Ways to Communicate and Connect With People Living With Dementia

Communicating and engaging with a person living with dementia can be challenging. For family and friends, it can be difficult to connect with a person who may not recognise them or displays behavioural changes. However, it is possible to continue to have a meaningful relationship with people living with dementia. Dealing with the impacts of the condition and creating comforting and positive interactions can help you to connect and communicate more effectively.

How Does Dementia Affect Communication?

People living with dementia often find it more difficult to express themselves. This is due to the impact that the condition has on the brain, making it harder for people to understand others, to remember words and phrases, and to organise words into sentences. People living with dementia often have a shortened concentration span and can easily lose their train of thought or become distracted. Many people living with dementia will also forget or not be able to recognise their loved ones, which makes it especially hard for them to trust the people around them. However, despite these challenges, communication and genuine connection with people living with dementia is possible. 

Learning to Deal With Memory Loss and Confusion 

Memory loss is one of the major symptoms of dementia, and unfortunately this is something that you will have to get used to as your loved one lives with the condition. In the later stages, people living with dementia will often not remember people, places and items. They won’t recognise loved ones, will become confused about the layout of familiar spaces, and won’t know the purpose of common items such as cutlery. This degree of memory loss can be very difficult to deal with as a loved one.

Although these changes can be upsetting or confronting, it is important to learn to deal with memory loss in a person living with dementia. It is still possible to have a positive relationship with someone, even if they cannot always remember who you are. Some methods of assisting a person with memory loss include providing visual prompts. Photographs and other items can act as reminders and assist the person living with dementia to remember important people and places. 

Because people living with dementia will often think they are in another part of their life, normally their youth, you can engage with them as though you are there too. Don’t try to correct them or explain; ask about what life is like in this era and listen to their recollections rather than criticising them for not being in the present.

Coping With Changes in Person’s Cognitive Ability 

As with memory loss, watching the deterioration of a person’s cognitive ability can be distressing for loved ones. In the early stages of the disease, prior to a diagnosis, dementia may present as the inability to manage daily tasks. You might notice that your loved one is losing track of their wallet or keys, can’t remember to attend appointments, or isn’t managing to effectively feed themselves anymore. All of these can be initiated by damage to the brain cells, which is the cause of dementia.

Different areas of the brain are responsible for different functions, such as memory, movement, reasoning, and speech. If cells in a specific area of the brain are affected, the person will struggle with these sorts of activities. It’s important to understand that in most cases, changes in the brain that cause dementia are permanent. You cannot fix a person’s memory loss or difficulty with thinking, but you can accept these challenges and work with them to make life easier. 

Remember to always be patient and reassuring with a person living with dementia. Never criticise them for not being able to do something – it’s not from a lack of effort or apathy. If they are forgetting things, try making suggestions instead of correcting them; for example, if they forget a person’s name, you could say “I think her name might be Anna.”

Coping With Changes in Behaviours 

When you witness your loved one behaving in a very different and sometimes upsetting manner, this can be a challenge. However, it’s important to realise that the experience of living with dementia can be quite distressing for the person. Memory loss, confusion and the inability to communicate effectively can be extremely frustrating, and some people will become angry or aggressive due to this. Others will become unsure of themselves, or may become disconnected and apathetic towards life. All of these are normal and can be addressed with love and compassion.

Firstly, it’s important to understand and expect changes in behaviour for a person living with dementia. Some common changes you might witness in your loved one include wandering, restlessness, sleep disturbance, or angry outbursts. Often, these behaviours can be associated with certain triggers, and working these out can assist in managing them. For example, the person living with dementia may become restless and fidgety at a certain time of the day. 

Physical Frailty and Dependency 

Although dementia is a condition affecting the brain, people living with dementia will often experience physical problems as well. Physical frailty is considered to increase your likelihood of developing dementia, while a stronger and healthier body can prevent the condition in some people. People living with dementia will often become highly dependent on their loved ones, due to their confusion when navigating spaces and their inability to remember things like what time they have to be at a certain location or why they need to go to the doctor. Your loved one may need assistance with personal and home care such as toileting, dressing and bathing. These needs are often a lot for family members or friends to manage on their own, and it can be a good idea to seek some support with home care. 

Engaging Loved Ones With Activities 

Although verbal communication with a person living with dementia can be difficult, there are many other ways to connect and engage. Activities can be a fantastic bonding exercise that are accessible for you and your loved one and that help to create a calming and enjoyable experience for you both.

When planning activities, it’s important to focus on the abilities and skills of the person living with dementia. This is not intended to be a challenge or a puzzle – you want to find something that they will find pleasurable and easy. You may be able to link activities to the person’s life before their diagnosis: for example, if they have always loved trains, then helping them to build a model train track might be fun. If they used to love sewing, an activity like sorting buttons or spools of thread might appeal to them.

