How to talk to people with dementia: 15 tips for communicating

The set of diseases and disorders known as dementia are one of the biggest challenges facing medicine today. With an increasingly aging population, the prevalence of this type of disorder is increasing over time and more and more cases are being consulted.

Psychologists and neuropsychologists, as well as any other type of professional in the health field or even at the social level, must therefore be properly prepared to deal with this type of patient, taking into account the possible difficulties they may encounter. present.

Among them we can find a basic aspect that can make the interaction very difficult, both to assess their abilities and to perform different therapies that help to maintain and improve their skills to the maximum: communication. That is why in this article we are going to mention a number of small things to consider when talking to patients with advanced dementia.

    Briefly recalling the concept of dementia

    Dementia is understood to mean in the face of a type of disorder characterized by the presence of the loss or deterioration of one or more mental faculties the deterioration generates difficulties in daily life or a reduction in the subject’s quality of life (causing a no – existing limitation). This is usually deterioration that progresses gradually and irreversiblyAlthough there are some that are treatable or in some cases even have a full recovery (like those caused by infections).

    This deterioration is usually due to organic causes, although in some cases the exact reason for its occurrence is unknown (although neurochemical and structural alterations are known that generate or participate in symptoms, not because they occur). The course can be very variable in each case, although the tendency is towards a gradual or phased deterioration in most cases.

      How to talk to someone with dementia

      There are many different dementias, which can affect different abilities. In many cases, it ends up showing a deterioration of the ability to attend to, remember, retain or even understand and processing what they are told can complicate their processing and even their assessment. That is why we offer below a series of indications which may be useful in the treatment of a patient exhibiting these characteristics.

      1. Speak clearly and vocally

      A major aspect when communicating with a patient with dementia is the fact be ready to adapt to the person’s needs. Our tone should be appropriate to what the person needs and should be able to understand what we are saying. The voice is the key.

      2. Short sentences, slow pace

      The use of structures that are too complex will make it difficult for the patient to understand. Use vocabulary appropriate to the patient’s abilities (and knowledge and level of education) and sentences as short and clear as possible. Ambiguities should be avoided and a slower pace should be used.

      3. Repeat things

      Whether there are problems encoding new information, keeping it, or just paying attention to it, it can be difficult for a person with more or less advanced dementia to grasp what is being asked of them straight away. Repeating instructions may be more than necessary depending on the case.

      4. Make sure you understand what you are saying

      Related to the above, it is essential to ensure that the patient understands what is being asked of him. It must be done in such a way that the patient does not feel ridiculed or hurt for asking for new explanations.

      And it should be borne in mind that many people, even if they retain sufficient abilities, claim to have understood what is said to them out of shame or out of social desire, and this is something that actually hinders effective communication.

      5. Tolerate frustration and don’t get angry

      It can be frustrating that a person does not understand what we want to say to them, does not achieve improvement, or that there is no effective means of communication between the patient and the therapist. Dealing with this type of patient may require a certain amount of patience, in addition to the fact that the patient is not.

      6. No complaints

      It may seem obvious, but often the environment or even some professionals (especially those who are not specialized in this sector) tend to blame in one way or another for forgetting or loss of faculties. The person does not forget things because yes or because they do not value what they are told: they are affected by a disorder he cannot control that makes him unable to store information.

      In addition, especially in the early stages of dementia, patients are generally aware of the presence of deficits. Blaming them will only increase their discomfort and anxiety about the deterioration they have already perceived.

      7. Avoid distractors

      It can be difficult for a person with dementia to stay focused. This is why it is advisable that attempts at communication take place in a context where there are as few distractions as possible. A crowded office or a turned on radio, for example they can easily lose track.

      8. Find ways to communicate

      It is not uncommon for serious problems to arise with oral communication. In addition, at an advanced stage, people with dementia may become mute, unable to follow a conversation to lose focus or even remain absent. It is important to try to find a way to communicate, as socialization is important and can be reassuring.

      If oral language doesn’t work, maybe they can use gestures and mimes, or pictures or drawings that represent various concepts. They can also serve songs that relate to them. If you are losing focus, a pat or a small slap in your hand can help them take the situation a step further.

      9. Start the interaction

      While it may be good to let the patient take the first step in communicating, the truth is, it can be difficult for them. Many dementias end up affecting the ability to motivate action and interaction, so this will usually be more effective. let the professional try to establish the interaction and direct it.

      10. Better indications or concrete elections than general propositions

      It is a small mistake that some people make that can affect the performance and the performance of the person in the task given to him or the question put to him. Making general propositions first means that you have to imagine and generate responses, as well as you have to deal with the idea of ​​whether or not to do it. It also involves a lot more effort greater risk of confusion.

      If we want him to act, it is important to indicate what he is supposed to do, in a concrete way. It is not the same as telling someone to raise their hand and ask if they can lift it. This is the first case where you can do it, while in the second it can be interpreted as a simple question to be answered. Also, maybe decision making is one of the damaged skills. It can be helpful to evaluate it, but you should keep in mind what you are seeing at any given time. A hand. Abilities tell you to do something.

      11. Try to use positive sentences

      is good use instructions and phrases that express what the patient is doing or should be doing on the positive side, avoiding the use of negations that are more complex to understand.

      12. Give it time

      Sometimes something that is interpreted as a lack of memory or reasoning skills may actually be a processing speed issue. By this we mean that we should not rush and jump from one thing to another, but we should give the patient a reasonable amount of time. so that it processes information and / or expresses itself.

      13. Position, an important element

      Another aspect to consider when talking to a patient with dementia is where or how much space we occupy. We have to stand in front of the person, face them and be relatively close, So that our person captures his attention and is easier to observe our sign language and listen to our voice.

      14. Don’t rush to identify everything as a symptom of dementia

      We must keep in mind that it is not uncommon for people with dementia or just elderly people to have hearing problems, which in turn need to be assessed when examining a patient. so as not to confuse a sensory problem with symptoms of dementia. It is also necessary to assess in advance whether or not you have been to school, which is also relevant in terms of adjusting tests and treatments to your needs.

      15. Always keep him in mind and treat him like a grown up and dignified person.

      A person with dementia is still an adult. The treatment towards her he must always respect his dignity and he must be treated with respect.

      Even if the person does not know where they are or with whom, they should be treated like adults and not infantilized. Likewise, they should not be spoken of as if they were not present, even if they did not show any reaction to the stimulation or to the language.

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