15 Tips for Communicating with Mid- to Late-Stage Alzheimer’s Sufferers

Communicating with Gestures

As Alzheimer’s disease progresses, people often becomes confused and have difficulty communicating. They may struggle to find the right words to express themselves, or may forget the meaning of words and phrases. They also may rely more and more on gestures, especially as their verbal skills decline.

Home care that is focused on the patient and aligned with that individual’s choices ideally includes communication between the individuals living with the disease and their entire care team. Despite the challenges, there are ways to communicate more effectively with a loved one or client who has Alzheimer’s disease, even when they completely lose the ability to put their thoughts into words.

There are several strategies you can use to improve communication. In addition to what is said, remember the importance of non-verbal communication. The presence, touch, gestures, and attention of caregivers can help to communicate acceptance, reassurance, and love to a person with Alzheimer’s disease. In all cases, do your best to treat the patient with dignity and respect, no matter how frustrating communication may become.

15 Tips for communicating with mid- to late-stage) Alzheimer’s patients or loved ones:

  1. Make eye contact. Always approach from the front and speak face-to-face. Speaking from the side or from behind can be startling. It is vital that you know their attention is focused on you. Read what they are saying with their eyes. Try to understand what is being said based on the context. If the person is struggling to get an idea out, offer a guess.
  2. Be at their level. Move your head, bend your knees or sit down to be directly in front of them. Don’t stand or hover over them. That can be intimidating and scary. If they are focused on their fear, they can’t focus on you and what you are saying.
  3. Introduce yourself by name every time you start to speak, unless you are sure the person remembers you. Also, say their name often throughout the conversation.
  4. Speak slowly at about one half of your normal speed. Take a breath between each sentence. Allow more time for the person to process information and to respond to a question. Rephrase rather than repeating something that isn’t understood. Find a different way to say the same thing
  5. Speak in short, direct sentences with only one idea to a sentence. Many people with Alzheimer’s can only focus on or process one idea or request at a time.
  6. Increase your use of gestures and other non-verbal communication. Closely observe the person and try to recognize what they are saying and feeling without words. Show them what to do. Demonstrate each sequence of a task and allow them to complete one step at a time.
  7. Avoid interrupting. A person with dementia may lose their train of thought. Avoid criticizing, hurrying and correcting. It will not change their behavior. Only you can change.
  8. Allow them to interrupt you, or they may forget what they want to say.
  9. Tell them what you are going to do before you do it, particularly if you are going to touch them. They need to know what is coming so that they don’t think that you are grabbing them
  10. Speak calmly with an upbeat tone of voice, even if you don’t feel that way. If you sound angry or agitated, they will often mirror that feeling back to you. Even when you’re frustrated, try to keep your voice gentle. Your nonverbal cues, including the tone of your voice, can send a clearer message than what you actually say.
  11. Only ask one question at a time. Let them answer it before you ask another question. You can ask who, what, where and when, but NOT why. Why is too complicated. They will try to answer, fail and get frustrated. Break down requests into single steps.
  12. Don’t say “remember.” Many times they will not be able to do so, and they will feel you are pointing out their shortcomings. That is insulting, and can cause anger and/or embarrassment.
  13. Turn negatives into positives. For example, say “Let’s go here” instead of “Don’t go there.” Be inclusive and don’t talk down to them as if they were a child. Respect the fact that they are an adult, and treat them as such.
  14. Do not argue. It gets you nowhere. Instead, validate feelings, by saying, “I see that you are angry (sad, upset, etc…).” It lets them know that they are not alone and then redirects them into another thought. For example “It sounds like you miss your mother (husband, father, etc…). You love them very much, don’t you? Tell me about the time…” Then ask for one of their favorite stories about that person.
  15. Avoid distractions. Communication is more difficult — if not impossible — with a background of competing sights and sounds.

All behaviors, including negative reactions to daily care, are a form of communication. Most persons with Alzheimer’s will exhibit behaviors that show how they feel. This way of communicating is used because they cannot make their needs known in other ways. For example, a person may resist getting dressed because of joint pain due to arthritis, but he or she cannot express this discomfort in words. Early on, they might have a hard time concentrating and experience irritability, anxiety or depression. Later in the disease, other symptoms may occur, including: sleep disturbances, outbursts, emotional distress, paranoia, delusions or hallucinations.

Communicating with your loved one or client may be challenging, especially as the disease progresses. Remind yourself that the person isn’t acting this way on purpose. Don’t take it personally. Practice patience and understanding in order to help the person with Alzheimer’s disease feel safe and secure.

At Dakota Home Care, a top-rated provider of dementia care in Bismarck, ND and the surrounding areas, we will work with you and your loved one to develop a care plan that meets your needs and theirs, even when they have difficulty expressing what those needs may be. Contact us at (877) 691-0015 today for a free in-home assessment as a first step toward getting help with the challenging job of caring for a person with Alzheimer’s.




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