A Simple Shift in Speech: Communication and Dementia

Vicky Pitner   -  

Communication is simply the act of sharing information with one another. It might be an expression of a need or a more complex conversation to express thoughts and ideas. People living with Alzheimer’s disease or other types of dementia often have difficulty sharing thoughts and feelings, either due to aphasia (unable to understand or express speech due to neurocognitive disorder), or experiencing visual hallucinations, episodes of delusions, where the person may believe something that is not true.

Conflicts and arguments can happen quickly when we fail to really understand the challenges that communication can bring for someone living with dementia. If we continue to use the same conversation skills that we have always used, the person with dementia may not understand those same skills. Because the connections between neurons in the brain breakdown or the brain atrophy in Alzheimer’s disease, it is impossible for the person with dementia to remember facts accurately, or stop delusional thinking. They are physically unable to change their behavior, so we MUST change ours if we want to create an environment that promotes well-being.

Change is not easy, but a simple shift in our speech can result in helping the person with dementia feel understood, respected, and thus, minimize the disagreements and frustrations that causes families so much stress and anxiety.

Below are simple changes we can begin to practice when interacting with our family member with dementia. Practice is the key word, because this does not happen overnight. But once you get the hang of the “new you,” your confidence will improve  and you can tackle the harder things that come up.

  • Put your ego aside! If your family member thinks that he/she got married in 1982 instead of actually 1942, let it go. The person may simply want to enjoy reminiscing about the wedding. Facts are not important, but feelings are. Avoid correcting the dates, places, etc. and just go with the flow and enjoy the time “conversing” about a pleasant memory with the person.
  • You can repeat yourself, talk louder, demand for them to remember, or even scold them for asking the same question over and over, but it is impossible to make a person remember when they cannot. Memory loss is not just forgetting events, the person also has difficulty storing or retrieving memories, such as being unable to recall eating breakfast. Getting mad and showing your frustration can easily erupt into a disagreement.
  • Take the word “remember” out of your vocabulary. If the person could remember, they would. But when they are questioned if they remember something and they don’t, they feel shame, embarrassment, and sadness that they have disappointment you and are only reminded they have dementia. Just look at their facial expression next time you question why they don’t remember something. It is truly heart breaking.
  • Take responsibility for everything! What is the big deal for apologizing for something you did not do when your family member who doesn’t even understand your reality anymore? If you are accused of taking your family member’s glasses off the nightstand, and you know he left them in the bathroom, just apologize and explain you will look for the glasses.

These simple strategies will help create a more loving, compassionate and safe environment for your family member. Yes, it is very hard for us to apologize for things we didn’t do, avoid correcting a fact, or take the blame to divert a conflict, but what is really important in life? It is so necessary to let go of your agenda, and help your family member feel understood and accepted. Perhaps we need to put more value in being kind and compassionate over the need “to be right.”

If you would like more information on our Memory Ministry, Memory Cafe, or support trainings we offer, please contact Vicky Pitner at vpitner@firstumc.org