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Family Living Focus: Caring for loved ones with dementia: Communication is key

Each person living with dementia is unique; as their dementia symptoms progress, they journey down a path entirely their own. Their caregivers make this same journey, in a way. Over time, caregivers must adapt to meet their loved one’s evolving needs and abilities. This is especially true where effective communication is concerned.

The first signs of dementia include difficulty finding words, inability to follow conversations, scattered logic when writing, an apparent disinterest in what others are saying, frequently interrupting speakers and expressing “mismatched” emotions. Caregivers must expect that their loved ones will lose verbal faculties before the ability to interpret nonverbal signs and signals.

This progression reflects the division of communication into three elements: body language, tone and pitch, and the actual words we use. Body language and tone account for over 90 percent of the messages we send, yet these cues are often delivered subconsciously. Caregivers of people living with dementia must learn to become highly intentional about how they employ nonverbal communication strategies. They must also turn their attention to their loved one’s ways of using these cues, recognizing that this is likely the most accurate and efficient mode of communication at their disposal.

These strategies can support effective communication:

Nonverbal

• Exaggerate facial expressions to communicate emotions.

• Do not pace or move around when speaking.

• Use touch as a way to keep a loved one’s attention and demonstrate care.

• Point to objects when mentioning them.

Verbal

• Remain calm and use a gentle tone of voice.

• Use short sentences that focus on a single idea.

• Give extra time for response.

• Use orienting labels that help define where, when, and who; for example, “Next Tuesday, your daughter, Melanie, is visiting you.”

Other

• Develop and maintain routines.

• Limit background noise, like the television, which may be distracting.

• Know baseline behaviors and demeanors to better recognize and understand changes.

• Coach others to utilize the same communication styles to minimize confusion.

These same principles apply in emergency situations. Although caregivers are likely to experience a lot of stress, it is important to control the signals they send through verbal and nonverbal messages. Tone, stance, and facial expressions are the cues dementia patients rely on most when trying to understand what is going on around them. A caregiver that reveals too much of their own distress risks adding unnecessarily to the distress of their loved one. The resulting confusion can negatively impact a loved one’s capacity to communicate. This subsequently limits a caregiver’s ability to accurately interpret what they are trying to express.

In these dire moments, it is critical to employ the right strategies to understand a loved one’s verbal and nonverbal cues. When a caregiver can do so effectively, they are able to provide this information to first responders. This, in turn, allows medical professionals to make timelier, more accurate diagnoses. And when time is of the essence, proper communication can make a significant impact on a loved one’s prognosis.

During an emergency, caregivers should maintain eye contact and, if possible, comforting touch such as holding a loved one’s hand or stroking their hair. These small actions can help orient and soothe a dementia patient who is overwhelmed by the sudden rush of bodies and equipment. Set a confident example for first responders, most of whom do not receive any sort of specialized, targeted training for serving dementia patients. Demonstrate the best way to communicate with your loved one.

It is also important for caregivers to equip themselves with knowledge of the medical complications to which their loved ones are most prone. For a majority of patients, these include stroke and heart attack as they are associated with increased age. Knowing how to identify common cardiovascular events and the first steps to take when they occur will facilitate better overall outcomes and more productive conversations with dispatchers and responders in the event of an emergency.

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Information adapted from article by Shannon Raynard in Today’s Caregiver Newsletter, January 30, 2014 – Issue #684.

If you would like more information on “Caring for Loved Ones with Dementia – Communication is Key” contact Gail Gilman, Family Life Consultant, M.Ed., C.F.C.S. and Professor Emeritus University of Minnesota at waldn001@umn.edu. Be sure to watch for more Family Living Focus™ information in next week’s paper.

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