I took this photo of street art in the suburb of Buckland in Atlanta, Georgia USA.
After last week’s Health-e-Byte about the importance of maintaining supportive relationships, many readers asked how to achieve this with someone who has dementia and may not be able to communicate as they once could.
Here are my suggestions from personal and professional experience.
Regardless of the stage of dementia to which someone has progressed, you can still connect with them in a meaningful way. It may not be the same way that you communicated with them in the past, but you can still bring them warmth and reassurance.
Firstly, don’t be afraid to stay connected with a person who has been diagnosed with dementia. Friends often withdraw because they don’t know what to say or how to behave around someone with dementia. Many people don’t understand the disease so they think there’s no point in staying in touch. Yet maintaining your relationship with a person who has dementia — is THE most important thing you can do for them. It can also offer respite for their day-in-day out carer. Relationships — especially long standing friendships — are the best medicine — as I discussed in last week’s Health-e-Byte. Conversely, loneliness is as damaging as smoking 15 cigarettes a day.
When you communicate with someone who has dementia, be patient and relaxed.
Make use of non-verbal cues like eye contact, touch, and a warm smile — whatever feels most comfortable for the person in question.
Speak in a gentle, reassuring tone.
Use short, simple sentences and give them plenty of time to process what you’re saying because it may take them longer to respond.
Avoid distractions — this is more important than people realise.
Turn off the TV and radio if you’re at home, and avoid crowded, noisy, public places if you’re out.
A park with a pond is a beautiful, calming environment to spend time at. Go for a walk if they are capable and draw their attention to the flora and fauna around them.
Ensure you have their attention before speaking, and stay still while you talk so they can focus on you.
Another way to connect is through shared activities. Jigsaw puzzles, quoits, darts and old-fashioned games can provide easy conversation, or simply engender a sense of belonging and sharing. If they are able to play a musical instrument, ask them to play a favourite tune for you.
Don’t argue or correct what they’re saying. This is a tricky issue and one that is hotly debated. However, from my observations, the best approach is to validate what a person is saying without agreeing with an obviously false statement. Accept that what they are telling you is their reality. Neutral statements such as ‘That must be difficult,’ or ‘that sounds like fun,’ (depending on what they have said) may help you transition to a different topic of conversation.
The term for unintentional creation of false or distorted memories is confabulation. It occurs as the brain unconsciously fills in memory gaps with fabricated information that makes sense to the person describing the event. The content of a confabulated memory can range from minor, plausible inaccuracies to bizarre and fantastical events.
An example of confabulation is a person recounting a detailed story about their childhood that never happened, but they believe it did. It might be an amalgamation of different movies they saw, or weaving someone else’s childhood into their own. Another common instance of confabulation is ‘remembering’ eating a certain food for breakfast when in fact, they ate something else. This might be a case of remembering what they used to eat when they were growing up, which now comes to be front of mind.
If a person becomes less verbal, you might consider reading to them about subjects they find interesting. If they are able to answer, ask for their opinion about what you are reading to them.
Communicating sensitively and effectively with someone who has dementia will also give YOU a mental workout. As I’ve mentioned in previous Health-e-Bytes, facts fray, but feelings stay. In other words, a person with dementia may not remember the facts and details of your visit, but they will remember how you made them feel. The warmth and delight you bring through your presence is much more important than anything you say. My motto with Dad was always: Keep him safe (physically and emotionally) and bring him joy.
Please share this Health-e-Byte with anyone who knows someone with dementia — and who wants to enrich their own life.
