Communicating with Dementia and Alzheimer's Clients
Effective and compassionate communication with clients suffering from dementia is critical for professionals and family members alike. We need to have an understanding of "where" our loved ones are, what they are capable of understanding, and the rate at which they are able to process information. Poor communication can create confusion, anxiety, and even depression in some circumstance.
First, we need to have a good understanding of "where" someone is in their journey with dementia. Perhaps they have long periods of lucidity with only occasional memory issues or maybe they are interpreting the world around them from a specific time in their lives, like when a former spouse was still alive. The "where" can very over long stretches of time or may switch frequently during a single conversation. For instance, my grandmom suffered from Alzheimer's and during the later years of the disease she believed she was a young wife with children. Later, her memory shifted to a time when she only spoke her native Polish and was unable to understand English.
The exact "where" is really unimportant. What is important is your reaction and how your modify your communication techniques to deal with your loved one's interpretation of reality. For example, I have seen numerous examples of loving family members, acting with the most sincere and best of intentions, trying to help loved ones "remember". This is typically useless and highly detrimental to the individual. It makes little sense to attempt to explain to a person with dementia that their husband has been dead for over 20 years.
This type of communication will most likely to result in needless confusion and agitation every time it is repeated. That is why it is important to educate all family members to utilize other techniques. It is always best to distract or redirect the client in these situations. Continuing with our example above, if a client says that she needs to get dinner ready for a husband that has passed away years ago, you might tell the client that her husband called earlier and said that he would be home late. Then you could redirect the client with a mentally stimulating game or a simple task like folding towels or taking the dog of a walk. The point is that you need to communicate with the person "where" they are at, not where you want them to be.
How you communicate, your approach, is the most important part. Dementia patients may or may not recognize you from time to time, but they will know if they like you. A friendly, slow, and compassionate approach is more likely to result in a better outcome than a rushed or fact based style. You will quickly realize that it is futile to attempt to explain to a person with dementia that you are going to help them dress, do their hair, and then take them out to lunch in single burst of communication. That is likely to be too much information, delivered too quickly, and may result in creating any number of undesirable emotions from sadness to fear.
Instead , try a slower, more bite-sized approach. In a situation like the one just described, you might begin by bringing out two dresses and starting a conversation about how each one complements her eyes. Next, mention how pretty she'll look in one of them and ask her if she would like to put on the blue one of the green one. By restricting the choices to which dress she would like to wear you will be more likely to avoid resistance to getting dressed at all. You've also limited the communication to a single issue and eliminated the potential for negative reactions to information overload.
You can easily envision similar approaches to the next steps like fixing her hair, getting her shoes on, or even ordering at the restaurant. The point is to approach each necessary task in the same slow and compassionate manner. No technique will be successful every time and you should not expect perfection. If you have managed to get her into a green dress, but she simply won't let you fix her hair - let it go. She's better off looking like Medusa and enjoying herself, than being unhappy. You'll be happier too!
Lastly, we are really talking about treating dementia patients with the compassion and dignity that they deserve. Stepping back from the "big picture" allows us to look at the smaller, perhaps more meaningful, moments of caring for a loved one. If you slow down and look closely you'll find the priceless pieces of love and joy in these tiny moments. If you make the time to find precious moments with those you love, you'll have the greatest treasures of your life.