BEFORE TALKING WITH SOMEONE WITH DEMENTIA OR ALZHEIMER’S DISEASE:
- Know the older adult first! (know their likes, dislikes and names – the name they like to be called).
- If you are a caregiver, read their chart or history. Are they a morning person or are they up at night? Know as much about them as you possibly can.
- Think about how you are presenting yourself
- Try a CALM, gentle, matter of fact approach
- Use a non-demanding approach – try humor, cheerfulness
- Try using a gentle touch, from the front (if appropriate) to communicate your message
Begin the conversation socially (i.e., “Hi, my name is Michelle”). Use your name often and wear a nametag, if possible.
WHILE TALKING WITH SOMEONE WITH DEMENTIA OR ALZHEIMER’S DISEASE
- Approach from the front and talk to the person in a place with no distractions. It may sound obvious, but make sure hearing aids are turned on and have batteries.
- Begin by identifying yourself and addressing the person by the “best” name
- Look directly at the person and make sure you have his/her attention
- Make sure you are at eye level with the person (not looking down). Get at their level.
- Speak slowly and say words clearly and in a soft low pitch voice – gentle tone
- Ask only one thing at a time and do not rush
- Use short, simple sentences and questions (e.g., “are you cold?”)
- Use very concrete terms and familiar words
- Use actual names, instead of he and she, when referring to others
- Talk in a warm, easy-going, pleasant way
- Talk in a quiet, calm voice.
- Speak in positive terms
- Ignore harmless hallucinations or delusions
- Treat the person with RESPECT
WHEN YOU ARE HAVING TROUBLE BEING UNDERSTOOD
- Be patient; allow enough time
- Demonstrate visually what you are saying by pointing, touching or drawing
- Use short simple terms
- Be repetitive and consistent (if you need to repeat 3 times)
- Try a less difficult, more simple way to say it
- Try a hug and a change of subject
- Do not rush the person. Allow plenty of time for a response. If there is none, repeat the question, exactly as it was phrased the first time. If there still is no answer, reword the phrase.
- If possible, change who is asking the question or making the request. Someone else may have more success.
WHEN YOU ARE HAVING TROUBLE UNDERSTANDING
- Listen actively and carefully to what the person is trying to say
- Try to focus on a word or phrase that makes sense
- Respond to the emotional tone of the statement
- Experiment with supplying words
- Encourage the person to point or gesture
- Stay calm and be patient
- Ask family members about possible meanings for words, names, phrases
- Listen to their voice and gestures which may give clues to understanding
THINGS NOT TO DO
- Don’t argue and don’t give orders to the person.
- Don’t tell the person what he/she can’t do.
- Don’t “talk down” or appear superior to the person.
- Don’t treat them like a child.
- Don’t ask questions that require the person to remember facts.
- Don’t talk about people with the disease in front of them.
- Don’t use sarcasm or inappropriate humor. Alzheimer’s patients misinterpret humor.
- Don’t orient the person to person, place and time – validate their feelings and statements.
WHEN VERBAL COMMUNICATION JUST DOESN’T WORK
- Try distracting the person.
- Ignore angry or agitated statements if you can’t think of a positive response.
- Try other forms of communicating (songs, massage, favorite foods, walking, etc.)
- Give the person something to do. Try activities, a walk, giving them food or something to hold.
- Slow down!
- Again, try someone else. The Alzheimer or Dementia patient may just not like what you are wearing that day.
- Try again later.
COPING WITH CHALLENGING BEHAVIORS
- Build a positive, trusting relationship. You are familiar, you are safe.
- Use effective verbal and nonverbal communication techniques.
- Encourage independence in the person. Try to help the resident build a sense of control and competence over his/her life.
- Avoid arguing, yes/no battles, rational or logical explanations, and debates.
- Tell “therapeutic fibs” or “bent facts” to save a patient grief and reduce problem behaviors (i.e., validation therapy). Validate their hallucinations or delusions.
- Redirect or divert the person’s attention to a positive topic, activity, or object.
- When a behavior requires intervention, act quickly with positive techniques and activities.