Remember, activities for people living with dementia are not the same as activities for children. Anything that isn’t age-appropriate might be insulting to them, or they may find it boring. On the other hand, anything that is too difficult, like memory games, will be frustrating. You need to try to find that comfortable middle ground, which may require some trial and error. Even if you don’t have success in your first attempts at arranging an activity, try again! 

Some activities that you may like to try include:

• Scrapbooking with old photos
• Jigsaw puzzles
• Painting and drawing
• Knitting
• Crafts, like making necklaces or decorating boxes
• Listening to music
• Giving each other hand massages
• Cooking and baking.

Create a Positive Environment 

It is vital that you always endeavour to create a positive mood when engaging with a person living with dementia. Although they may not seem to know what is going on, people living with dementia can be highly attuned to the emotional responses of others. If they know you are angry, frustrated or upset with them, they will probably feel those emotions themselves. 

Always try to be reassuring and positive. Remember, it can be scary not being able to remember things, or not knowing who you are talking to. Try to put yourself in their shoes and think about what they might want from an interaction. Create a sense of comfort and encourage the person living with dementia to communicate in ways that work for them. Keep your sense of humour; laughing together at mistakes and misunderstandings can help bring you closer together.

If you do feel annoyed or frustrated, don’t be afraid to take a break. Leaving the room for a few moments can help you to calm down and return in a more positive headspace. Caregiving is hard, and seeking some support is a good idea if you’re feeling stressed or overwhelmed. 

Communication Tips

When communicating with a person living with dementia, it’s a good idea to keep in mind that they may not always understand what you’re trying to say the first time. Be patient and understanding; if the person doesn’t understand, try rephrasing or repeating what you said. Asking a lot of questions isn’t always a good idea, as the person can feel like they are being interrogated. Instead, keep your communication conversational. You can chat and make comments that don’t require a response. This will put the person at ease and not make them feel pressured to always find an answer.

 Some things to keep in mind when communicating with a person living with dementia include:

Be respectful

Just because the person is finding it more difficult to understand you, this doesn’t mean that they are child-like or not intelligent. Avoid “baby speak” and keep your voice at a normal level. 

Use shorter sentences

Long sentences that take a while to get to the point can be more difficult for the person living with dementia to follow. Use short and simple sentences instead.

Pause

Between sentences, pause and allow time for the person living with dementia to process what you have said. Give them time to respond if you have asked a question. Don’t worry if the pause feels awkward or too long, as the person will appreciate the extra time.

Stay with one idea

Conversations that jump around through a lot of topics can be confusing and hard to follow. Stick with one idea for a while. If the person doesn’t seem engaged, you can try another topic. 

Ask simple questions

When you need the person living with dementia to give you information, phrase your questions in the simplest way possible. Yes or no questions are a good way of doing this, or you can provide two clear options. For example, you could ask ‘Are you hungry?’ followed by ‘Would you like an apple or a pear?’

Don’t interrupt or interject

Often a person living with dementia will take a while to complete a sentence. Try not to complete their sentences for them or assume what they are trying to say. Be patient and wait for them to finish. If they are looking for help, you can provide gentle prompts or suggestions.

Include them in conversation

Never speak about your loved one living with dementia as though they are not there. Dementia can be a very isolating experience. Always include the person living with dementia in conversation with others. This will help them to keep their sense of self-worth. 

Non-Verbal Communication 

Up to 90% of our communication is non-verbal. When connecting with a person living with dementia, it’s especially important to keep these non-verbal communication techniques in mind. Often, a person living with dementia will struggle to express themselves with words, but their other cues will help you to understand what they are trying to say. 

Facial Expressions and Body Language

Be conscious of your facial expressions and body language. We can say a lot with our gestures, so avoid anything that will appear aggressive or frustrated. Open and relaxed body language helps to put a person at ease. Try to be at eye-level instead of standing over someone, and sit or stand in front of them so they can clearly see and hear you.

Tone of Voice

Also consider your tone of voice. Avoid speaking loudly or crossly. If a person doesn’t understand, raising your voice will not help. If you do suspect hearing problems, you can check with their doctor.

Use of Gestures and Visual Prompts

Using gestures and visual prompts can aid in communication. For example, when it’s time to get dressed, you can mime putting on your own jumper. If you’re talking about certain people, you can use photographs of them to help the person living with dementia remember who you are referring to.

Connecting and communicating with a person living with dementia is often difficult, but can be achieved with perseverance and understanding. Don’t be disheartened if you feel like you’re not always succeeding; spending time and engaging with your loved one living with dementia is always a good thing.