Written by Eliza Brown
Connecting with a loved one who is living with dementia can be challenging. The following tips can help inform our interactions so they are helpful rather than challenging.
Don’t argue. Easier said than done, right? Just try to keep in mind that arguing doesn’t help solve anything and tends to make everything more difficult. If the person living with dementia says that they must wash the table after dinner because they believe it’s part of their “job as the waitress,” get them a clean, warm cloth and let them help wash the table. Don’t tell them that it’s been years since they worked as a waitress or tell them to sit down because you are taking care of it. Those comments don’t get you to your goal of a clean kitchen any faster. If they can still safely wash the table, then it would be more trouble and stress to argue than to comply.
Focus on what they can still DO and what they still HAVE. It can be easy to dwell on what is lost when it comes to dementia, but, if possible, try not to focus on the losses. Focus instead on what they still have. If their vision is poor, but their hearing is still good, try reminiscing verbally instead of showing them pictures from their past. If they are losing their ability to hear, but they can still get around well, go on walks with them instead of engaging in lengthy conversation. If they are passionate about organization, sorting would be an excellent option. Have them try sorting colored or patterned socks, stacking or counting coins, or putting paint swatches in order. If baking has always brought them joy, keep simple cookie mixes on hand for them to put together and assist as needed with the oven. Ask them to help you frost cookies, decorate cupcakes, or even mix up a box of instant pudding. These are all options for differing skill levels and can be tweaked to fit anyone’s abilities. It just takes a little bit of creativity and patience to uphold meaning in their life by focusing on what their gifts and passions still are.
Give visual cues while speaking. When asking someone living with dementia a question, you may want to give visual cues as you speak. Hearing loss and slower processing times mean that they might not always understand what you are saying right away, so any hints you can give are helpful.
When asking what they’d like to drink, make a motion like you’re drinking from a cup. If you’d like them to brush their hair, act like you’re brushing your hair while you verbally ask them to brush theirs. If it’s time to do physical therapy exercises, do the exercise alongside them so they can see exactly what is being asked of them. Motioning while you’re speaking might also help you be clearer and more concise with your language.
Additionally, if the person living with dementia doesn’t seem to be understanding what you’re saying, use fewer words. Instead of “would you like to start getting ready for bed,” try asking “is it bedtime?” Instead of “are you ready to go get something to eat for lunch?” ask “are you hungry?” If you make eye contact, speak slowly, clearly, use the lower register of your voice, use fewer words, and try to physically show what you’re saying while you’re saying it, you might have more success with communicating!
Lead with empathy. This person’s entire world is confusing right now. Things don’t quite fit together. Imagine waking up and not knowing whether your spouse is living, or not knowing whether you are twelve or seventy years old. Imagine feeling tired but not knowing where you sleep; feeling hungry but not knowing where your food is stored; wanting to go to the store but not knowing where your keys are, and then being told that you can no longer drive. It is like they are losing their footing and might not know where to turn for help. If you can keep in the back of your mind how lonely this disease can become, it will help to approach those living with dementia a bit more gently, and with a bit more compassion. Their world is changing, and they are losing parts of themselves, and we can help by leading with empathy.
Mirror emotions. If you sit to chat with someone living with dementia, first try to observe what current emotions they seem to be experiencing. If they seem down, speak with them calmly and softly, ready to listen. If they seem stressed or anxious about something, don’t assure them everything is okay before you take the time to really listen to what their concerns are. To communicate effectively, there needs to be trust between you both, and they likely won’t trust you if you tell them everything is fine. If they are laughing and jubilant when you approach, join in on their joy, even if what you want to speak with them about isn’t joyful. And if they are angry, you can be angry alongside them – try to understand what they are angry about and show them your sense of justice along with theirs. Once that understanding and trust is built between you two, you can ease into the conversation you were hoping to have. By mirroring their emotions back to them, you are showing that you understand them, something that is often lost with dementia.
Give options instead of asking yes/no questions. If you ask someone “are you hungry?” and they say, “no,” that is essentially the end of that conversation. And sometimes with dementia, a response of “no” is simply automatic. Instead of asking a yes/no question, try giving options instead. Even if they don’t want either option, at least a conversation is opened to figure out what it is that they want or need.
Instead of asking “are you hungry?” try asking “would you rather have grilled cheese or a turkey sandwich?” If they aren’t in the mood for either, you can begin the conversation there. Instead of “where would you like to go?” try asking “would you rather sit on the porch or in the living room?” If possible, use hand gestures and point to the front porch or the living room to help them understand your question. Sometimes dementia will diminish word recollection, and they experience something called “aphasia.” Someone living with dementia might want to sit on the porch but might not be able to think of the word “porch.” Options eliminate any embarrassment or frustration that might arise with aphasia and might also help them communicate their needs effectively and confidently.
Garden Spot Village offers a variety of resources for families living with dementia. Garden Spot Village at Home can provide non-medical care for the activities of daily living as well as a needed break for caregivers. In addition, DayBreak offers adult day services, which can also provide a needed break for caregivers. Meadow View Memory Care offers residential options, often with direct admission. To learn more, call 717.355.6000.