10 tips for communicating with a person with Alzheimer’s disease

10 tips for communicating

Caregivers may find that patients with Alzheimer have trouble finding the correct words, repeat the same words or phrases over and over, substitute similar-sounding words, make up new words, lose their train of thought, have trouble organizing words, revert to a native language, start cursing, speak less often, rely on non-verbal gestures, or have difficulty understand conversations, questions, and instructions. Establishing communication with a person with dementia is not easy, but it’s not impossible either, and these tips may help.

  1. Dignity, always dignity. You should always treat the patient with the dignity and respect that an adult person deserves. Even if Alzheimer’s disease manifests as a regression to childhood, you should never treat them like children – for like children, Alzheimer patients can usually tell that they are being treated like infants. Other than using short words and sentences, you should behave to the patient as you would to anyone whom you love and respect, regardless of whether the disease has left them a shell of their former selves.
  1. I don't want to think, I want to feel. This condition messes with people’s thinking and speaking abilities, but the feelings remain the same. To figure out the emotion that the patient is trying to express, focus less on what they are saying and more on how they say it – including tone of voice and body language. Likewise, respond to the feeling and not the words.
  1. I wanna hold your hand. A handshake, a hug, a look, a smile can go a long way. Touching and body language can get through to the person with Alzheimer’s disease even after words have lost meaning. Moreover, absence of contact may make the person feel rejected and isolated.
  1. Speak Softly (You're Talking to My Heart). Your own tone of voice can have an effect on the patient as well. Once again, how you say things means more than what you day, so if you raise your voice or speak sharply, the person may react similarly. It’s best to talk in a low pitch, gentle tone that projects friendliness and warmth.
  1. Live for the moment. People with Alzheimer’s can’t look past the immediate present, so you should make the most of it by emphasizing positive feelings. For example, if the person has a hard time expressing themselves, choosing the right word, or remembering something, don’t correct them or argue with them. Instead, encourage them to continue with their own train of thoughts, such as it is. Furthermore, try not to be sad – or at least not show it – about losing a loved one (a loss that doesn’t necessarily begin with death) but be glad – and show it – for your time together.
  1. All you need is just a little patience. It can be difficult to bear with an Alzheimer patient’s discourse – after all, if you wanted, a long, rambling story that doesn’t make much sense, you’d just watch The Walking Dead. As easy and tempting as it may seem to just tune out and ignore the person or even leave them hanging, the fact remains that the Alzheimer patients needs to be listened to and know that what they're saying matters to the listener. Such an exchange may take time, as the person assimilates what you say to or ask them and come up with a response – which may not be related to the subject at hand, so the process may have to be repeated several times. Thus, patience is essential. 
  1. Voices carry. Some caregivers talk about people with Alzheimer’s disease like they are not even there. However, though it may appear as if they’re not, and even if the meaning of the words escapes them, they will most likely grasp the intent. In keeping with the fact that feelings count more than words, the patient may forget – and given the nature of the condition they probably will – what was said about them, but the feeling of being treated like they don’t exist will remain.
  1. Say it with your eyes. As the disease progresses communication between caregiver and care receiver transitions from verbal to non-verbal. The first step to successfully achieve the latter is to establish eye contact with the patient. Additionally, pointing, gesturing, touching, and facial expression can all be employed as visual aids to convey a message.
  1. Body language ↑. As the caregiver relies more on body language, he or she should encourage the patient to follow suit so they can communicate using the same, well, language. If you read the signs correctly, the person’s body can talk to you even if the person can’t, or won’t. For instance, if the patient is fidgety, avoids eye contact, folds their arms, etc., that may mean they don’t want to speak to you at the moment. Conversely, if they smile, seem relaxed, get close to you or touch you, that may mean they are open to communication. Learn to identify and capitalize on the times when the person is in a better mood, and avoid those during which the patient is more confused or tired due for example to sundowning.
  1. Noises carry. Loud noises and distracting activities make it difficult for people with Alzheimer’s disease to concentrate. Try to find a quiet setting in which to engage in strictly one-to-one conversation with the patient. That doesn’t mean the person has to be isolated from the outside world; they can and should go outside and mingle with people, just remember that bustling places and large gatherings can disorient and confuse the person are thus not the best scenarios for effective communication.

Related Read:

- 12 resources for Alzheimer's disease communication problems.

- Communication.