Behavior management can be a challenging aspect of caring for a loved one with dementia, as the condition can cause changes in behavior and communication. However, there are strategies that family caregivers can use to effectively manage behaviors and improve communication with their loved one over time.
8 Strategies for Communication with a Loved One with Dementia
Dementia is terrifying and confusing for your loved one, but it can be equally heartbreaking and challenging for those around them. As communication deteriorates over time, it’s important to try various communication styles to help find a way to work with it that works for both of you. Here are eight communication strategies to try.
Use nonverbal communication Nonverbal communication, such as facial expressions and body language, can be more effective than verbal communication in some cases. For example, a calm and reassuring facial expression and posture can help your loved one feel more at ease, even if they are unable to understand or process your words.
Avoid negative phrasing. Phrasing conversations in the negative is less direct and can, in turn, be confusing. Instead of saying, for example, “don’t go over there” say, “stay here.” The task is much clearer in the latter and more likely to get you the result you’re after with less frustration for both of you.
Use simple and clear language People with dementia may have difficulty processing and understanding complex or abstract language. Using simple and clear language, and speaking slowly and distinctly, can help improve communication. Tone of voice can also impact the way your loved one perceives your communication. Use a calm, relaxed tone; your loved one will often feed off your emotions as a caregiver. As someone loses their ability to communicate with language, emotion-based expression and communication becomes more prominent.
Use contextual cues Contextual cues, such as gestures, props, and pictures, can help your loved one understand and communicate their needs and desires. For example, if your loved one is having difficulty expressing that they are hungry, you could offer them a picture of a sandwich or a bowl of soup to help them communicate their desire for food.
Validate their emotions People with dementia may experience a range of emotions, including frustration, anger, and sadness. It's important to validate these emotions and acknowledge them, rather than dismissing or minimizing them in conversation.
Use distraction and redirection If your loved one becomes agitated or upset, you can try using distraction or redirection to redirect their attention to something else. This could be something as simple as offering them a puzzle to work on, or suggesting a change of scenery.
Establish a routine Establishing a consistent routine can help provide structure and predictability for your loved one, which can reduce confusion and agitation.
Use positive reinforcement Positive reinforcement can be an effective way to encourage desired behaviors. This could be as simple as praising your loved one for completing a task or expressing appreciation for their efforts.
Which Stage of Dementia is Associated with Communication Challenges?
There are four stages of dementia that are characterized by their relative communication skill deterioration. Here’s how each stage affects communication:
The Stages of Dementia and Associated Loss of Communication Skills
(Source: Chart Adapted from Dementia Care Central and republished from Caregiver Resource Center)
Early-stage dementia / Alzheimer’s
Your loved one may struggle to concentrate and stay connected to conversations.
They may struggle to find the right words when speaking or writing.
They may repeatedly lose their thoughts when speaking or frequently repeat themselves.
At this stage, the person with dementia is likely aware of these problems. They may try to conceal them or accidentally overcompensate for them.
Moderate or mid-stage dementia / Alzheimer’s
As dementia progresses, your loved one may experience worsening aphasia which may manifest as:
Increased difficulty following conversations, storylines in books, TV shows, or movies.
Poor recall for recent events.
Frequent loss of their thoughts/storyline when speaking.
Increased trouble with finding the right words when speaking or writing, leading them to sometimes substitute words that could sound similar or invent entirely new words.
A loss of vocabulary, like proper nouns and slang terms.
Difficulty with remembering and following directions.
Increased use of hand gestures to communicate.
Severe or late-stage dementia / Alzheimer’s
During the later stages of dementia, your loved one may experience worsening symptoms that are obvious to others, but less obvious to themselves, such as:
A complete inability to follow more complicated trains of thought, experiencing difficulty with anything other than simple conversations or instructions.
Further loss of vocabulary, including personal information and loved ones’ names.
A tendency to talk about nothing, with increased rambling or babbling.
End-stage dementia / Alzheimer’s
Finally, your loved one may become completely non-verbal in their communication, experiencing:
An inability to speak or respond verbally.
Difficulty or complete inability to understand when spoken to.
Closing Thoughts
By using these strategies, family caregivers can effectively manage behaviors and improve communication with their loved one with dementia. It's important to remember that each person is unique and what works for one person may not work for another. It may take some trial and error to find the strategies that work best for your loved one, but with patience and persistence, you can improve communication and create a more positive and supportive environment for your loved one with dementia.
If you’re providing care to someone with dementia, we invite you to check out our free resources. To get more information about the resources we have available to you as an Orange County, California caregiver, contact us at the California Caregiver Resource Center of Orange County.
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