There are ways to lower the stress...

Dementia makes communication difficult and frustrating for those living with the disorder and their loved ones. But we have some pointers for people wanting to do a better job of it.

First, it’s important to understand that Alzheimer’s disease and dementia take varying forms that eventually lessen someone’s ability to communicate. People living with those conditions often have difficulty processing what others are telling them and have trouble putting together the words they need to express themselves. Sometimes they use curse words or speak about inappropriate things.

Reducing stress for both of you

Here are some best practices for communicating with them from Shannon Braun, director of Episcopal Retirement Services’ Center for Memory Support and Inclusion.

Also, Braun offers some reasons why it’s important for people with memory issues to continue socializing – even when they find it embarrassing that they can’t recall names. As we will see, recent studies found that older people who are facing loneliness and social isolation have a significantly higher risk of developing dementia.

When greeting them:

• Approach them from the front, and introduce yourself, greeting them by their name.
• If necessary, lower yourself to their physical level so you can look them in the eyes.
• Even if you’ve known them a long time, tell them not only your name but who you are.
• Name tags can be helpful when a group of people is involved. People with memory issues often are embarrassed by their inability to recall names.
• Keep eye contact.
• Be aware of your body language and facial expressions that might indicate disinterest.

Be aware of your tone:

• Monitor the tone of your voice.
• Speak slowly and distinctly. Use short sentences.
• Use familiar words, avoiding slang and phrases that can be confusing.
• Avoid using pronouns. Instead of saying, “Here it is,” say: “Here is your toothbrush.”
• Always treat them with dignity and respect.

Things to avoid: 

• If they say something you don’t agree with it, don’t argue. It often just makes things worse.
• Focus on the feelings they’re expressing rather than the facts.
• Don’t pepper them with questions, and avoid saying things like, “Don’t you remember who I am?”
• In other words, avoid quizzing them. Nobody likes that, especially someone with memory issues.

• For the same reason, don’t criticize them or correct their responses.

General things to remember:

• Even if they’re telling you something that is false, such as their long-deceased parent is still alive, avoid correcting them. Instead, listen to what they’re telling you and try to understand the emotions they’re trying to express. Use this as a way to learn about their parent, for example.
• Limit distractions to the conversation, such as a crowd of people around or a loud radio or television.
• If they’re having trouble saying something, encourage them to point or use gestures.
• Patiently wait for their answer. Sometimes they’re figuring out the words.
• After a while, repeat the question.
• If you want them to do something, don’t ask, “Do you want to take a walk now?” because the answer likely will be no. If you say, “It’s time to take a walk,” there’s less possibility they’ll say no.
• Give one-step instructions.
• It may be necessary to write things down.
• Again, always treat them with dignity and respect.

For care partners:

For people with Alzheimer’s or dementia, embarrassment about forgetting names and other factors make it more difficult to engage socially, but it is important to do so – for both those with the disorder and those who care for them – Braun said. She recommends support groups as one way to avoid embarrassment because people in those groups understand what is happening.

Recent studies have linked loneliness and social isolation in older people with a 49-percent-to-60-percent greater likelihood of a future diagnosis than those who don’t feel lonely or isolated. Here’s information about one of them. Here’s a medical editorial about some dementia-causing factors.

Meanwhile, here’s an earlier conversation we had with Shannon Braun.