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Communication & Dementia – Four Essential Strategies for Success

Posted on: Jul 07, 2020

David Troxel, MPH, co-author of The Best Friends Approach to Dementia Care and Consultant to Christian Horizons

This week Christian Horizons continues an 8-week campaign to improve the lives of its residents living with Alzheimer’s disease and other dementia.

The premise of the campaign are that socialization and activity remain important for people living with dementia, despite the challenges of the COVID 19 environment. Each week staff will focus on a specific topic or activity to encourage connection and community – particularly important during this time of limited family visits and infection control.

This week’s focus is on communication – offering Christian Horizons staff associates and family members ideas on how to enhance communication for persons living with dementia.

Sadly, most people living with dementia experience damage to the language centers. Sometimes it’s hard for them to understand spoken and written language or directions. It’s hard for them to communicate their needs. Part of this is due to the three A’s, aphasia, apraxia and agnosia:

Aphasia is a communication disorder caused by damage to the brain that causes loss of ability to understand or express speech

Apraxia is a problem completing a motor action/physical action after being asked (for example, putting your arm through the sleeve of a sweater)

Agnosia is the inability to recognize common objects or things (thinking a coffee cup is a hat)

Successful care partners recognize these losses and develop strategies to make the best connection possible. Christian Horizons, as part of its dementia friendly ministry, recognizes that even with dementia, we all have a need to communicate, a need to connect.

Here are four essential ideas for family and professional care partners.

In conversation:

Use the person’s life story liberally to provide comforting clues and cues - Remind your father about his teacher of the year award or your mother about her caring career in nursing. This helps them feel known and connected to positive memories.

Don’t correct or argue – It’s okay to provide some gentle cues to reality (“mom would you believe you are 80 not 60!”), but if someone is stuck on a false memory jump into their realty (“mom you look wonderful whatever your age” vs “mom, you are not 45!”). Correcting the person can add to confusion and reinforce his or her sense of loss or confusion.

Focus on emotion over words and language – the person with dementia can understand smiles, affection, and kindness. To paraphrase the famed poet Maya Angelou, “People will never remember what you said of did but will always remember how you made them feel.”

Give a lot of compliments - The person with dementia often experiences fear, losses and embarrassment. Take a few minutes and offer some authentic compliments, “Mom, you look so pretty in that beautiful pink sweater,” or “Dad, you headed up 15 church committees – that’s amazing!” A compliment lifts someone’s spirits and is a life-affirming gift to the person living with dementia.