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Communication and dementia
Zimbabwe Alzheimer’s and Related Disorders Association (ZARDA)
Extracted from the ZARDA June 2007Newsletter

This letter explains some of the changes in communication that occurs as a result of dementia and suggests ways carers can help. It also includes some personal tips on communication written by a person with dementia.

Some changes in communication

Each person with dementia is unique and the difficulties in communicating thoughts and feelings are very individual.
There is a range of causes of dementia, each affecting the brain in different ways.

Some changes you might notice include:

• Difficulty in finding the right word. They might say a related word instead of one they cannot remember.
• They may talk fluently, but not make sense.
• They may not be able to grasp part of it.
• Writing and reading skills may also deteriorate.
• They may loose the normal social coventions of conversation, and interrupt, ignore another speaker, not respond when spoken to or become very self centered.
• They may have difficulty expressing emotions appropriately.

Where to begin

It is important to check that hearing and eye sight are not impaired. Glasses or a hearing aid may help some people. Remember, communication is made up of three parts:

• 55% is body language which the message we give out by our facial expression, posture and gestures.
• 38% is the tone and pitch of our voice.
• 7% is the words we use.

These statistics high light the importance of how carers present themselves to the person with dementia. When caring for a person with dementia who is having difficulty communicating, remember they may pick up on negative body language such as sighs and raised eyebrows.

What to try

Caring Attitude

• People retain their feelings and emotions even though they may not understand what is being said, so it is important to always maintain their dignity and self esteem.
• Be flexible and always allow plenty of time for a reponse'
• Use touch to keep the person's attention and to communicate feelings of warmth and affection.

Ways of talking

• Remain calm and talk in a gentle, matter of fact way.
• Keep sentences short and simple, focussing on one idea at a time.
• Always allow plenty of time for what you have said to be understood.
• It can be helpful to use orienting names when ever you can, such as "your son Jack".

Body Language

• You may need to use some hand gestures and facial expressions to make your self understood.
• Pointing or demonstrating can help.
• Touching and holding their hand may help to keep their attention and show you care.

The right environments

• Try to avoid competing noises such as TV or radio.
• If the carer stays still while talking, it will be easier for the person with dementia to follow, and will show that the carer is prepared to work at trying to understand them.
• Maintaining regular routines helps to minimise confusion and this can assist communication
• It is much less confusing for the person with dementia if every one uses the same approach. Repeating the message in exactly the same way it is important if there are several carers. It may be useful to discuss this with other relatives, friends and paid carers to decide on the style that works best.

What not to do

• Don't argue with the person . It will only make the situation worse.
• Don't order the person around.
• Don't tell the person what they can and can't do. Instead state what they can do.
• Don't be condescending. A condescending tone of voice may be picked up, even if the words are not understood.
• Don't ask a lot of direct questions that rely on a good memory
• Don't talk about people if they are not there.

Tips from a person with dementia

Christine Boden was diagnosed with Alzheimer's disease at age 46, and now lives with rediagnosis of frontotemporal dementia, made when she was 49. She has shared a number of her insights about ways, family and carers can help a person with dementia. Christine is also the author of "Who will I be when I die"?, the first book written by an Australian with dementia.

• Give us time to speak, wait for us to search around that untidy heap on the floor of the brain for the word we want to use. Try not to finish our sentences. Just listen, and don't let us feel embarrassed if we lose the thread of what we say.
• Don't rush us into something, because we can't think or speak fast enough to let you know whether we agree. Try to give us time to respond - to let you know whether we really want to do it.
• When you want talk to us, think of some way to do this without questions, which can alarm us make us feel uncomfortable. If we have forgotten something special that happened recently, don't assume it wasn't special for us too, just give us a gentle prompt- we may just be momentarily blank.
• Don't try to hard though to help us remember something that just happened. If it never registered, we are never going to be able to recall it.
• Avoid back ground noise if you can. If the TV is on, mute it first.
• If children are underfoot, remember we will get tired very easily and find it very hard to concentrate on talking and listening as well! May be one child at a time and without background noise would be best.
• Maybe ear plugs for a visit to shopping centers, or other noisy places

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