Communicating with a loved one who has dementia
With increasing numbers of cases in Atlantic Canada, experts offer tips
Twenty-nine-year-old Cody Dickeson from Amherst, N.S. liked telling his grandfather stories.
He also enjoyed showing him images, patterns and shapes.
“Gramp would seem to remember lots (of things) just (from) a basic image of a truck and tell stories of what he remembered,” Dickeson said about his late granddad, who had Alzheimer’s.
Alzheimer’s is one kind of dementia, an umbrella term that refers to a range of symptoms that include memory loss and difficulties with thinking, problemsolving or language, says Beth House, Dementia Friendly Communities lead at Alzheimer Society of Nova Scotia.
In addition to Alzheimer’s, dementia also includes vascular dementia, Lewy Body dementia, and frontotemporal dementia. An estimated 16,300 people were living with dementia in Nova Scotia as of 2022.
CHANGING BRAIN
It isn’t uncommon for people with the condition to have less control over their emotions and how to express them.
“As the brain is changing, people living with dementia may have challenges with expressing themselves, finding the right words, understanding what is being said to them, reading or writing. As the dementia progresses, these symptoms can get worse,” explained House.
“People may speak less, withdraw from conversation, say something out of context or have trouble following directions with multiple steps.”
Set the stage
If you or someone you know has any form of dementia, you might be wondering about communication with them.
“If they wear glasses, they should have their glasses on; if they wear hearing aids or dentures, they should have those on as well,” said Laura Macwilliam, manager of programs and services at Alzheimer’s Society, P.E.I.
Noise levels in the surrounding environment can become distractions, so you can turn off TVS or music.
“Never communicate with a person affected by dementia from another room, between barriers, or in a loud, angry, or strict voice as this may trigger ‘reactive behaviours,’” added Christine Waddell, director of clinical care at Right at Home Canada.
HOW TO APPROACH
It’s always best that you approach your loved one from the front so you don’t startle them.
She says not everyone’s dementia journey is the same. It will help if you can focus on their abilities, rather than what they can’t do.
“Contradicting them or convincing them that what they believe is untrue or inaccurate can cause frustration,” said House.
Be mindful of language
Director of operations and field development at Right at Home Canada, Karen Platt adds,
“Your loved one will hear your tone and respond to it, so ensure you are calm, patient and positive.”
Your posture and facial expressions matter, too.
“If you can have an open posture and be relaxed, it will be received more effectively,” shared Macwilliam.
Non-verbal cues from your loved one with dementia are also important.
Simple, short and familiar words and phrases are helpful, offered Macwilliam. Pronounce your words clearly and use gestures to provide visual cues. Making eye contact when possible or culturally acceptable is also effective.
“Touch the person’s arm or hand to support connection,” offered Dani Depetrillo, chief operating officer of Right at Home Canada.
THE IMPORTANCE OF VALIDATION
Validation while communicating with your loved one is paramount.
“It is important to let them know you care about what they are expressing,” shared Lyn Stuart, Cape Breton Region’s caregiver support co-ordinator for the Caregivers Nova Scotia Association.
PATIENCE GOES A LONG WAY
Rapid-fire questions that require an immediate response are a big no, according to Right at Home Canada’s director of community engagement, Rica Esguerra.
“They often need time to think, as the brain processing is slower. Never ask, ‘Do you remember?’ or say ‘I already told you this,’ as these will cause increased anger and frustration,” Esguerra said.
“Be mindful of questions that will require short-term memory. Something as simple as ‘What did you have for lunch?’ might be a point of stress for them.”
TRY AGAIN LATER
Avoid shouting, getting angry or reacting negatively when you do feel frustrated. Instead, take a break. You may also want to try a different approach. For Dickeson, playing UNO with his grandfather seemed to help, and so did music and playing certain songs that seemed to trigger memories.
CARE FOR YOURSELF
As a caregiver, a person can go from feeling contented to feeling sad, afraid, guilty and helpless within a single day.
“It’s important to remember that these emotions are to be expected given the situation,” said Macwilliam.
Burnout is a real concern for a caregiver, according to Stuart. Make sure you have self-compassion, boundarysetting and mindfulness.
“Ask for help, practice saying no … and know when you have too much on your plate,” added Stuart.
Figure out the kind of help you need most.
“Hire help and support as needed to share the responsibility of caregiving,” said Platt.
Making sure you eat, exercising regularly and share your feelings with friends and loved ones, said Macwilliam.