Experts Recommend These Communication Tips When Caring for Someone With Dementia

Staff members in assisted living and memory care communities who provide dementia care receive specialized training on how best to interact with residents who are living with dementia. This includes seniors receiving Alzheimer’s care.

If you are caring for someone with dementia, tips from professional caregivers — such as how to communicate more effectively — can help alleviate stress and make your time together more meaningful for both of you.

“People often ask us how to deal with a family member with dementia or how to help someone with dementia,” says Heather Renter, Ph.D., Director of Education and Research of the Memory Care Learning Center at Heritage Community of Kalamazoo.

“What we try to help them understand is that working on how they communicate with their loved one is the single most important thing they can do. This is true whether they’re caring for a parent at home or their family member is living in our community.

“Learning how to listen, how to really pay attention to what their loved one is telling them, is at the top of the list.”

8 Recommended Communication Dos and Don’ts

Each person’s path along the dementia continuum is different, and dementia behaviors will change as the journey continues. Still, many communication strategies remain effective from the earliest stages to the point where verbal communication may be sporadic at best.

Professionals who engage in caring for dementia patients, including our own caregiving team, offer the following tips for families who want to improve the way they communicate with their loved ones.

1. Do practice good listening skills.
   Whenever possible, give your loved one your full attention while talking with them. Let them know you’re paying attention through eye contact, appropriate facial expressions, gestures and other body language, such as nodding your head in agreement. This can be especially effective for older adults in a later stage of dementia. If you’re unsure about something your loved one is trying to convey, offer your own interpretation and see if they confirm it. If your loved one seems to be in a negative frame of mind, be empathetic and try to find out why. There may be a relatively easy solution.
2. Don’t interrupt loved ones when they are trying to talk.
   Part of being a good listener is giving the other person time to organize their thoughts before speaking. In people with dementia, this can take longer because the disease affects regions of the brain that control speech and memory. If, for example, your father is searching for words to express himself, avoid the temptation to jump in and finish what you believe he wants to say.
3. Do be respectful by giving loved ones the opportunity to speak for themselves.
   Try not to respond on your loved one’s behalf. For instance, if during a doctor’s appointment your mother’s physician asks a question that she can answer, give her the chance to do so. Excluding loved ones from conversations can leave them feeling invisible, frustrated and disrespected.
4. Don’t insist on correcting loved ones if they perceive something else to be true.
   Those in a more advanced stage of dementia may hold different perceptions of reality. To them, what’s in their mind is real. They may confuse one family member for another or believe they are living in a period from their past. This is a phenomenon known as time shifting, in which long-term memory may fill gaps in short-term memory. Arguing about details won’t change your loved one’s mind and could cause anxiety or agitation. Instead, go along with what they’re saying or change the subject.
5. Do use simple words, short sentences and easy questions.
   Limiting the amount of information your loved one has to process will make conversations easier. For example, when talking about what they’re going to be doing, focus on just the next couple of activities rather than the entire morning or afternoon. Ask questions they can answer with a yes or no. Instead of an open-ended question, offer a choice of two or three options when asking what they want to do (or eat or drink).
6. Don’t point out that loved ones have forgotten something.
   Telling your mother she didn’t remember to do something is likely to make her feel defensive (as though you’re blaming her) or inadequate. Even using phrases such as “Do (or don’t) you remember” can cause her to feel flustered. Try instead to take the focus off of her. If appropriate, offer a gentle reminder that it’s time to do whatever has been forgotten. When you want to engage her in reminiscing, tell her that you remember a certain occasion or event and let her chime in if she wants to.
7. Do be patient and take a break if tensions are mounting.
   Keep in mind that a disease is preventing your loved one from communicating with you as they did before dementia was diagnosed. At times, they may seem the same as they always were. But, as this article by Harvard Health Publishing describes, dementia can cause brain functions to fluctuate from one day (or one hour) to the next. Your loved one can’t control when memory lapses will occur or their perceptions will shift. Conversations can be challenging for both of you. If you notice that stress is building, move on to a different topic or take a breather.
8. Do talk with loved ones in a calm, quiet environment.
   Carrying on a conversation in a loud or hectic setting can be difficult for anyone, particularly for those with hearing loss. For adults with dementia, being in a place where there’s a significant amount of background noise, activity or other stimuli makes it considerably harder to process information and engage in the conversation.

What To Look For in a Memory Care Facility

The time may come when moving your loved one into an assisted living or memory care community is the best option for ensuring they stay safe and receive the care they need to flourish.

Some senior living communities, such as Heritage Community of Kalamazoo, offer a continuum of care that includes independent and assisted living as well as memory support. This type of community appeals to couples who want to remain together, should one partner need a different level of care in the future, and for older adults who prefer to stay in familiar surroundings even if their health needs change.

You’ll also find stand-alone communities that provide only assisted living or memory care.

The best time to begin looking at potential communities is while your loved one can participate in the decision-making process. Note: Many communities have a waitlist, which means your choices may be limited if you have to make a quick decision.

Ideally, you’ll want to select several communities in the area you’re considering and visit each of them at least twice. You may want to screen the communities on your first visit and wait until the second visit to bring your loved one with you.

Key Questions To Ask When Visiting Memory Care Facilities

Here are some important questions to ask memory care facilities when you visit:

• What sort of specialized training has the staff received?
• How large is the community and what’s the staff-to-resident ratio?
• Does the community offer on-site medical services or have a registered nurse on site at all times?
• How are personalized care plans created and maintained?
• How structured are daily routines?
• What types of activities are available to support residents’ physical, emotional and cognitive health?
• How secure is the environment, and do residents have access to outside areas (with supervision)?
• How does the staff handle behaviors such as wandering, agitation and aggression?
• Do residents have private rooms and bathrooms, or are living spaces shared?
• What are the dining facilities like, and can they accommodate special dietary needs?
• What is the fee structure? Is there an entrance fee or does the community offer monthly rentals?
• What does the monthly fee cover? Are there other expenses not included in the monthly fee?
• Is there a waitlist? If so, how long is it?
• What happens if my loved one wants to move out?

Talking With Your Loved One Before the Move …

How you approach your parent or spouse about moving to an assisted living or memory care community depends on where they are in their dementia journey. In general, the sooner you begin these discussions the better.

You’ll probably encounter some pushback. After all, change can be unsettling, and the older we get the harder it can be to make a major change, like moving to a new community.

It will help if you emphasize how safe your loved one will be, the type of care they’ll receive, the sort of activities they can enjoy, and the many other positive aspects of being in an assisted living or memory care community.

… And After

The time it takes to settle into new surroundings varies. You can help with this transition by visiting your loved one often and assuring them you won’t disappear.

Your family member may be confused or express a desire to “go home.” The staff can work with you to help them feel more at ease. Using the communication strategies in this blog post will make a difference as well.

Contact us to learn more about assisted living and memory care at Heritage Commufnity of Kalamazoo and to arrange a visit. You can also reach us at (269) 364-6560.

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