Dementia will gradually affect the way a person communicates
Good communication is key in all walks of life, but when it comes to helping somebody to live well with dementia, finding the right words at the right time can be a minefield. “For a person living with dementia, language can become more difficult over time,” explains Dr Tim Beanland, Alzheimer’s Society Head of Knowledge.
“They may have trouble finding the right word, may repeat themselves or use one word when they mean another. Developing sight or hearing problems as part of the illness can also make it harder to communicate.”
All this can cause a loss of confidence, create anxiety and depression or lead to the person living with the condition becoming withdrawn.
“Realising they are unable to express themselves as they used to can cause frustration or mean behaviour becomes challenging or difficult to understand,” says Dr Beanland.
900,000 people are currently living with dementia in the UK
These issues are faced by 900,000 people currently living with dementia in the UK. But it isn’t just the person living with the diagnosis who can struggle.
“While they may have trouble finding the right words, the things other people say are just as important,” he explains.
“Whether it’s a partner, family member or friend, knowing how to navigate conversations can improve relationships in an instant.”
Here, Dr Beanland highlights a few pitfalls that can trip us up – and explains what we should be saying instead.
While it can be tempting to try to jog the memory of somebody living with dementia, this kind of question is often a reminder of memories lost.
It can also sometimes feel like the person is being tested.
This can be a frustrating or painful experience, and there’s also no evidence that prompting the person in this way will help them to recall or hold on to those memories.
Try this instead: It can be pleasant and comforting to talk about the past, however, it’s usually more helpful to lead the conversation and allow the person to join in.
Instead of posing a question, try leading with: “I remember when?” That way, they can search their memory calmly without feeling embarrassed, then join in if they like.
‘I’ve just told you that’
It can be difficult answering the same question several times, especially when you are trying to keep frustration or upset from your voice. However, reminding the person that you have just answered their question will not help them retain the information for next time.
It is likely to just remind them of their condition, which can be distressing for you both.
Try this instead: Aim to answer repeated questions calmly and patiently.
And if you feel the need, take a break and remove yourself from the conversation for a while.
Remember, the person cannot help repeating themselves and it is important for them to feel heard too.
‘But your brother died 10 years ago’
A person living with dementia may forget about a past bereavement or ask for somebody who has died.
Reminding them of a loved one’s death can be painful and they may react as though they are hearing the news for the first time.
Try this instead: How to respond to these types of difficult questions will vary for different circumstances, however, it’s always important to show sensitivity and minimise distress. Don’t avoid the question as this can cause them to feel more anxious.
For some, encouraging them to talk about the person they are asking about can be comforting.
Ask how they are feeling generally. Sometimes dwelling on a particular family member or friend can be a sign they have an unmet need or worry.
‘What did you do this morning?’
Avoid asking too many open-ended questions about the past as it could be stressful for a person with dementia if they can’t remember.
While it might seem polite to ask somebody about their day, it’s better to focus on the present.
Try this instead: Instead of asking them about something that has passed, speak briefly about your own day and give them time to ask you questions about it.
This may encourage them to offer information about what they have done.
Discuss things in the present and use items you see around you, such as photos or ornaments, to stimulate conversation.
‘Do you recognise me?’
It can be distressing when somebody with dementia doesn’t recognise you, especially if you have a close relationship with them.
Remember that it is likely to be upsetting for them to not recognise people around them too.
Avoid too many open-ended questions this can stressful
Asking the person if they know who you are could also make them feel guilty or anxious if they don’t remember, or it can be found offensive if they do.
Try this instead: The way that you greet somebody with dementia might change depending on the stage of their condition – judge for yourself, but keep it friendly.
A warm hello could suffice, or it may help to say your name to them.
‘Let’s have a cup of tea, then we can go for a walk and get lunch in your favourite cafe’
Long, complex plans or sentences can be difficult to grasp for somebody with dementia.
It’s hard to process many ideas at once as cognitive abilities slow down.
Try this instead: It’s better to give directions or instructions one step at a time, so use short, simple sentences as much as possible.
Avoid speaking in loud environments and wait until you have the person’s full attention before you start talking.
‘Do you need some help with that, love?’
Words like “love”, “honey” and “dear” can sometimes be patronising for people living with dementia.
This is particularly true if this is not how they were referred to before having dementia.
This is sometimes referred to as “elderspeak” and can cause older people to feel infantilised.
Try this instead: Always remember the person behind the dementia, using their name as often as appropriate.
This helps keep their dignity intact and aids concentration too.
- A third of us will develop dementia in our lifetimes. The Alzheimer’s Society works to help end the devastation caused by dementia, providing help and hope for everyone affected. Visit the website for more information or donate at alzheimers.org.uk
WHAT TO DO IF THINGS DON’T GO TO PLAN
Despite your best efforts, conversations might not always develop the way you hope they will. Small things can make a big difference and by making a few adjustments, people with dementia can live better with their condition.
So how can you save an awkward moment? If the person you’re talking to is having difficulty understanding you, try to rephrase what you’re saying in a slightly different way.
Humour can help to relieve tension and bring you closer together, so try to laugh about misunderstandings and mistakes. Just make sure the person doesn’t feel you are laughing at them.
Choose a place that is familiar and private to bring up any more difficult conversations, and allow plenty of time, so the conversation is not rushed.
If you need more tips on how to approach communication, Talking Point is the Alzheimer’s Society online community, where people can ask questions and share experiences on how to best support someone with dementia.
It’s free to use and people can remain anonymous there to discuss sensitive issues and seek support more privately.