and Smile.
• Simple - Use simple words and simple sentences. And give instructions one step at a time. Too much information can be overwhelming for a person with dementia.
• Slow - Speak slowly, and allow enough time for the person to understand each thought or question.
• Show - the person with dementia what you are saying; don't just say it. Use body language, facial expressions and gestures to tell your story so the person can benefit from your words and your actions. For example, point to objects or demonstrate an action, such as brushing your teeth.
• Smile - A smile sends a powerful message of reassurance. Be conscious of your facial expressions. Using facial expressions to show that you are friendly will help the person with dementia better understand the tone of the discussion.
• Speak in a tone that is calm and reassuring.
• Make certain that the person with dementia has the best chance of seeing and hearing you. This involves checking that the person is wearing glasses and hearing aids, if necessary, and that talking occurs in a quiet environment.
• Approach the individual from the front. It may startle and upset him if you touch him unexpectedly or draw near from behind.
• Before asking the individual to do something, address him by name to get his attention. While you are speaking, maintain eye contact to help him focus.
• Ask only one question at a time and allow time for an answer. If he does not seem to understand, repeat the question using the same wording. If this does not work, after a few minutes, rephrase it.
• Allow the individual adequate time to respond in conversation or when performing an activity. Rushing will increase confusion.
• If the individual repeatedly asks a question, keep in mind that he cannot remember the response you have just given him. Instead of answering the question after a second or third repetition, reassure the individual in some way-everything is fine, you will be with him, you will help him.
• Eliminate distractions, such as the TV or radio, when talking to the person with dementia.
• Avoid statements that sound negative. For example, instead of "Don't go outside," say, "Stay inside."
• Use humor whenever possible, though not at the individual's expense.
• Break down all tasks into simple steps. Tell the individual one step at a time what to do. Giving too many directions at once or too quickly will increase confusion. If the individual gets upset and becomes uncooperative, stop and try again later.
• Keep on talking, even when a person may no longer be verbal. Chat about things that mattered to the person and mention names of family and friends. Even if communication is one-sided, it can loudly show that you care.