Dementia is a progressive condition which affects different areas of cognitive functioning. As well as experiencing memory loss, a person living with dementia will also often experience increasing difficulty communicating with others as their condition progresses, and more parts of the brain become affected.
There are several different reasons for this, and everybody will have a different experience of dementia and how it affects their life and their communication – depending on the type of dementia they have (Alzheimer’s Disease is the most common), their lifestyle, and their individual personality.
However, generally speaking, as a person’s dementia develops it becomes more difficult for them to express their thoughts and feelings, remember important facts (such as names and important contextual details), and process rational thought. The temporal lobe can also become affected, meaning that speech becomes impacted.
This can be extremely frustrating and disheartening for a person with dementia, and they may lose confidence or become distressed or upset. It’s up to all of us, then, to make sure that we know how to be as supportive as possible and try to make sure that we are supportive when communicating with a person who may have dementia, verbally or in writing.
There are several things you can do to communicate in a supportive, accessible way for a person who may have dementia. (Spoiler alert – lots of these tips are generally applicable to good communication!)
- Speak slowly and clearly without being patronising. As dementia can affect processing time, it may take someone a bit longer to understand what you have said and respond accordingly. That does not mean that you should patronise them, or speak overly slowly or loudly as this can be offensive and may come across as demeaning. Breaking longer sentences up into shorter chunks can help.
- Don’t interrupt, or correct someone for making a mistake. A person with dementia may repeat phrases, or use the incorrect word. If you can, avoid correcting them and do not rebuke them. People often lose confidence in communicating as they are afraid of making mistakes, and so creating a supportive environment is important. Avoid phrases such as ‘you already told me that’, for example.
- Use simple language. You should avoid being patronising, but make sure that the language you are using is simple and clear. Try not to use jargon or unnecessary extra clauses. Present information in the order it needs to be processed, not in order of what you think is most interesting, to make it as easy as possible for a person to understand.
- Break up written information by using bullet points, and pull-out boxes. Processing and remembering information is much easier when it is broken up into chunks. Dementia can cause visual disturbance, and so using clearly contrasting colours in a clear, easy to read font can help.
- Ask direct questions. Giving somebody too many choices and options can be confusing, particularly if it means the person will have to rely on their memory or understanding of a wider situation in order to answer. Instead, try to phrase questions so that the person can answer with a simple ‘yes’ or ‘no’. For example, rather than asking ‘what would you like to eat?’ (where there are many possible answers), you could ask ‘would you like a cheese sandwich?’ (where the answer is ‘yes’ or ‘no’).
- Give contextual clues. It can understandably be upsetting for a person with dementia who is experiencing memory loss, confusion, or difficulty expressing themselves, and they may feel embarrassed. There are certain ‘clues’ you can give someone in a non-judgmental way which can aid them without being patronising or overbearing. For example, you could say ‘you did a great job painting the kitchen yesterday. It looks really good now that it is painted white.’ Phrasing it like this adds context, and means the person can join the conversation if they want to, but it doesn’t put pressure on them to remember or respond in the same way that ‘how was painting yesterday?’ might do.
- Be patient. Give people time to respond, to avoid them feeling pressured, and do not interrupt. If you need to clarify the meaning of something, it is better to wait until a person has finished speaking and then repeat what they have said back to them to clarify their meaning.
- Be more Lady Gaga. One of the best examples of putting these tips in practice and communicating clearly, patiently, and supportively with a person with dementia is Lady Gaga in her performances with Tony Bennett, who has Alzheimer’s Disease. In this moment especially, she makes sure Tony feels in control and reminds him of their next song without making it obvious to him, or the audience, that that is what she’s doing. She asks him to sing it to her, reminds him that he sings it often, and then repeats the song title again – all while being friendly, kind and patient in what could otherwise be a highly stressful or pressured situation.